After seeing our family doctor, who then sent me to a urologist, Dr. J. Paul Whelan -- the first step was an Ultrasound to see “what could be seen”. But the ultrasound couldn’t reveal enough information.
So Dr. Whelan scheduled me for a Cystoscopy, which he performed at the Royal Jubilee Hospital -- a thin tube with a camera and light at the end is inserted into the urethra, enabling him to see inside the bladder. The Cystoscopy does not take long and requires no anaesthetic. Laying there, I could also see the images on a large computer screen.
Although earlier on, I'd been told by my family doctor that for someone of my age (87 years young), blood in the urine usually means only one thing: cancer of the bladder.
However, that day during the Cystoscopy -- to my disbelief -- several tumours appeared. I immediately thought of them as “alien stowaways”.
[We don’t hear much about bladder cancer, yet it’s the fourth most common cancer in men. Unfortunately, research into this disease lags far behind most other cancers, due to lack of funding.]
The tumours were at such a stage, Dr. Whelan said he needed to get them out quickly, and told me surgery will be necessary.
There is usually a long wait time, and on top of that it was August -- traditionally a “down-time” -- but luckily for me, he was able to book the operation later that same month.
So I went back to the Royal Jubilee Hospital for the surgery, called a “transurethral resection for bladder tumour” or TURBT. [This procedure is only effective for early-stage cancer.]
In my case I had a choice between general anaesthetic, or a spinal anaesthetic, and I opted for the latter.
I stayed overnight in hospital. Very early next morning, Dr. Whelan came by and said the surgery went well, and he had the necessary material to have the analysis done. So I was sent home. (continues below . . )
The week after the operation was an awkward and messy one, having to use a catheter -- but necessary. Slowly but surely. the liquid changed from pale red, to deep orange, then to a normal colour.
Two weeks later we returned to the urologist's office to hear the results of the analysis. It was a positive report.
That was not the end, however. Next step: preventative therapy -- Immunotherapy, involving a series of treatments using the “BCG” vaccine. Amazingly, this is actually a form of the tuberculosis vaccine.
BCG stands for “Bacillus Calmette-Guerin”, named after two French scientists who developed the vaccine between 1908 - 1921.
Doctors aren’t 100% sure why it works, but believe it makes the bladder react in a way that triggers the immune system to get rid of cancer cells.
So it’s not the vaccine itself that gets rid of the cancer cells, but the BCG somehow kick-starts your immune system, and it’s your immune system that fights the cancer cells.
In my case, it was a poignant situation: after WWII in the Netherlands, I had tuberculosis and spent a few years in a sanatorium. [See my blog post of August 4, 2008 about the Zonnestraal Sanatorium]. So the thing that nearly killed me, now helped to save my life.
The BCG is administered by the urologist's very capable LPN. Since having that first round of BCG, over 6 weeks once a week, I’ve had two other rounds but these were three treatments, also once a week.
Recently the latest Cystoscopy procedure gave the “all clear”. Dr. Whelan pronounced my bladder a “work of art”, knowing that I’m an artist, but also meaning he thought his surgery was a work of art too.
Throughout all of this, with support and care from Natasha, my wife, plus many good wishes from friends far and wide, I maintained a positive outlook. I worked hard on keeping my spirits high and did a lot of meditation and contemplation.
In many ways, I have been very lucky: being able to see an excellent specialist - urologist Dr. Whelan - relatively quickly (normally long wait times). Then the urologist getting surgery booking quickly, before the “alien stowaways” as I called them, broke through the protection wall of the bladder. If that had happened, the whole bladder would have had to be removed – major surgery.
Thankfully, thanks to destiny and my ‘guardian angels’, this was not necessary.
Because bladder cancer has a high recurrence rate, the highest amongst the cancers, it requires “life-long surveillance”. So the doctors keep you on this regimen of having BCG treatments twice a year, plus further Cystoscopies, to monitor things. [This makes it “the most expensive cancer to treat, on a per-patient basis.” ]
I thought to share this personal experience on my blog, at age 87, since to me it is worthwhile communicating to others the importance of taking very seriously any warning signs like I had at the beginning.
Henri van Bentum
