William B. was going about his typical Saturday as a mailman when he came home and noticed some alarming symptoms. He had been experiencing a slight pain in his side that he attributed to a pulled muscle or something minor. But during a trip to the bathroom, he saw what appeared to be “straight blood” while urinating. He went to the emergency room the following day.
He was told he needed to see a urologist as soon as possible and was even flagged down on his way out by the doctor who treated him, who emphasized how important making the appointment was. He called, made an appointment for the next day, and underwent a CAT scan.
An Alarming Revelation
The morning after his appointment, William received a call from his urologist with his results: He had aggressive stage 3 bladder cancer.
“At that point, the life drained out of me,” he said.
William underwent a cystoscopy in which a thin camera is used to observe the inside of the bladder. The following day, he received more unwelcome news—he would have to have his bladder removed.
William asked about the possibility of a neobladder operation, a surgical procedure in which a new bladder is constructed from part of the intestine to allow a patient to control urination. He was told that the hospital knew of a doctor who could do it, but William wasn’t comfortable unless the surgeon routinely performed this procedure.
“I was understandably upset because I didn’t want to lose my bladder, so I decided it was time for a second opinion,” he said.
William then made an appointment at Fox Chase Cancer Center, where he met with Marc Smaldone, MD, MSHP, FACS, a urologic oncologist with experience performing neobladder operations.
Options Suited to the Patient
After he met with Dr. Smaldone, William was told that his cancer appeared to have spread from his bladder and that he would have to undergo a procedure known as TURBT within the week. TURBT, transurethral resection of bladder tumors, is used to biopsy and remove bladder tumors. The procedure is conducted through the urethra, so no incisions are needed. In William’s case, TURBT was used to biopsy and determine the tumor stage.
Dr. Smaldone explained that once the bladder and the other tumor came out, William would have to start chemotherapy for six weeks, followed by a short break before his neobladder surgery.
Before removing William’s bladder, Dr. Smaldone told him that scar tissue could develop and cause a urinary blockage requiring smaller surgeries. William eventually developed a blockage and underwent more minor surgeries to remove scar tissue.
For a more practical approach to these recurrences, Dr. Smaldone referred him to Jay Simhan, MD, FACS, a Fox Chase-Temple Urologic Institute surgeon specializing in reconstructive urology and urologic prosthetics.