CLEVELAND — According to the American Cancer Society, more than 82,000 people will be diagnosed with bladder cancer this year. Less than twenty thousand will be women.
Bladder cancer is typically a disease that affects older people over age 55, with the average age of diagnosis being 73. However it does happen to younger patients. If those younger patients are female, the treatment options often impact quality of life.
Edith Washington was 44 when she was diagnosed in October of 2022. She suffered frequent urinary tract infections, but when she noticed blood in her urine, she went to the doctor immediately.
"I had no pain, just blood in my urine," Edith said.
The mother and grandmother knew she would require surgery and she was concerned about how her life would be impacted. She went to urologic oncologist Adam Calaway, MD. at University Hospitals Seidman Cancer Center.
"He gave me three options and one was having the bag and all of that, another was a permanent catheter and I didn't want to deal with none of that," Edith said.
She chose the third option, while more invasive, she believed it would maintain her quality of life.
Dr. Calaway would create a new bladder using around a foot and a half of her small intestine. The intestine would be cut and then folded.
"It's a little bit like origami to some degree, you're taking something and folding it into something beautiful," Dr. Calaway said.
But this protocol may not always be the right option, especially in otherwise young and healthy patients such as Edith. Traditional surgery can impact the patient physiologically – with the loss of the ovaries and hormone function – and can lead to sexual dysfunction through the loss of vaginal length and lubrication.
"It's been reserved for men and and some of the reason is, because historically for bladder cancer surgeries in females, we would remove the bladder, the female organs and the anterior vagina, which then requires us to repair the vagina and then put the new bladder on top," Dr. Calaway said.
It often put the patient at risk for serious complications and impacted their quality of life.
But Dr. Calaway was going to give Edith an organ-sparing neobladder. It was the first time this was done at University Hospitals Seidman Cancer Center.
"We were able to spare the vagina and the nerves to help with sexual stimulation and potentially new bladder continence, and we were able to spare some of the support structures to hopefully avoid hypercontinence and the leakage aspects," Dr. Calaway said.
It's been nearly a year since Edith's surgery. She's now cancer-free and says everything works as it should, including no impact to her sex life.
"They pretty much guaranteed me freedom as close as I can get to normalcy, I have it," Edith said.
She will continue to have follow-up scans every six months for the next few years in order to make sure the cancer doesn't return.
Since the surgery, Edith has returned to work as an independently contracted medical courier and enjoys spending time with her four adult children and seven grandchildren.