Bladder Cancer Survivor
- Diagnosed with invasive bladder cancer in May 2010 at age 52
- Treated with chemotherapy and surgery, including neobladder surgery
- In remission and fully active in his life
Although he has a job that many people would think is very stressful, Chief Bret Farrar of the Lakewood Police Department says it is probably the easiest job he’s ever had. “I’m not out in the field making split-second, life-or-death decisions.
I have a lot of respect for the people I work with who are doing that every day.”
Bret had been working long hours since the shooting deaths of four of his police officers in late November 2009, so when he noticed a little blood in his urine a few months later, he thought it might be the result of working long hours, or the stress he was under, or perhaps an ulcer. He went to a doctor in Puyallup who performed a cystoscopy (a test that allows the inner lining of the bladder and urethra to be seen) and a biopsy.
“I could tell by the look on my doctor’s face that it wasn’t good,” Bret says. He was diagnosed with invasive bladder cancer in May 2010 at the age of 52. His doctor referred him to Jonathan Wright, MD, a urologic oncologist at Seattle Cancer Care Alliance (SCCA).
Many years before Bret had cancer, he'd signed up for the bone marrow registry after a childhood friend received a bone marrow transplant for leukemia. Bret has been a bone marrow donor for two unrelated patients: one in 1989 and the other in 1992. “The second time, one of the nurses told me the odds of being a match twice were like winning the lottery. I thought maybe I had good cancer karma,” he jokes.
According to the American Cancer Society, smoking is the greatest risk factor for bladder cancer. Bret had started smoking when he was 18 years old. “You think you’re bulletproof, that it happens to everyone else. If you would’ve told me I had lung cancer, I wouldn’t have been surprised. But if you told me I’d get bladder cancer from smoking, I would’ve quit a long time ago.”
“Dr. Wright was awesome,” says Bret. "He’s very calming and knowledgeable, and he has a great bedside manner. He laid out a treatment plan for how we were going to cure it, and I just basically did what he told me to do.”
Dr. Wright recommended chemotherapy followed by surgical removal of Bret's bladder. According to Dr. Wright, “The combination of chemotherapy and surgery improves survival in patients with muscle invasive bladder cancer over surgery alone. However, not all patients are candidates for chemotherapy. In Bret’s case, because of his good health, we were able to treat him with the combined approach.”
Since Bret was otherwise healthy, Dr. Wright and Elahe Mostaghel, MD, PhD, a medical oncologist at SCCA who specializes in treating urologic cancers, were able to reduce the duration of Bret’s treatment by using a more intense chemotherapy regimen. Every other week, he spent several hours at SCCA on Thursdays and then again all day on Fridays for his chemotherapy treatment.
By the third treatment, he still had a full head of hair. “It was pretty cool that I hadn’t lost my hair and I thought I was going to be one of the lucky 20 percent who keeps their hair,” Bret says. “But then, on my way home from treatment one day, I ran my fingers through my hair and it came out in clumps. I stopped on the way home and bought some clippers and my daughter shaved my head that day.”
Surgery and the neobladder
After he was on chemo for a few months, Bret had surgery to remove his bladder, prostate, and nearby lymph nodes. Since he’s still very active, Bret chose to have a new bladder constructed over having an external bag that would need to be drained periodically. The new bladder, called a neobladder, was constructed from a section of his bowel. Bret spent a little over a week in the hospital recovering from surgery. For the first couple of weeks after he returned home from surgery, he had to give himself injections and periodically flush his neobladder using a catheter.
A couple of weeks later, he spiked a high fever. “I’ve never felt so sick in my life." He asked his wife Cindy to take him to UW Medical Center, "where they knew who I was and what I had just been through.” At UWMC, Bret learned he had a blood infection and was hospitalized for a week. According to Dr. Wright, because this is such an extensive surgery, complications and re-hospitalizations are relatively common, making it important to choose a clinic, like SCCA, for its extensive experience managing these types of scenarios.
Taking togetherness to the extreme
Almost at the same time Bret was diagnosed, Cindy had discovered a lump in her breast and while he was home recuperating from his biopsy surgery, she found out she had breast cancer. So, right before Bret started chemotherapy, Cindy had a double mastectomy. He was taking care of her while she was recovering from surgery; then as she started getting stronger, his chemo started to kick in and he became weaker.
“We’ve been together for more than 35 years. We do everything together,” says Bret. Maintaining his sense of humor was a key in dealing with the diagnoses. “Cancer is all-consuming, so I think it was actually a godsend that we both had it the same time. Neither one of us could focus too much on ourselves or wallow in what we were going through because we each had to be there for the other.”
Life after cancer
In their spare time, Bret and Cindy like to spend time at the beach, go to estate sales, and flip houses. And since he’s a police chief, he gives a number of public appearances, including an annual fallen officer food drive that he and Cindy established, which continues to grow every year.
Bret is open about his cancer and his treatment. “When I was first diagnosed, being able to talk to another bladder cancer patient was so helpful. In fact, it was probably one of the reasons I chose the neobladder. So I’m very happy to talk about my experience and have talked with probably half a dozen men who’ve been diagnosed with bladder cancer.”
Dr. Wright agrees. “It is a very frightening time for patients and the unknowns ahead can be difficult to face. Having people like Bret to help personalize their experience and let patients know that they can live full and active lives after all of this is so valuable.”
Because of the neobladder, Bret needs to drink a lot of water. “I guess there is kind of an up side—since you have to force the urine out, I don’t have to get up a bunch of times in the middle of the night to pee like many of my friends who are in their 50s,” he says.
For the first two years after treatment, Bret saw Dr. Wright every six months. Now he sees him once a year for check ups and his prognosis is good—he’s cancer-free.
“It’s been a very tumultuous period—with the death of the officers and then Cindy and I both being diagnosed at the same time; but now it’s almost like I never had cancer.”