Severe Bladder Cancer Disproportionately Affecting Black Men in U.S.

  • The American Cancer Society reports there are 81,400 new cases of bladder cancer each year.
  • About 62,100 cases are diagnosed in men and 19,300 in women.
  • Bladder cancer tends to be diagnosed at later stages in women and Black Americans.
  • Experts say misdiagnoses in early stages and lack of access to healthcare are some of the factors contributing to this.

Bill Thompson, 49, of Dallas, Texas, always considered himself a healthy person. He was fit and worked out regularly, ate well, and never had brushes with serious health problems in his youth.

When he thinks back on it all now, he says he realizes there were signs he had a serious health problem for the past 15 years. He just didn’t recognize them at the time.

Then, he was dealing with gout, a buildup of uric acid in the blood stream that can lead to swelling and pain in the joints and feet. The condition can also lead to arthritis.

Thompson told Healthline that he received treatment, going on steroids and pain medications, increasing his water intake — basically, he “didn’t pay a whole lot of attention to it,” trusting that the treatment he was receiving would clear away his health problems.

That didn’t happen. A mass in his bladder detected by his urologist that was originally thought to be benign was found to be a malignant tumor.

He started urinating blood and experiencing back pain. Eventually, another tumor was found wrapped around his spine and another in his liver.

At age 45, Thompson was happily raising his two boys Jaxson and Jayson together with his wife, Uti. He was a nutritionist and fitness instructor with a successful career as a commercial lender. He felt as if he was on top of the world. Then he was diagnosed with stage 4 bladder cancer.

Within half a year, he dropped from 185 to 140 pounds.

He said he went from trying to put his health concerns out of his direct field of vision to having difficult conversations with his wife about a potential future for his sons without him being there. Thompson said the idea of not being alive to see his sons grow and to be near his family and loved ones “petrified” him.

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Bill Thompson (center right) credits the support of his wife, Uti (center left), and their sons Jaxson (left) and Jayson (right) with helping him through his long journey battling bladder cancer. Image via Bill Thompson

Bladder cancer is the 6th most common cancer in the U.S.

Thompson’s experience is more common than many people realize. The American Cancer Society reports there are 81,400 new cases of bladder cancer each year — about 62,100 in men and 19,300 in women. Beyond this, 17,980 people die from bladder cancer each year nationwide. More common in men than women, it also occurs more commonly in older adults, with the average age of diagnosis being 73.

While the typical cases are found in older white men, Thompson, a young Black man, falls in another statistical category.

The National Comprehensive Cancer Network (NCCN) reports that bladder cancer, the sixth most common in the United States, tends to be diagnosed at later stages in women and Black Americans.

A paper in the journal Cancer backs this up, stating that, while less common, women and Black people who are diagnosed “present with more advanced bladder cancer and have worse cancer-specific survival than other patient populations.”

Dr. Shilpa Gupta, an oncologist at Cleveland Clinic, said that Black people, specifically Black men, tend to have worse outcomes due to some of the same overarching healthcare inequities that plague our society at large.

Black Americans tend to have less access to healthcare resources and the financial stability to access healthcare that could help them seek out needed cancer treatment, she said.

In general, smoking is a major risk factor and she said men who are heavy smokers tend to be the most common people who receive diagnoses.

Thompson said he wants people to know that this is in many ways a “silent killer.” Oftentimes, common symptoms can go undetected or passed off as the result of a far less serious disease.

Gupta added that many times early signs of bladder cancer — like blood in the urine — are deemed and treated as urinary tract infections at first, leading eventual diagnosis to come at more severe stages.

A partner in the process

Thompson said that his journey with cancer has been frustrating and scary as well as “awakening.” A self-described “private person,” he said that once he received his stage 4 diagnosis, he was forced to “open up and share” his experience with friends and family.

Having cycled through countless urologists and oncologists through the years, he said connecting with family friends and community resources helped him know when to ask the right questions, seek out the treatment that he needed and, most crucially, gain emotional support from his community of family and friends.

“It was amazing support not just for me but my family. I was in the hospital for 8, 9 months, and my kids were going to school and sports. It was just helpful having support and to reach out and opening myself up to people to take responsibility for my own health,” Thompson said. “I must say that opening up to other people was a pivotal challenge for me when it came to my healing process.”

When it came to his actual medical treatment, Thompson explained that — as with most people living with cancer — he went through a “trial-and-error approach” to see what worked best for his healthcare.

A big part of that was finding physicians who would serve as “a partner through the process,” he said.

“The first couple of doctors we started with would dictate to do one thing and then another and it would get frustrating because I always left disappointed,” Thompson said.

He was given different radiation treatments, going through three different doctors before one sat him down and said, “We have a fight ahead of us. The only way we will get there is partnering together as we go through this.”

Thompson said just hearing that was invaluable to him. He was put on a new diet to ensure he stayed healthy through the radiation process. His tumors did go down in size, but his health was deteriorating.

Thompson said he was experiencing bad pains, his weight kept dropping, and he wasn’t responding as well to such aggressive therapy.

He spent 6 months in rehab after surgery was done to remove the tumor around his spine, but he and his wife felt he was too frail — now about 145 pounds — to go through more intensive chemotherapy. Eventually, he was directed to an experimental trial of Tecentriq, or “atezolizumab,” at The University of Texas MD Anderson Cancer Center.

The therapy has been a success. He goes in every 3 weeks to receive the therapy and said even after his first few doses he started to gain weight and feel stronger.

Now in his fourth year of the treatment, he said he is now arriving at a transition period — this regimen is to end after 5 years.

“This year is pretty monumental. I’m facing that decision that this is the last year of treatment and then I’ll hopefully be starting the next phase where I’m healthy enough for my body to take over,” he said.

And so far, so good. Thompson now weighs 165 pounds, bikes every week, and says he’s “at the best shape I’ve ever been in.” And crucially, he’s able to be there for his children, now 11 and 9 years old.

“Cancer isn’t a death sentence,” he stressed. “It’s a constant journey. Cancer as you’ve probably heard is an ‘awakening’ experience. It awakens you to change what you need in your life. You need to be in tune with your body, you can’t just put in a Tylenol and move on, you’ve gotta get to the root of the problem and solve it.”

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