2. Doom

After I found out that I had bladder cancer, Dr. Gaynor sent me through more tests. Immediately after leaving her office, I headed to Quest for blood tests and the radiologist for x-rays. Then home. I turned on the computer and looked up bladder cancer. And not all the news was bad. It turns out that bladder cancer is fairly common, especially in men. Many cancers are not life-threatening, I learned. And some are addressed with little more than minor surgery. My mind gravitated to the most favorable outcome. Okay, something is definitely going on, I thought, but let's not carried away.

So when I told my wife, Kate, of my condition, it was not an easy conversation, to be sure. Emotions started rushing. But I was in a reassuring mode. When I later told some members of my broader family, I simply described the problem as a mass in my bladder. After all, I had yet to receive an official diagnosis. Still, that did not prevent Kurtzke Nation from going into full panic mode. Phone calls and e-mails began to fly.

Me? I went about being normal, going to a Baltimore Orioles baseball game on the weekend, work on Monday, a graduate-school class on Tuesday, and an academic symposium on Wednesday. Of course, not everything was normal. Interrupting my normal life was a CT-scan in the middle of the week and a meeting with Dr. Greg Schenk that Friday, April 15.

Dr. Schenk is a surgeon who specializes in urgological cases, including those that are cancer-related. He's a strong, trim, healthy-looking guy whose black-rimmed eyeglasses surround his bald head. His conversation style is direct and his voice commanding. Because of his directness, whatever optimism I had going into the meeting quickly went away.

I started the conversion by saying that I understood how bladder cancer was fairly common and some can be easily solveable. That's true, he said, "but now let's talk about you." Boom. He continued to talk, but I didn't hear him. The words, "let's talk about you," rang in my head. I gripped Kate's hand. Then my mind began to refocus, and I heard him say that my tumor was "ugly." Boom boom. More words went by, and I missed them all. "Ugly"? Oh my.

Dr. Schenk went on. He pulled out a brochure that showed pictures of different kinds of bladder tumors. Surface-level ones, known as Stage I cancer, are what I had been hoping for because they're the easiest to treat. Stage II tumors go a bit deeper into the bladder wall but is still localized. Stage III tumors penetrate the bladder muscle and enter the bloodstream, which is how cancer spreads. Stage IV tumors break through the bladder muscle and wall, infect lymph nodes, and indicate cancer on the march to other vital organs. Metastatic Stage IV confirms that tumors are aldready present elsewhere in the body. The odds of surving cancer decline as stages increase.  

So ugly means what? I asked. He then turned to pictures of my CT-scan. His response: Stage III, and maybe worse. Boom again. I gripped Kate's hand tighter at this point. Holy God! How can this be? After all, I felt fine. How could a tumor so big grow inside and me not feel it? And, not to overlook this point, did I really have cancer? I then saw the diagnosis with a check mark next to the word, "malignant." "Darlene told you as well," he added. Yes, she did. But as a non-smoker -- smoking is the leading cause of bladder cancer -- I had been clinging to the possibility that this was all one big mistake. Now, the randomness of the cause made it even worse.

Survival rates? For Stage III cancers, the odds of living are 50-50. What made my odds worse: likely spread to a lymph node adjacent to my bladder. That technically pushed me into Stage IV, although there was no evidence of cancer in other organs, commonly known as metastatic cancer, which is usually what Stage IV refers to. Still, now my odds of dying in the near term were much higher than living. 

Okay, what's the plan for treatment? "I'm going to beat up your body," he said. Several rounds of chemotherapy followed by major surgery to remove the bladder itself. Remove the bladder? Why? Because bladder cancer has a high rate of recurrence. He then began drawing the surgical procedure on a piece of paper. He would remove my bladder, prostate (due to its close proximity to the bladder) and the lymph nodes that he believed were infected. Then he would go into my small intestine, which is part of the colon, remove a section, formulate it as a new bladder, and then hook it up. It's called a neo bladder. How in God's name is that even possible?

Under the best case scenario, all this would take at least six months, with several additional months needed for recovery. In my favor were my relative youth, lack of other illnesses or complicating conditions, and physical strength. Doing chemo before surgery, which is a relatively new approach, would improve my odds, he said.

But one thing was clear: my life up to that point was over. Done. Going forward, I had to focus solely on survival. No work, no school, no entertainment, nothing else. Instead, a battle to hold on to life itself.

As Kate and I left Dr. Schenk's office, we collapsed into each other's arms. Tears flowed. I did not want to die. Not now. Not like this. The other thought that came into my head: I had to survive this to be with Kate. There is no one more important to me, and no one I love more, than my wife. And I couldn't have her be a widow in her 40s. When her dad, Mike, was on his death-bed, the last words I said to him were, "I will take care of her." Now those words were about to be put to the test.

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Reader Comments (2)

Look at how far you've come.......I would now call Dr. Doom Mr. Magic!

February 6, 2012 | Unregistered CommenterBetty Siebert

Jim: Thank you for sharing the details of your difficult journey with honesty and even humor. You have faced a dire circumstance and successfully fought through it with the strength of will and the blessings of faith and family. Your inner strength is inspiring. Please keep writing, and I’ll keep reading.

February 6, 2012 | Unregistered CommenterJeff Noe

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