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