New Tactics for
After decades without treatment advances, options for
patients with bladder cancer are now more numerous.
By Kendall K. Morgan
When Karl Pritchard noticed blood in his urine one morning in February 2014, he made an appointment with his primary care doctor. The doctor told Pritchard,
who was 76 years old at the time, that if he didn’t
have a bladder infection, the blood was probably a
sign of cancer.
When a course of antibiotics didn’t resolve the
issue, the doctor ordered a CT scan and had his
office schedule an appointment with a urologist near
Pritchard’s home in Edenton, North Carolina. The
urologist performed a cystoscopy, threading a small
tube with a light and lens through the urethra and
into the bladder, which revealed a tumor. The spe-
cialist surgically removed a sample of tumor tissue
that included the inner wall of the bladder and its
underlying muscle. The biopsy results and CT scan
indicated the cancer was boring its way into the
muscle layer of the bladder wall.
Within weeks, Pritchard had robotic surgery to
remove his bladder. After pathology reports came
back, he was diagnosed with stage III urothelial
carcinoma. Urothelial cancer is the most common
type of bladder cancer in the U.S., and the standard
treatment for Pritchard’s type of cancer includes
surgery and the chemotherapy drug cisplatin.
However, during Pritchard’s operation, the surgeon
discovered the tumor had damaged his left kidney
by blocking blood flow to the ureter, a duct that
transports urine from the kidney to the bladder.
His right kidney was also damaged due to a complication from surgery.
The compromised kidney function made Pritchard
ineligible for chemotherapy, which for decades had