Almost exactly one month ago, I noticed thrice in one day that there was bright red blood in my urine. At my wife’s suggestion, I mentioned it to my physician the following Wednesday, and one week to the day after the appearance of the blood (which did not recur), I had a CT-Scan, and the radiologist at the Hillsdale Hospital noticed a nodule on the wall in my bladder.

Having been down a similar road back in 2012, I got on the phone, and the wheels began to turn. This past Friday, at the National Institutes of Health, Dr. Piyush K. Agarwal conducted a transureth resesection, removed the tumor, which was located on the right lateral wall of my bladder whence it extended onto my right ureteral orifice, and resected down to the muscle and fat of the bladder. Here is what the tumor looked like before it was removed:

Dr. Piyush and his team found other similar material elsewhere on the bladder wall and scraped it off. The pathologists will be looking at it all in the next seven to ten days. It is in all likelihood cancerous. Whether it is slow-growing or aggressive I will learn in due course.

I cannot say that I enjoyed the operation. But it was less invasive than the prostatectomy I had in 2012 and the removal of my gall bladder in 2010. You can read about what was done here, where they report,

This procedure, also called “transurethral resection of the bladder tumor,” is common for early-stage bladder cancers, or those confined to the superficial layer of the bladder wall. This bladder cancer surgery is performed by passing an instrument through the urethra, which avoids cutting through the abdomen. The surgical instrument used for this operation is called a resectoscope. A wire loop at one end of the resectoscope is used to remove abnormal tissues or tumors.

What they do not tell you — lest you be too horrified — is the path they take to get to the urethra in the first place. All that I will say is that, in the aftermath, my male member was rather tender.

The good news is that I did not have to watch the procedure — anesthesia helps — and that I bounced back rather quickly and was on a plane home the next day. The bad news is that, if they find cancer, I will have to undergo the same procedure in three months and then repeatedly for a while after that because there is no other way to examine what is going on inside my bladder.

It will be worse if the cancer is aggressive — for then I will be slated for six treatments at weekly intervals via a catheter (and there will be numbing of the male member but no anesthesia). The standard treatment is called intravesical immunotherapy, and here you can find it described as follows:

Bacillus Calmette-Guerin therapy: Bacillus Calmette-Guerin (BCG) is the most effective intravesical immunotherapy for treating early-stage bladder cancer. BCG is a bacterium that is related to the germ that causes tuberculosis (TB), but it does not usually cause serious disease. BCG is put directly into the bladder through a catheter. The body’s immune system cells are attracted to the bladder and activated by BCG, which in turn affects the bladder cancer cells. Treatment is usually started a few weeks after a transurethral resection of the tumor and is given once a week for 6 weeks. Sometimes long-term maintenance BCG therapy is given.

Treatment with BCG can cause symptoms that feel like having the flu, such as fever, chills, and fatigue. It can also cause a burning feeling in the bladder. Rarely, BCG can spread through the body, leading to a serious infection. One sign of this can be a high fever that does not get better when you take a pain reliever (such as aspirin, ibuprofen, or acetaminophen). In such cases, you should see a doctor right away. These infections can be treated with the antibiotics used to treat TB.

I am told that BCG was discovered more or less by accident when bladder cancer patients who contracted tuberculosis magically recovered from the former condition.

There are other possibilities — none of them pleasant to contemplate. If the tumor dug into the muscle, the cancer may have spread beyond the bladder. About that, I will learn also in seven to ten days.

I apologize for subjecting you all to this. But there is a moral, and you ought to give it thought. Most cancer can be treated … if it is caught early on. The problem is that one rarely gets any kind of warning that one has bladder cancer. I had bright red blood in my urine. Many women and men with this condition do not ever have this symptom. So the thing tends to sneak up on you, and when you learn it is already too late. I was lucky (at least, I think that I was lucky. We shall see). If you see blood in your urine, seek medical help. It does not generally happen unless something significant is wrong.

There is another moral. Listen to your wife (or your husband). Your spouse cares more about your welfare than you do.