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Back in the Soup: Cancer Again
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.
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Praying for your full and speedy return to health.
Paul, Thank you for sharing this with us. I’m sure I can presume to speak for the entire Ricochet community in wishing you a rapid recovery and a return to cancer-free good health.
Prayers, professor, from my family to yours.
Damn it. Cancer is such a jerk. Best wishes for good news and a return to good health.
Dr. Rahe, The procedure is just as painful for a female without anesthesia as for a male. In my case it turned out to be an infection, and not cancer. This was about 45 years ago, so please go see a doc if there is blood in your urine.
Will keep you in my prayers Dr. Rahe.
All the best. You’re newest book on Sparta’s Grand Strategy on Persia is the first I’ve been able to find on audiobook. I expect many, many more, Professor.
So sorry to hear about this. Get well soon. You are needed.
Dear Paul:
With concern and affection I offer my best wishes and, inevitably for a correspondent who has just entered his ninth decade, some empathic resonance.
Truly, with all best hopes and admiration,
Milt
“There is another moral. Listen to your wife (or your husband). Your spouse cares more about your welfare than you do.”
Thank you for this. I can’t wait to show it to Ray (Mr. TerMend) as soon as he wakes up from his nap.
Best wishes from both of us to you.
Mr. Rahe – My gosh!! You have been through it! Thank you for being brave enough to share your experience – you may save a life – men are terrible about admitting discomfort, seeing symptoms or getting regular checkups – a pain, but small potatoes in comparison to say the least. God bless and I wish you good news and wellness soon. PS My aunt (through marriage) was diagnosed with bladder cancer – she was cured and lived to a very old age. Treatments have come a long way.
Dr Rahe – I’ll echo TCG and add – You are a blessing to those of us you touch. I’ll include you in my prayers.
My prayers for a swift and complete recovery, professor.
Paul…our very best wishes to stay resolute through this. My wife had ovarian cancer. Her surgeon took out a tumor the size of a football…no exaggeration. It was fairly early stage and while chemo was a trial, she stayed strong through out and is now living her life, with her doctors confident it won’t return. Cancer treatments have progressed to an amazing degree, to the point where many women with stage four are walking around in remission. Making up your mind to just go through what needs to be done is key. Tim
What the hell?! Some days, it seems half the people I know have cancer, and all of them the ones with exactly the gifts the world can’t do without.
And then I look at all the stunning good unleashed time and again through those who live their crosses with grace, and I have to bow my head and stop my lips, and offer another fiat with my tears and objections.
At those moments, Julian of Norwich comes to mind: “All shall be well and all shall be well and all manner of things shall be well.”
I don’t understand it, but I believe it. We are made for eternity, and we have no idea, until the very end, what God wants of us on earth.
Here’s hoping that what He wants of you is to manifest His power over sickness. And here’s hoping, too, that whatever He wants of you, you and your family have all the grace you need and more to accomplish it in abundance.
I was sad to hear this. You’re in my thoughts.
Prayers for the best news possible under the circumstances.
I’m still learning about immunotherapies (psychologists are not the first-line professionals to get all the details on treatment ; ) but the stories I’m hearing illustrate their potential to change cancer treatments in a really significant way.
Our prayers are with you big guy . . .
This stinks. Saying prayers for you today.
Blessings to you for peace and healing.
Hang in there. Praying for better days ahead.
We expect nothing less than good news in seven to ten days, Prof. Rahe.
Dammit, Doc. I’m so sorry for your news. You and your family are in our prayers.
I like what Katie said about the mystery of it all. The only thing I’ve been able to make of my own family’s recent struggles with cancer and tumor treatment is God’s call to go out into the deep. Bishop Barron has a wonderful homily on today’s Gospel reading here. I hope and pray you find comfort in his message and in the days and weeks to come.
Peace be with you.
My prayers. That’s what doubling up on books will do to you!
Though I have yet to read it, your thesis on Sparta sounded like the most interesting book of this last year. It’s on my to-do list.
As someone who has been tested more than once for bladder cancer, I send you my prayers, and mostly my prayers that you are free of any cancer.
“. . . a wonderful instance of advice being given on such a point, without being resented.” (P&P XXVI)
Bravo, Professor. Best wishes.
Praying for you Paul. My kids and I will say a prayer for for you at Our Lady of Pompeii tomorrow with the rest of their school.
Praying for you and your family Paul.
Praying for you. And amen to listening to your spouse about cancer checks!
May you have a blessed Lent and be healed.
Prepare for battle: As Fr. Z reminds us – go to confession.
My prayers are with you.
I can only echo what others have said. Prayers in our house, Professor.