Lifetime Relationship, or: Lucky for me, I’ve contracted a cancer I can afford. For now.
What if I offered you a cancer that could be surgically removed, but which also was likely to recur? You could be cancer-free after surgery, technically, but hanging over your head, for the rest of your days, would be another tumor, ever possible. A cancer without remission. No escape. You may live out your days without another tumor. Or you may keep requiring surgery to remove tumors. Someday one of them could be quite dangerous. Most tumors fall into one of two categories: Some which are inconvenient, low-grade mutations growing like evil broccoli into the bladder center, which cannot be left but which don’t necessarily threaten your life. And others which lie flat on the bladder wall, growing instead into the bladder itself. Left alone, these high-grade, flat tumors compromise the bladder quickly, seeking to escape and wreak havoc elsewhere. I have the former type — so far. 30% of people in my situation “graduate” and become a factory for high-grade tumors.
A low-grade, non-muscle invasive urethelial carcinoma used to be called “superficial” because it rests on the bladder lining and is usually a localized threat. The grades of this cancer refer to how distorted the cells appear to the pathologist’s eye. Here, low-grade tumors are less likely to return or threaten anything other than the bladder lining. High-grade tumors are more chaotic in structure, and feature a high recurrence rate and threat to the underlying tissue, the muscle, the fat surrounding the bladder, and distant organs.
I am the current owner of low-grade, non-muscle invasive bladder cancer. As fightbladdercancer.co.uk puts it: “Bladder cancer is … the cancer that has the highest recurrence rate. This will mean that you are likely to have a lifetime relationship with investigations and treatments as your medical team works to remove the tumours and then works hard again to help prevent them coming back.”
A lifetime relationship. You will always be just months away from your next cystoscopy. You will study often your urine stream, looking for blood. If you’re in public and there isn’t time to study, you glance, at least. Every time. If you have nocturia, an exotic term for waking up to pee overnight, you may not study or glance. You may continue back to your…