“Patti Hansen: Rock Steady” despite bladder cancer

In this month’s Vogue Magazine, former ’70’s model Patti Hansen opens up about her recent struggles with bladder cancer. The 54 yr. old has been Rolling Stones Keith Richards wife for that past 27 years. In August 2007, after finishing the Rolling Stones A Bigger Bang tour, Hansen who had been spotting for months, urinated blood. Shortly thereafter, she was diagnosed with Stage II bladder cancer. This was actually Hanson’s second brush with cancer, having been diagnosed with breast cancer in 2005, after a routine mammogram found a small tumor. She was treated with a lumpectomy. This time, Patti had to undergo 3 months of chemotherapy, followed by surgery to remove the cancer. During this procedure, her bladder was removed, along with her appendix and a full hysterectomy (removal of the uterus and cervix). A new bladder, called a “neobladder” was created from a piece of small intestine. Two years later, Hansen is cancer-free and has become a handbag designer for Hung On U.

The main reason Hanson says she gave the Vogue interview was to help remove the stigma of bladder cancer in women:  “It’s not something people talk about,” she says. “When I found out that I had it, I thought, Oh, my God, this is an old man’s disease. You go to Sloan-Kettering and you’re sitting there with all these men with prostate problems. And all the information I was getting out of Sloan was for men. They have really got to move this forward for women, because now they are seeing more and more women with bladder cancer. I’ve already met two other women in this area with it.”

For the basics about bladder cancer, see our story about “Stand and Deliver” teacher, Jaime Escalante.

According to the National Cancer Institute: It is estimated that 70,530 men and women (52,760 men and 17,770 women) will be diagnosed with and 14,680 men and women will die of cancer of the urinary bladder in 2010. The majority of those diagnosed are over 55 years old, with a median age of 73 years. Men are four times more likely to bladder cancer than women.

Although bladder cancer is more common in men, studies have shown that women are more likely to have more advanced tumors and have a worse prognosis than men at almost every stage of the disease. According to a report published by the National Cancer Institute, the survival rate for women with bladder cancer lags behind that of men at all stages of the disease. African-American women, particularly have poor outcomes when diagnosed with bladder cancer. They present with the highest proportion of advanced and aggressive tumors when compared to African-American men and Caucasian men and women. In addition, the number of women diagnosed with bladder cancer has been increasing.

A January 2009 article posted on Medscape.com reviewed an editorial published in the January 1, 2009  issue of the journal Cancer. It reported that the difference in outcomes may be due to a delay in diagnosis  in women. In the editorial, Mark H. Katz, MD, and Gary D. Steinberg, MD, both from the University of Chicago Medical Center, in Illinois, write “It is our impression that, all too often, bladder cancer is not even in the differential diagnosis when women present to primary-care physicians complaining of hematuria or a change in voiding symptoms.” Initial symptoms are more likely to be interpreted in women as due to bladder infections or gynecologic issues, and women may be treated for bladder infections, or seen by a gynecologist before the proper testing to done to rule out bladder cancer. In addition, many women themselves ignore or misinterpret the most basic symptom of blood in the urine,  associating it with menstruation or menopause,  and delay reporting this symptom to their doctors.

Bladder cancer may cause these common symptoms:

* Finding blood in your urine (which may make the urine look rusty or darker red)
* Feeling an urgent need to empty your bladder
* Having to empty your bladder more often than you used to
* Feeling the need to empty your bladder without results
* Needing to strain (bear down) when you empty your bladder
* Feeling pain when you empty your bladder

Bladder cancer symptoms may be identical to those of a bladder infection and the two problems may occur together. If symptoms do not disappear after treatment with antibiotics, insist upon further evaluation to determine whether bladder cancer is present.

What is a “Neobladder”? (Source: United Ostomy Association)

A neobladder is made from loops of the intestine. First, the surgeon removes a section of intestine. He then reconnects the bowel so there are no changes in bowel function. The piece of intestine that was removed is cut open to create a “flat piece” instead of a hollow tube. The flat piece of intestine is sewn together to form a pouch. The ureters (tubes that carry urine from the kidneys to the bladder) are connected to one end of this pouch and the other end of the pouch is connected to the urethra. Urine will drain from the kidneys through the ureters and into the new “bladder.” The new bladder will store the urine and the individual will void through normal channels.

Procedure
The bladder is removed. A urinary reservoir is made out of bowel and is attached to the urethra, so the patient can void normally. Spontaneous voiding is accomplished by straining.

Advantages:
• Urinary continence is possible
• Normal urination route
• No external collection pouch

Disadvantages:
• Possible nocturnal leakage
• Possible need of clean intermittent self catheterization
• The long-term results are not known
• Chance of pouchitis (inflammation of the reservoir)

For more information, click here to go to our Resounding Health Casebook on Bladder Cancer

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

8 Comments

  1. Bonnie Belisle

    September 29, 2010 at 1:30 pm

    Patti — Thank you so much for sharing your story! I, too, have bladder cancer (T3a N2 muscle invasive high grade urothelial carcinoma) and didn’t know anyone who had it nor had I ever heard about it. And, never smoked a day in my life! I’ve always been very active and healthy with never any medical issues! I did join BCAN – Bladder Cancer Awareness Network (www.BCAN.org) and wear the orange wrist band and ordered a bunch for my friends. (Even though “orange” is NOT in my color palette! 🙂 )

    Had my bladder removed and hysterectomy Dec. ’09 at Stanford using the Da Vinci robotic medical system — I was 62. I could not do the neobladder due to the cancer destroying muscles in my urethra which would cause incontinence, so had the urostomy and wear the pouch — which is working well and you just learn to deal with it. My surgery was last Dec. They also removed 16 swollen lymphy nodes with 11 showing cancer (6 being in the para-aortic area). I started chemo end of Jan. ’10 with six 4-wk cycles of chemo (cisplatin and gemcitabine).

    I was given a grim outlook due to the invasiveness of my bladder cancer. So, I did a lot of praying and so did my friends and family — I kept a positive attitude, sent my horse out to a trainer to keep her in shape — went up and rode her about 3x a month after the first 3 months of surgery recouping. My PET Scan in May showed no detectable cancer, still finished up chemo to July 1. Next PET Scan would be in 3 months. In the meantime I got some energy back and my husband and I and our 2 horses did a lot of horse camping and riding in the mtns. beginning mid-July — you know “make hay while the sun shines”! And my Aug. 30th PET Scan also shohw no cancer! Praise the Lord! Will have another in another 3 months.

    My docs are thrilled, but not as thrilled as I am. And, I am thrilled that you are doing well over the last two years!! We do need more public awareness for bladder cancer to get the research dollars headed in that direction! So glad you are writing about your experience. Thx again,

    Bonnie Belisle
    [email protected]
    Groveland, CA

  2. Christine crews

    October 1, 2010 at 11:45 am

    I am 45 been fighting bladder tumor’s for 15 yrs. I have never smoked I’m in great shape run marathon’s and teach group fitness classes and personal trainer. The tumor’s are getting more aggressive but still no invasion. However, I have a many sugeries and treatments of BCG. Doctors now want me to have my Bladder out and neo bladder. I would like to hear from anyone who has had this done and is an Athelete how does this affect everyday life at such a young age.

    Thanks for any info.

  3. Carolyne

    October 4, 2010 at 8:38 pm

    I am a 68 years old. I had breast ca surgery (lumpectomy) in 2008. In 2009 after complaining of frequent urination,( I had no other symptems) and trying several medications for frequent urination, my doctor did a cystoscope at my request. During the procedure, bladder ca was discovered. I have never smoked in my life, but here I was with a smokers cancer. I was sent to USC for a surgery consultation with Dr. Gill. Surgery was scheduled for later that week.It was a robotic surgery. I was not a candidate for the neobladder because of the location of the cancer. I had a urostomy. It has not been a quick recovery. I was told it would take a year to fully recover. I had chemo of cistoplatin and gemcitaban even though all my 100+ lymph nodes were clean.

    I have a pouch, it took time to find the proper fit pouch but after I found the right one there has been no problem. It truly becomes 2nd nature. It is my gift of life and I am very thankful!!!!!!!

    Patti, Please help to get the info out about bladder cancer and pray for a cure!

  4. Linda Klemm

    October 24, 2010 at 12:57 pm

    Wow, I’m only the 4th one to comment…not many of us women out there who know about this. After all of a sudden seeing blood in my urine it took several weeks to finally figure out I had a cancerous bladder tumor….some of the longest weeks of my life, of course. I was 54 years old. I smoked but quit over 30 years before so it’s pretty hard to swallow that as being the cause. I was to routinely have it removed on an outpatient basis. While getting ready to eat something and get ready for discharge in my outpatient room I developed excruciating pain and had to be kept overnight for pain management. They sent me home the next day only to develop delerium, shortness of breath, fever, and itching; (my pain was being masked with the drugs they sent me home with) causing my family much concern and phone calls back to the hospital. Sunday morning with symptoms only getting worse, my family chose to take me back to the ER where I had to be intibated and taken to surgery again to fix the hole that had developed in my bladder filling my body with urine drowning me on the inside. I spent the next couple of days in ICU – then to a regular room and then finally being dismissed on that Friday. I’ve had many rounds of BCG with lots of side affects but I always say “it’s not chemo” and try not to complain. A year and a half ago I developed carcinoma insitu and went to another urologist for a second opinion who also sent me to an oncologist who said he usually doesn’t see patients like me and sent me on my way, thankfully not bad enough. The second urologist said technically I didn’t have cancer back and that I should continue to do maintenance BCG. I have cystos no more than 4 months apart. This will be my life routine going forward – hopefully for a very long time. I felt like Patti exactly when they handed me the pamphlet with the picture of the elderly man on it – how can this be me? It bothers me that doctors don’t do a routine urinalysis during yearly exams…I understand it’s not an expensive lab test and if it caught an early case, it would be so worth it. Thanks, Patti for sharing your story and bringing awareness about this up. I’ve never heard of another woman in her 50s with it. You certainly have had more than your share – my prayers are with all of us.

  5. Joan Greene

    October 27, 2010 at 8:08 am

    I went through this starting two years ago. Misdiagnosed as possible kidney stones. Thank the Lord that I was referred to a wonderful doctor, two in fact, here in northern New Jersey. The tumor was removed, and after undergoing three months of chemo, my bladder was as well, and I received the “Indiana pouch.” Of course, just about everything else was removed as well. But I am still here on this blessed earth, enjoying my life. Other than some nocturnal leakages every so often, I am adjusting to my new body part and believe it is adjusting to me as well. I firmly believe in sharing my experience with as many women as possible because of the similar symptoms to other issues. Too many women don’t even consider the possibility of bladder cancer because so much of the literature refers to it as a “man’s disease.” Well, ladies, be alert and take good care of yourselves and have your doctors explore all possibilities – and above all else – get good fast action. Don’t put it off. It’s your life. I bless my friends and family for getting me through this so far. I thank my faith in God and good doctors and nurses. It’s not a pleasant experience. It’s hard and can get you down if you let it. DON”T LET IT BEAT YOU. If you believe in yourself, you can get through it. Thank you Patti Hansen for putting a spotlight on this health issue.

  6. Tamitha

    October 27, 2010 at 12:29 pm

    I would like to respond to Christine Crews with regards to having a neo bladder. I was born with a rare birth defect that caused me to have at least two major surgeries for the past 42 years. Over the past twenty years my biggest problem was with infections that never went away. Even with IV antibiotics and a port. My urologist in Little Rock, AR suggested I see a specialist in Jackson, MS. After three years of treatment with him I decided to have the Mitrofanoff procedure. I kept a portion of my bladder and the rest was replaced with bowel. I chose to close off the urethra and have a stoma that I cath whenever I need to urinate. The stoma is in the “hole” of my bellybutton and if I didn’t have previous scars, you really wouldn’t notice except for a pinkish color. I’m very active…always exercising, running, you name it. Here is the kicker…it took a year and a half to get to this point. The first year I thought I’d made a big mistake. I still had infections, stones, and lots of leakage at the stoma. Sometimes I wore a pouch over the stoma when I knew irrigation would not be possible. But after a few surgeries to tweak everything, I’m happy with my decision. My only restriction is making sure I always have a catheter handy. I cath every four to six hours depending on how much liquid I’ve had. This is a a total lifestyle change, but for me it has been worth doing. I spent 8 days in the hospital and two months with two catheter bags attached to my legs. After they are removed, you are put on a schedule to cath every two hours for weeks and adding an hour after a period of time. And yes this means setting your alarm for every two hours at night. I did lots of research before my surgery but I still had no idea how difficult the first 6 months would be. Take your time and make the best decision for yourself. Best wishes, Tamitha

  7. MJ Kelly, MD

    October 27, 2010 at 11:33 pm

    I want to thank those brave women for sharing their stories online.
    Early detection can be life saving with bladder cancer. When one is experiencing irritative urinary symptoms such as urgency, frequency and pelvic pressure, especially in the presense of microscopic or visual bleeding in the urine, INSIST that your primary care physician send you to an experienced urologist.
    And one last thought…STOP SMOKING!

  8. Mesothelioma Medical

    November 2, 2011 at 6:04 pm

    I do accept as true with all the ideas you’ve offered for your post. They’re really convincing and can certainly work. Still, the posts are too short for beginners. May just you please lengthen them a bit from next time? Thanks for the post.

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