Joel Fine, 74, a patient at Atrium Health Levine Cancer Institute, recently had his bladder removed as part of cancer treatment. But despite a life-changing surgery, he hasn’t lost his positive attitude or passion for endurance sports.
“I feel the only way to go throughout life is to be positive,” he says.
Joel is an avid endurance athlete and first got into the sport 20 years ago when a friend was diagnosed with multiple myeloma. To show his support, he joined the Leukemia & Lymphoma Society’s Team in Training, where he raised money for cancer research by participating in endurance challenges. After 26 marathons, he decided to try triathlons, even completing three full Ironman events.
“I take it as a personal challenge,” he says. “I’m not competing against anybody but myself. These races are very challenging and very satisfying.”
Learning he had bladder cancer
When Joel was 72, he experienced an increased frequency of urination. He often woke up three to four times during the night to use the bathroom. He visited a urologist near his home in Asheville, who recommended a transurethral resection of the prostate (TURP).
“The treatment changed my life,” says Joel. “I was able to sleep through the night and everything was great for about six or seven months. Then some of the symptoms started to reappear.”
He returned to his urologist, who told him he either had an infection or cancer. When biopsy results came back inconclusive, Joel underwent a more invasive biopsy in the hospital. The tissue sample tested positive for cancer.
He was diagnosed with bladder cancer in February 2020.
“We caught it early,” says Joel. “It had not invaded the muscle layer.”
He began six weeks of Bacillus Calmette-Guerin (BCG) treatment. BCG is an immunotherapy to treat early-stage bladder cancer.
About six weeks after treatment, Joel underwent another biopsy, which found that the cancer was still there. He had an additional six weeks of BCG treatment. Unfortunately, the next biopsy also showed that the cancer was still present.
Pursuing other treatment options
Joel’s urologist referred him to Stephen Riggs, MD, a urologic oncologist at Levine Cancer Institute. Joel also made appointments with physicians at UNC Health and Duke Health for second and third opinions. In the course of three days in November 2020, he met with all three physicians. He chose Dr. Riggs to continue his treatment.
Dr. Riggs specializes in treating bladder cancer and is passionate about helping his patients achieve their highest quality of life.
“My father and grandfather died of bladder cancer,” says Dr. Riggs. “My interest in treating the disease is both personal and professional.”
Dr. Riggs performed another biopsy, which indicated the cancer had started to spread to the upper part of the urethra. Dr. Riggs gave Joel several treatment options and encouraged him to connect with some of his previous patients and the Bladder Cancer Advocacy Network.
“It was incredibly informative,” says Joel.
Ultimately, Joel opted to have his entire bladder removed (also called a cystectomy), which provided his best chance for a cure and was the best fit for his lifestyle. Joel now wears a urostomy pouching system that catches and stores urine outside his body.
“I decided, at my age, it would be easier if I had the ileal conduit procedure should I reach a point in the future where I was unable to take care of myself,” he says.
Undergoing bladder removal surgery
Joel underwent surgery in February 2021. Dr. Riggs performed the entire surgery using minimally invasive robotic technology. He removed Joel’s bladder, prostate, lymph nodes and part of his urethra.
Thanks to both robotic technology and the use of an Enhanced Recovery after surgery protocol Joel experienced a faster-than-average recovery.
“We do both robotic and open surgeries here at Levine Cancer Institute,” says Dr. Riggs. “When performing minimally invasive surgery, we typically expect patients will get on their feet a little faster.”
“The surgery was on a Tuesday and by Friday I was released, and my wife and I drove home,” says Joel.
A quick recovery from bladder removal surgery
“I was sore after the surgery, but it wasn’t painful,” says Joel. “That weekend, I moved around slowly. By Monday morning, I decided I was going to begin walking on the road where we live. I was able to recover so much quicker than I or anyone expected and by the end of that week I was walking a couple of miles.”
Joel attributes his fast recovery to Dr. Riggs’ talent and experience and the fact that he used robotic surgery rather than a more invasive approach. He also says going into the surgery in good physical shape and with a positive attitude helped him recover faster.
The surgery was a success.
“When I went back for my first follow-up visit, the pathology was negative in all of those areas,” he says.
Bouncing back with a positive attitude
“I had an extremely positive attitude,” says Joel. “I also had tremendous support from my wife, sister and friends.”
Joel experienced some setbacks in recovery, including lower body lymphedema and swelling, which made it difficult to walk, run and sleep.
“But believe me, if that’s the only complication that I have coming through this, I’m very accepting of it,” he says.
Since undergoing surgery in February, Joel has completed four half-marathons, an 18-mile race and two half Ironman triathlons, which consist of a 1.2-mile swim, 56-mile bike ride and 13.1-mile run. He plans to compete in more races before the end of the year.
“I get such pleasure from competing in these events,” says Joel. “I do something physical every day. If I don’t do it, I feel like something is missing.”
He adds, “I’m ecstatic that I was able to come back as quickly and as well as I have following surgery.”
Joel has done most of his follow-up visits with Dr. Riggs virtually. Every six months, he gets a chest, abdominal and pelvic scan.
“I can’t say enough about the care I received at Levine Cancer Institute,” says Joel. “It was top-notch.”
Giving hope to others with cancer
“I hope Joel inspires other people with cancer to see what’s possible,” says Dr. Riggs. “Even with a difficult diagnosis, you can reframe your experience and decide what’s important to you.”
Joel’s encouragement to others with cancer: “Don’t be afraid. Be concerned, do your homework and talk with others. Keep a positive attitude. There will be some moments where you’re going to be a little depressed and ask, ‘Why me?’ but you can’t change the situation. The only way to go forward is with a positive attitude and as much knowledge as you can.”
He adds, “If I can help just one other person in my situation, that’s my goal.” And with that, Joel heads outside for a run.
Learn more about advanced bladder cancer treatment at Levine Cancer Institute.
