On July 28, University of Colorado football coach Deion Sanders revealed that he was diagnosed with an aggressive form of bladder cancer—but now, after treatment, is considered cured.
“We’re going to beat it, ain’t we?” Sanders, who is 57, asked one of his doctors, Dr. Janet Kukreja, who appeared on stage with him at a press conference in Boulder. “It’s beaten,” she responded, later adding that as an oncologist, she does not “use [the word cure] lightly.”
The spotlight on bladder cancer is “long overdue,” Kukreja told TIME after the press conference. (She is the director of urologic oncology at the CU Cancer Center on the University of Colorado Anschutz Medical Campus.) “It’s high time that people recognize bladder cancer is a very serious cancer, and a very common cancer.”
Here’s what to know about the disease, as well as what it’s like to live with a restructured bladder.
Who’s most at risk for bladder cancer?
More than 80,000 new cases of bladder cancer are expected to be diagnosed in the U.S. this year, according to the American Cancer Society. The disease is far more common in men than in women. “The male to female ratio is about 60%-70% male to 30%-40% female,” says Dr. Jonathan Rosenberg, chief of the genitourinary oncology service at the Memorial Sloan Kettering Cancer Center. “It’s a big split.”
Other common risk factors include smoking, exposure to certain industrial chemicals, older age, and chronic bladder irritation and infections.
Sanders publicly hinted at a health problem throughout the football off-season, but did not reveal the cause of his symptoms until now. He was diagnosed with very high risk non-muscle invasive bladder cancer, Kukreja confirmed to TIME, which means his disease was confined to the inner lining of the bladder and hadn’t spread to the muscle layer or the rest of the body. “It was caught at just the right time,” she says, noting that Sanders initially learned about it incidentally from a follow-up CT scan he had related to vascular surgery. “It was totally not what anybody thought was going to come from that,” she says. “That’s usually not how we find it. Usually we find it because people have blood in their urine.”
What’s bladder removal surgery?
Some bladder cancer patients opt for intravesical therapy, which means chemotherapy is administered directly into the bladder; others benefit from approaches like immune checkpoint inhibitors, or a combination of both. During the press conference, Sanders said he chose to have his tumor surgically removed, which is called a cystectomy.
“Given his commitments to his family and to the team, he elected to undergo a bladder removal,” Kukreja said during the press conference. “We performed a full robot-assisted laparoscopic bladder removal and creation of a new bladder. And I am pleased to report that the results from the surgery are that he is cured from the cancer.”
There are several ways to reconstruct the bladder after removal, but Sanders’ team opted for a neobladder, in which part of the intestine is used to create a new bladder that’s remarkably close to normal anatomy. Patients typically stay in the hospital for two to five days after surgery, and then use a catheter for a couple weeks before beginning to train their new bladder, Kukreja says. “When people empty, they have to kind of push their abdominal muscles, like they’re doing a sit-up,” she says. “It’s not hard to learn—it’s just a new muscle memory. Most people can do it and do it well.”
About half of people with a neobladder experience leakage overnight, Kukreja says, which Sanders spoke candidly about during the press conference. “It’s a totally different life,” he said. “I depend on Depends … I cannot control my bladder.” At one point, he joked that he may need to have a “porta potty on the sideline” of games in case he needed to pee.
Still, patients who opt for bladder removal tend to recover well after surgery. “Our surgeons here have looked at it, and about a year after surgery, quality of life is mostly at baseline in the most important ways,” Rosenberg says. “People can do almost everything they want to do in life regardless of the type of urinary reconstruction. It’s a big change, and it’s not a trivial surgery, but it’s hopefully a curative surgery and gets rid of the problem.”
Catching bladder cancer on time
Throughout the press conference, Sanders urged people to pay attention to their own health and get a check-up if they notice anything unusual. There’s no screening test for bladder cancer, but experts agree that if you notice any blood in your urine, you should take it seriously and make a doctor’s appointment.
“I can’t tell you how many times people come in and they say, ‘Well, a year ago I saw a little blood in my urine, and it just went away. It was there for a day, and it went away, and I kind of let it go,’” says Dr. Daniel M. Geynisman, chief of the division of genitourinary medical oncology at Fox Chase Cancer Center in Philadelphia. “So now it’s six months or nine months later, and that can be a huge amount of time in this disease.”
Most of the time, there will be a non-cancer-related cause, he adds, but even one fleeting day of bleeding calls for proper evaluation. It’s not worth taking any chances, he stresses. “If you see blood in your urine, you have to go get it checked out,” Geynisman says. “Do not let it go. It’s not normal.”
