Not a great topic for polite conversation, but Karla Boatright must start her story with her yearlong struggle against a determined bladder infection.
That’s what she thought, anyway. Just one symptom, burning, so she and her doctor tried an antibiotic, gave it some time, then tried another. And another. And another.
Nearly a year went by with no relief until she saw the second symptom, blood in her urine. Not a lot, she says, but fresh-looking.
“I knew that wasn’t right,” says Boatright of Neosho, Mo.
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The diagnosis came a week after a visit to the urologist: aggressive bladder cancer.
“I hadn’t even given cancer a thought,” she says. “I didn’t feel bad. I hadn’t lost weight.”
The diagnosis in January 2013 was a surprise all around. A much likelier candidate for bladder cancer was a 70-something male smoker. Boatright was 45 and didn’t smoke.
She and her husband, Bruce, knew their first task was to break the news to their two grown children and to close relatives.
“You shed a lot of tears the first couple days,” Boatright says, “but then you put your game face on.”
Her daughter was married and ready to start a family. Boatright had been looking forward to “the blessing of grandbabies.” But the future suddenly seemed uncertain, although Boatright didn’t say such things aloud.
Boatright came to Kansas City for surgery. For patients and doctors, her case offers several cautions about bladder cancer, says Jeff Holzbeierlein, urologist at the University of Kansas Cancer Center.
More men get bladder cancer than women, by about 3 to 1. It’s the fourth most common cancer for men. And most bladder cancer patients are in their late 60s and 70s. But women and younger patients must stay vigilant, Holzbeierlein says.
And if you’re a bottom-line kind of person, here’s Holzbeierlein’s:
“Any patient who can see blood in the urine must have an evaluation for bladder cancer.”
While other conditions can cause blood in the urine, including kidney stones, infections, trauma and even vigorous exercise, it’s never normal, he says.
A bladder tumor can be removed, but sometimes the entire bladder has to go, which is when things get complicated.
Holzbeierlein, who performed Boatright’s surgery, notes the three main options. One is a urostomy, much like a colostomy, with a pouch outside the body. Or the surgeon can create an internal pouch from colon tissue. It’s emptied through a catheter.
The third option is to use intestinal tissue to build a new bladder that empties normally, but the new bladder must be trained.
“It’s a rough go in the beginning,” Holzbeierlein says about that option. “It’s like having a baby’s bladder — it doesn’t hold much and you can’t control it.”
Boatright’s cancer had spread beyond the bladder. She underwent several months of chemotherapy, then had surgery in June 2013. In an eight-hour operation, her bladder was removed along with part of the vaginal wall, the uterus and 20 lymph nodes.
Boatright’s first choice was a rebuilt bladder that empties normally, but depending on what was found in surgery, Holzbeierlein said the internal pouch that emptied through a catheter was a possibility.
She got the rebuilt bladder. And the doctor was right, she says, that it would take time and patience to train the brain to communicate with the new bladder.
“I had daytime control in only about three weeks,” she says, “but I’m still working on the nighttime control.”
Holzbeierlein says a KU study found that most people think bladder cancer is related to what you drink, such as too much alcohol or drinks with sweeteners. But research has shown no such connection.
Instead, those who work around chemicals, including paints and dyes, and those who smoke cigarettes have a higher risk. For smokers, it may be that the chemical byproducts of smoking collect in the urine and sit in the bladder, resulting in DNA damage and then tumors.
Now a year from surgery and cancer free to date, Boatright says she feels “100 percent.” Holzbeierlein calls her “a great advocate,” answering the call to talk to other bladder cancer patients who want to contact someone who’s been through treatment.
Boatright and her husband own Neosho Graphics & Competitor’s Wearhouse sporting goods. She and her daughter, Katlynn Bishop, have started a new online business that offers apparel with “spiritually uplifting” messages about the fight against cancer. It’s called One24Boutique.com, and a portion of the proceeds go to KU Cancer Center.
“After you have cancer, you feel like you need to do something to help,” Boatright says.
The best news? She can see the future again. Her son, Carter, started his senior year at the University of Arkansas. And her daughter started her family.
“I have a grandbaby,” Boatright says, “9 months old.”