Bryon Lee lists the number of items, mainly juices that he can now enjoy without fear of bringing them up. - Colin Hamilton/Freelance Photographer Barbara Ellington & Yahneake Sterling, Flair Writers
When the leader of Jamaica's most popular band Byron Lee was stricken with cancer of the bladder in October last year, his50-year music career was put on hold. But, when a man discovers blood in his urine, it is not to be taken lightly. After he visited urologist Professor Lawson Douglas, a cystoscope was used to look at his bladder and he saw the tumor.
Lee, who is now 71, describes the tumor as the size of a peanut shell with tiny threads at both ends. It was at, "stage three with angry cells and growing". He told Flair the procedure is painless so men should have no fear. He also pointed out that being a diabetic, he had, over the years, done tests on his colon, blood checks and other medical examinations with regularity.
He took medical advice to have the procedure done in Florida where more advanced facilities would be available for what was required. Had he done a bladder check six months earlier, the size would have been a mere polyp. And, Lee is now emphasising that men grasp the importance of overcoming the fear of prostate checks.
New bladder
During the surgery, Lee's bladder, appendix and prostate were removed and portions of his large and small intestines were then used to make him a new bladder. "I remained in intensive care for three weeks but in spite of the complications, I healed and the doctors said in three months I could begin chemotherapy," he told Flair.
By the end of this week, Lee would have received the final in a series of 12 energy-sapping chemotherapy sessions. "They began at the end of January and when it is all out of my system, they will do a petscan to see how I have feared," he added.
He stressed that blood tests will not show this type of cancer and the organs removed were done for his protection.
For him, some side effects of the chemotherapy are severe weakness, nausea, vomiting and loss of appetite. He is only able to have beet, carrot and celery juice and can taste or enjoy noodles. "I have absolutely no appetite. I feel very weak but I can sit for hours in a car or on the sofa, however, I cannot stand for long," he admits. This is the resultof being wheelchair bound as he convalesced. But, his spirit is high.
What is cancer of the bladder?
Bladder cancer is one that has been overshadowed by the more prominent ones such as prostate and breast cancers. And, while it may be virtually unknown among many Jamaicans, at least one incident has been diagnosed every two months over the last six years or so.
This is according to urologist Professor Lawson Douglas who has been in the field of medicine for 40 years. The statistics are based on his own experience in his practice.
Put simply, bladder cancer forms in the lining of the bladder (the area that stores urine). While some bladder cancers remain confined to the lining of the organ, others may invade the muscle and other areas. Research shows that 90 per cent of the cases occur in people over 55. Like with some other cancers, smoking is the greatest single risk factor for bladder cancer.
The most common treatment for it is the removal of the bladder, but according to Professor Douglas, early diagnosis is key to avoid surgery.
See a urologist
"Most of the cancers we diagnose are not aggressive and that's why when anybody has urinary symptoms they should go and see a urologist especially if there is blood in the urine," Professor Douglas explains.
"If it is found early, in most cases this can be easily burnt off. If it is not diagnosed early, then it grows deep in the bladder wall and spreads around and when you diagnose it, it is a bit late and you have to take out the bladder."
Angry cells
Some cancers are more aggressive that some but most local cases, Professor Douglas notes, are normally not aggressive. Aggressive cancers are also referred to as 'angry cells'.
"We decide on how abnormal or how aggressive a cancer is by looking at it under the microscope. If the number of cells that you look at, look relatively normal, but they're still abnormal, it's an early sort of cancer, it is not an aggressive cancer" Professor Douglas stated.
"If the cells look totally abnormal, then it's graded as a very aggressive cancer and some people call these angry cells because they don't look like anything else, they look really strange, abnormal and angry. The more angry or aggressive cells you have the worse cancer it is," Professor Douglas added.
Three available options
But for the cases where the cancer is caught late, there are three options available to deal with the disease.
The bladder can either be removed and a new bladder is made using the intestines; the patient can be fitted with an ileal conduit (tube); or the bowel can be moved so that the urine is excreted through the anus.
If the patient opts to remove the bladder, and get a neo-bladder (bladder made from the intestines), the new bladder may become clogged with mucus.
"The intestine normally puts out mucus because that's what helps with the lubrication of the intestine and some of the substances in the mucus help the food to digest," Professor Douglas told Flair.
"When the new bladder is made from intestines, it continues to put out mucus and the mucus tends to clog the opening coming out."
The large intestines secrete more mucus than the small intestines, but over time, with no food to digest or absorb the intestines will produce less mucus. But, how does the doctor or the patient deal with mucus in the neo-bladder. "You may have to irrigate the mucus out of the bladder and watch the patient to see of the bladder becomes plugged up with mucus," Professor Douglas further explained.
With the neo-bladder, the patient can live a relatively normal life but frequent checks are necessary to ensure that it is in good working order. The down side is that patients may wet their bed at nights, and at times the bladder does not empty fully and it has to be done manually.
On the other hand, if the patient chooses the ileal conduit, life may not be as normal for them. "The best choice for the longevity of the patient is to give them what we call an ileal conduit (tube), this way you bring the bowel out on the wall, but the patient doesn't live a normal life because they have a bag on their side so they can't do things that everyone else wants to do," Professor Douglas said.
The other option which is not very popular especially in the United States, is the option to let the urine pass out through the anus during normal bowel movement because of the risk for infection in the kidneys.
Colon test
"Before this is done, we test the colon to make sure it can hold a lot of water without leaking so when you go to pass your faeces you pass out the urine at the same time," Professor Douglas said. However, persons who choose this option are more prone to colon cancer.
Recovery time for patients vary depending on the type of surgery that was done. If a laparascope is used to remove the bladder, healing time can take between two weeks to a month. For patients who do open surgery, healing time could take up to two months.
However, if chemotherapy is administered after surgery, there could be a six-month recovery timeline as chemo makes one ill.
Bladder cancer can spreadif left undetected, it can travel via the lymph nodes or the bloodstream and infect the liver, lung and bones. It can also spread to organs close by including the prostate, the urethra in the male, the uterus and the vagina in the woman, as well as the rectum. While most bladder cancers do not show symptoms in its early stages, urine in the blood is the most common symptom. Other symptoms include: pelvic pain, pain during urination, frequent urination or feeling you need to urinate without being able to do so, and slowing of your urinary stream.
Byron Lee is happy and lucky to be alive and he plans to use his celebrity status to encourage men to live a healthy lifestyle and most importantly, get regular health checks.
