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A Limited Window: Bladder Cancer Patient Shares Bond with Surgeon

Read Time: 4 minutes

PJ and Lexi with their son and daughter-in-law, who was in labor while PJ received chemo.
PJ and Lexi with their son and daughter-in-law, who was in labor while PJ received chemo.

PJ and Lexi DiPentino lived most of their married life in Denver, where they raised their five children. But in 2021, they decided to make a change. The couple moved to Livingston, Montana, a small town of 8,900 and home to the northern gateway of Yellowstone National Park.

PJ says, “It was a place where you didn’t think, ‘oh man, I’m going to get sick, and what are my options?’” 

He first noticed something was wrong in February 2023, when he saw blood in his urine. After a trip to the emergency room and a CT scan, a doctor came to him with some bad news.

“He said, ‘Hey, you need to get in touch with the urologist immediately. There’s a mass showing in your bladder, and I believe it could be cancer. So don’t take this lightly.’”

An orange-sized tumor was cutting off his kidney function, and 59-year-old PJ was diagnosed with stage 2 bladder cancer. According to the American Cancer Society, the average age of diagnosis is 73. Men are four times more likely to be affected by the disease than women.

PJ and Lexi with their grandson, Torenzo
PJ and Lexi with their grandson, Torenzo

PJ immediately began chemotherapy in Bozeman, about 30 minutes from his home. Doctors told him he had two options. The first was to continue chemotherapy and radiate the tumor.

“Option two was taking the bladder, the tumor, and the cancer out, but I’d have to be on an ostomy bag for the rest of my life,” says PJ. “And when you have bladder cancer, and you’re peeing once every hour, every single hour of the day— it's painful. And you're miserable. Option two was way more intriguing for me.”

His doctor recommended he see a surgical urology specialist at Huntsman Cancer Institute at the University of Utah in Salt Lake City.

A welcoming experience

Salt Lake City was a world away from Livingston. In PJ’s condition, the seven-hour drive seemed daunting. Instead, he and Lexi decided to fly.

“The whole thing about being sick and having cancer is there’s an incredible amount of anxiety, as the patient and the spouse,” says PJ. “It's bad enough that you're sick and facing mortality. You just want to get better. But in order to get better, you have to jump through so many hoops. And then you finally get to the point of getting on a plane and going to Utah. It’s overwhelming.”

The DiPentinos were also unfamiliar with the city and the Huntsman Cancer Institute campus. They were put in touch with Amelia Thelin, a patient navigator. These experts guide cancer patients through the health care system, helping with logistics and any financial or insurance questions. Thelin works with frontier and rural patients, like the DiPentinos, who often need help with travel arrangements.

“Our first contact with Amelia set the pace for the rest of the trip, that we were in good hands,” says PJ. “People were going to watch out for us, and I was going to be taken care of. And that's exactly what happened.”

This support was crucial as the DiPentinos faced an unexpected road bump. PJ’s surgeon—the one he had traveled over 400 miles to see—broke his collarbone in a bicycle accident. Schedulers quickly found another doctor when they heard about the couple’s limited time in Utah.

“We did not even meet our surgeon until an hour before the procedure,” says PJ.

PJ and Bogdana Schmidt, MD, MPH
PJ and Bogdana Schmidt, MD, MPH

Bogdana Schmidt, MD, MPH, urologic surgeon at Huntsman Cancer Institute, stepped in to take over PJ’s surgery with four days’ notice. 

“I believe in the patient-doctor relationship. I believe in building trust in the clinic and walking your patient through their diagnosis and explaining the steps,” says Dr. Schmidt. “But I also knew that I had to be able to meet a person and put them at ease and take good care of them basically in about a 15-minute window.”

Dr. Schmidt says that with bladder cancer, there’s an issue of timing. Patients need surgery around 6-10 weeks after chemotherapy, before the effectiveness of treatment wears off. 

“I knew that PJ’s surgery had to be within a relatively narrow time slot and delaying it much more would not have been beneficial for him,” says Dr. Schmidt. “I had to do a good job for them. They deserved it.”

What’s best for PJ

PJ and Lexi spent two weeks in Salt Lake City, trying to recover from the surgery where doctors removed his bladder and prostate. 

“It was two weeks of hell, the surgery and after the surgery. Being away from the family. Just me and Lexi out there in an area where we don’t know anything,” says PJ. “My body kind of just wanted to be home. And you know, we never felt frustration or anger or anything for the procedure. Just positivity.” 

The DiPentinos have not returned to Huntsman Cancer Institute, but they do stay in close contact with Dr. Schmidt. Dr. Schmidt says she likes to keep in touch with her out-of-town patients, in particular. 

“Getting to Salt Lake City and coming to see me is a real burden, and I didn’t want PJ to come see me for something I can tell him by phone or email. I wanted to make sure that I could keep in touch with his oncologist so that they can ask me questions, so that PJ can continue to have the benefits of Huntsman Cancer Institute care when he can’t come to see us for visits,” says Dr. Schmidt. “The community doctors are doing a really great job, but we have access to trials and resources here that can be helpful to patients. And if there’s a way for us to be able to share information, that’s an important role that we have.”

PJ and Lexi with their children
PJ and Lexi with their children

At the end of 2023—six months after his surgery—local doctors found that PJ had two cancer hotspots. The DiPentinos and his local oncologist reached out to Dr. Schmidt for her opinion. She took the results to her colleagues on a tumor board—a multidisciplinary team at Huntsman Cancer Institute that analyzes patient cases. After review, Dr. Schmidt urged the DiPentinos to do a course of radiation treatment.

“She said right after the surgery there were going to be some things we needed to monitor, she was straight up,” says PJ. “So, when it came back, it wasn’t really a surprise. It was more depressing. We went with Dr. Schmidt’s advice. She was all into, ‘this is what’s best for PJ, this is what you should look at. The follow-up care was incredible.”

Almost a year out from his surgery, PJ’s condition is now stable. After radiation, his hotspot is now the size of a fingernail.

“There’s no new stuff, and the old stuff isn’t in me anymore,” PJ says. “That's good enough for me. I would take that all day long over the condition I was in one year ago.”

PJ will have to continue with immunotherapy treatment for the rest of his life. But he relishes the positives. Some days, it’s golfing with his son. Other days, it’s enjoying time with their one-year-old grandson, who was born while PJ was receiving his first rounds of chemotherapy.

“He was literally born in the same hospital where I've been getting all my treatments. And we share that together,” says PJ. “That's why we went through all of it, so I get more time on this earth to be with my family. Man, people say to me, ‘Hey, how you doing?’ I'm glad I'm alive.”

Cancer touches all of us.