“Fiſty prcent Not only can diagnosis take longer in women, but
like Greene, they may delay going to the doctor in the first place because they don’t consider their symptoms alarming. Any bleeding after menopause is abnormal and warrants seeing your ob-gyn right away, cautions Fenner. “To help your doctor find out where the blood is originating, insert a tampon and remove it a few hours later. If there’s blood on the tip of the tampon, it’s probably coming from the uterus through the cervix. If the blood is on the string, it’s more likely that the blood has dripped down from the urine.” While it’s unusual for premenopausal women to get bladder cancer, which is more likely to occur after age 55, they should get prompt medical care if they see blood in the toilet between periods. Other warning signs include painful or frequent urination, abdominal or back pain, and changes in urine color.
Getting a Diagnosis To find out what’s sparking these symptoms—which can also stem from less serious disorders—ob-gyns typically start with urinalysis to check for blood and signs of urinary tract infections. Other common tests include urine cytology and an ultrasound or CT scan of the bladder to look for tumors or other causes of bleeding, such as kidney stones, says Fenner. “These tests are not always definitive, so we may need to look inside the bladder with cystoscopy,” in which a thin, camera-tipped tube is snaked into the bladder to examine it for cancer that may not be visible with other tests. Cystoscopy can also be used for bladder biopsies.
Promising Prognosis If cancer is found, adds Fenner, “the good news is that 75 percent of the time it’s early stage and non-invasive,
of bladder cancer
cases are linked to smoking, which is the No. 1 risk factor.”
which is the easiest to cure.” Along with surgical removal of the tumor, treatment may involve medications that are squirted into the bladder, such as Bacille Calmette Guerin (BCG), a modified form of the bacteria that causes tuberculosis in cattle. It works by revving up the immune system to block the growth and development of new cancer cells and has been shown to reduce recurrence. For more aggressive cancers, doctors typically prescribe chemotherapy. In some cases, such as Greene’s, it’s also necessary to
remove the bladder. Surgical advances mean that patients often don’t need an external bag to collect urine, says Fenner. “Most of these operations involve taking a piece of the bowel and creating an internal pouch that acts like a bladder, which works quite nicely.” After undergoing surgery of this type in January 2000, Greene had to learn how to insert a lubricated 16-inch tube into her stoma (a rosebud-shaped surgical opening in the right side of her belly) to drain urine from the internal pouch into the toilet. “A nurse showed me how to wiggle the tube around like a TV antenna to get the best ‘reception,’” says Greene, who carries a wallet-sized catheterization kit in her purse when she goes out. Three months after surgery, she was well enough to return to work.
Good News Today, more than a decade after her diagnosis, Greene, now 63, remains in remission and is writing a book about her cancer journey. “Although I had to lose my bladder to save my life, I continue to see patients in my psychology practice, work out at the gym, wear stylish clothing, and travel all over the world with my husband, Jack. At one point, I was told my chances of surviving another five years were only 20 percent, but I decided that I was going to beat the odds.”
FALL / WINTER 2011 pause 29
smilingworld/
Bigstock.com, Trinette Reed/Blend Images/Getty Images
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44