Few people are grateful to get food poisoning. But Gladys Mouzone, 65, knows a case of food poisoning may have saved her life.
In early 2020, Gladys — a retired housekeeper in the health care industry — sought emergency medical care for stomach upset and back pain. Though the diagnosis was food poisoning, a different problem emerged while the ER team was investigating the source of her discomfort.
They performed a routine urine test called urinalysis as part of her workup. That’s when Gladys got some news that surprised her — there was blood in her urine.
A Bladder Cancer Diagnosis at Penn Medicine
The ER team instructed Gladys to follow up with her primary care physician. But a gap in her health insurance coverage meant she put off the visit for more than six months. When she finally got to her doctor for a follow-up, a second urinalysis confirmed blood in her urine.
Her doctor recommended that she consult with a urologist, so Gladys saw Penn Medicine urologist Alan J. Wein, MD. Dr. Wein performed cystoscopy, an exam in which doctors insert a thin tube with a light and camera, called a cystoscope, through the urethra. He examined her bladder and removed some cancerous tissue.
Gladys says Dr. Wein found two tumors — one large tumor and one that was smaller. “I later learned that it was stage 1 bladder cancer,” she says.
With a
bladder cancer diagnosis confirmed, Gladys was then scheduled to see
Trinity J. Bivalacqua, MD, PhD, Director of Urologic Oncology at Penn Medicine’s Abramson Cancer Center. In February 2022, Dr. Bivalacqua performed a
bladder cancer surgery called transurethral resection of bladder tumor (TURBT). TURBT is a procedure that helps stage cancer to help determine the best treatment options.
“He scraped the inside of my bladder to remove the rest of the tumors,” she says. “And he explained that after the procedure, I’d need treatment to ensure the cancer was eradicated altogether.”
Intravesical Immunotherapy for Bladder Cancer: Quick and ‘Painless’
In March, Gladys began a six-week course of Bacillus Calmette-Guérin (BCG), an immunotherapy drug used to treat bladder cancer. She receives an infusion of the drug directly into her bladder, a bladder cancer treatment known as intravesical immunotherapy. The BCG treatment helps Gladys’ own immune system prevent the cancer from returning.
So far, the treatments have been comfortable, according to Gladys. “I would go so far as saying it’s painless,” she says. “You’re able to go home right away, but you can’t void for two hours after because they want the medicine to dwell in the bladder lining so it stimulates the immune system.” After two hours, she drinks between six to eight glasses of water to help flush the medicine from her bladder.
Once Gladys completes the six-week course of BCG treatment — known as induction therapy — Dr. Bivalacqua will do another cystoscopic exam using Blue Light Cystoscopy or enhanced cystoscopy which helps identify any regrowth of tumors in her bladder. He’ll examine her bladder for any remaining cancer and talk with her about whether she needs additional treatment.
As for side effects, Gladys says she felt some fatigue and flu-like symptoms after her second BCG treatment. She also noticed she must urinate frequently in the days following treatment.
“After the first treatment, I didn’t experience any of that. But it was explained to me that with each treatment, the side effects might get more intense,” she says. Gladys says she appreciates the way Dr. Bivalacqua talks with her about her bladder cancer treatment.
“It’s important that patients are counseled about their cancer diagnosis and the various forms of treatment we use to manage non-muscle invasive bladder cancer. At Penn Medicine, we are invested in educating and counseling patients about their specific cancer and how we personalize their cancer care” says Dr. Bivalacqua.
The Signs Were There
Gladys says that although her bladder cancer diagnosis came as a surprise, looking back, the signs were there. “From time to time, I’d see a little bit of pink on the tissue after I went to the bathroom,” she says. But because she takes blood-thinning medication, Gladys says she didn’t think anything of it, and she didn’t see the pink tissue often enough that she felt she needed to tell her doctor.
Not everyone who has blood in their urine has bladder cancer, but it’s the most common symptom of bladder cancer. Other bladder cancer symptoms include the need to urinate more frequently, burning sensation with urination, discomfort or pain while urinating.
“In order to diagnose bladder cancer in the early stages, we work with primary care physicians and other specialists about the signs and symptoms. In women, this is often thought to be a urinary tract infection, however, blood in the urine is abnormal and should be investigated especially in high-risk populations including patients that have a history of smoking or environmental exposures” says Dr. Bivalacqua.
Although doctors aren’t sure when bladder cancer began for Gladys, she learned tumors could have been present for months to a year.
That was a scary thought for Gladys, who likes to bake, talk on the phone with her sister and watch Court TV. That’s why she wants others to know how important it is not to brush off anything out of the ordinary.
“Talk to your doctor,” she says. “It may be nothing, but it may be the beginning of something serious. What I thought was nothing turned out to be bladder cancer.”