Dave’s Story: “Funny how life works.”

He didn’t know it yet, but an ordinary day helping his daughter would mark the beginning of an unexpected journey for Dave Oravetz. What started with small, occasional signs turned into a search for answers spanning multiple doctors and difficult decisions. Along the way, he leaned on his long experience with other cancers, the support of his loved ones, and his determination to keep moving forward. Dave’s journey is one of persistence, making careful choices, and finding strength in each new challenge. This is his story:

My first signs of bladder cancer appeared in early 2022. At the time, I was helping my daughter paint the inside of her new home. When I arrived home after a day of painting, I saw blood and blood clots in my urine. From this point on, blood and clots would appear occasionally, maybe every three to five months. I brought this to my primary care doctor’s attention, who referred me to a urologist, one from a large, well-known, and reputable urology group in the Atlanta area.

My initial urologist performed an in-office cystoscopy and allowed me to see what he was seeing on a screen in front of us, showing the inside of my bladder. He was not able to see anything wrong with my bladder. However, since there was blood detected (microhematuria) in my urine, and since there was scar tissue in my urethra (from a previous prostatectomy), he theorized the bleeding was a result of scar tissue. He subsequently performed surgery and took biopsies of areas near the bladder. The results were negative for cancer. At that point, he seemed to give up on determining the cause of the bleeding, suggesting a wait and see approach. He suggested returning in six months for a repeat of the tests, even though he was aware there were abnormal cells in my urine.

Since the source of the bleeding didn’t seem to be the bladder or urethra, I decided to see a nephrologist, who then performed various tests on my kidneys but found no issues.

After additional episodes of blood and clots in my urine, some lasting multiple days, I looked for another urologist. I went to Emory Urology (a urology group that I highly recommend). The initial urologist I saw at Emory did a cystoscopy, and like my previous urologist, was not able to see anything wrong. However, since there were abnormal cells in my urine, my Emory Urologist recommended and performed surgery, taking biopsies of various areas of my bladder. The results revealed high-grade CIS (carcinoma in situ) in multiple areas of my bladder. Although the results were surprising, getting a cancer diagnosis was not new to me, having been diagnosed with three other cancers in the past. It should be noted that CIS can be hard to detect as it is often not visible to the naked eye, which was the reason it was not seen during the cystoscopies.

After discussing the result of the biopsy with my new urologist at Emory, it was decided to go with BCG treatments (weekly bladder infusions with the tuberculosis virus for six weeks). After this treatment, my urologist planned on doing another in-office cystoscopy. However, I questioned the value of this, given that neither she nor my previous urologist could see the CIS with their naked eye in the past. After bringing this to her attention, she recommended another Emory urologist who could perform a blue-light cystoscopy, a procedure that uses ultraviolet light and a special imaging dye to detect bladder cancer tumors that are difficult to find with standard white light cystoscopy.

My second Emory urologist, one whom I cannot say enough good things about, performed surgery (a blue-light cystoscopy and TURBT). With the assistance of the blue light, he could see that the CIS was still present. The next step was another six weeks of BCG treatments and another follow-up surgery (blue light cystoscopy and TURBT). Unfortunately, the second blue-light cystoscopy still showed the presence of CIS, indicating it was resistant to BCG.

Following the second failed attempt to eradicate my bladder CIS via BCG, my urologist’s PA suggested a radical cystectomy (RC). This idea came as a shock. Up until this time, I was thinking there had to be some other treatment available that could treat this cancer without having to remove my bladder. But now looking back, if I had known what I know now about treating high-grade CIS, I realize that RC probably was the best option at the time.

After discussion with my urologist, it was decided to try Gem/Doce treatment, a treatment where two chemotherapy drugs are infused into my bladder weekly for six weeks. This was followed up with another surgery (blue light cystoscopy and TURBT). However, like the previous blue-light cystoscopies, the CIS continued to show up under blue light. Note, my reasoning for going with Gem/Doce treatment was the belief that the BCG treatments weren’t working due to my immuno-compromised condition, something resulting from my previous cancers.

At this point in time, the only treatment options left were clinical trials, possible treatment with ADSTILADRIN, and RC. Unfortunately, none of the drug treatments had shown to be effective over the long term and would mean continuing to have surgeries (blue-light cystoscopies and TURBTs) every three to six months, along with numerous catheter insertions. Discussing the remaining options with my Emory urologist, it was decided to proceed with the radical cystectomy. As a result of my age (71), it was decided to go with the ileal conduit and stoma option.

Moving ahead to today, it has now been seven weeks since I had the RC. Looking back, the surgery could not have gone better, and the recovery has been going equally well to this point. I needed a blood transfusion while still in the hospital due to some blood loss, but otherwise, there were no complications. I was home four days after the surgery and had no complications at home either. I am pleased to say that adjusting to life after RC hasn’t been as difficult as I thought it would be. So far, so good.

The results of the follow up tissue exam were in general very positive. The CIS was limited to the linings of the bladder and ureters, with no evidence of muscle invasion. The only negative aspect of the biopsy was that all resections of the right ureter showed the presence of CIS, indicating the possibility that not all of the CIS was removed. As a result, additional surveillance (more frequent CT scans) of the ureters and kidneys will be done in the future. I would be interested to know if others who have had an RC have had a similar tissue exam result (CIS in the ureter resections), and if so, if it led to later issues with the ureters or kidneys.

As mentioned earlier, this was not my first experience with cancer. I received a non-Hodgins lymphoma (NHL) diagnosis 22 years ago, a prostate cancer diagnosis 15 years ago, and a multiple myeloma diagnosis 14 years ago. The NHL was detected when I was 49 years old and occurred just after becoming unemployed. Having some time off, I found time to have a physical, and during the physical, the NHL was found. So, in a way, being let go from my job helped save my life. Funny how life works. But nevertheless, it was a stressful time in my life.

After aggressively treating the NHL about a year later, this cancer went into remission and continues to be so to this day. This was fortunate, as I had the indolent type, a type that was and still may be considered incurable.

My prostate cancer diagnosis occurred eight years later, at age 57. Discovering this cancer when we did was another fortunate event. In a CT scan done as a follow up to my NHL treatments, my oncologist noticed something unusual showing up in the prostate area and recommended further testing and seeing a urologist. Further biopsies revealed cancer in most of the samples taken of the prostate. But also fortunately, this cancer was detected before it spread outside the prostate. Having my prostate surgically removed 15 years ago effectively cured this cancer.

My third cancer was diagnosed a year after the prostate cancer diagnosis. It was detected when my oncologist performed a bone marrow test as a result of my red blood cell count not returning to normal after my prostatectomy the year before. The results of the bone marrow test showed that most of my bone marrow was made up of cancerous plasma cells. I will never forget the astonished look on my oncologist’s face when he saw the report. I was fortunate that this cancer was caught early, before it could severely weaken my bones and kidneys. The treatment for this cancer was initially six rounds of RVD (Revlimid, Velcade, and Dex) followed by a stem cell transplant. Later I was given bi-weekly Daratumumab, Revlimid, and Dex treatments over about a five-year period. Although not considered curable, my multiple myeloma has responded to its many treatments, and I am fortunate that it is in a stable state.

Looking back, I have been very fortunate with my cancers, especially in that they were detected early, and have responded to treatments. I have always kept a positive attitude and have always kept myself busy. Shortly after I was unemployed 22 years ago and received my initial cancer diagnosis, I found a new job. I then continued to work full-time for the next 18 years, semi-retiring at age 68.

Even now, at age 72, I still work part-time. Other factors that have helped me greatly over these trying years (besides keeping busy) has been having access to great medical care, having an employer who did not discriminate against employees with medical issues, eating healthy, getting plenty of exercise (running, jogging, bicycling), and most of all by having a great caregiver at my side at all times. My wife of 45+ years, who held a professional career herself, always put my health care needs first, and was always at my side every step of the way!

20 Years of Impact: 20 Voices of BCAN

For two decades, the Bladder Cancer Advocacy Network (BCAN) has been a beacon of hope, support, and advocacy for patients and their loved ones. As we celebrate 20 years of collective progress, we honor the voices that have shaped this journey—those who have faced bladder cancer with resilience, and those who have provided unwavering support.

Through our 20 Voices initiative, we are sharing powerful personal stories that highlight the impact of bladder cancer and the strength of our community. These voices reflect the challenges, triumphs, and hope that define BCAN’s mission for better todays and more tomorrows for all those impacted by bladder cancer.