Debbie’s Story: “At the start of my journey, I didn’t believe positivity mattered, but now I do.”

What began as a winter in Florida quickly became the start of an unexpected and life-changing journey for Debbie Pratt. From an initial diagnosis, she faced countless challenges, major surgeries, and rare complications along the way. Through it all, she leaned on expert care, the support of loved ones, her passion for cycling, and resources from BCAN to stay strong. Today, she continues treatment while embracing life with resilience and hope—sharing her story to inspire others navigating bladder cancer. This is her story:

My bladder cancer journey began in 2020 while spending a winter in Florida. My first real symptom was incontinence. Like many women, I thought bladder leaks might just be something I could manage with diet, and for a while, that seemed to help. But when the incontinence worsened, I went to see a doctor. At first, I was diagnosed with a UTI and put on two rounds of antibiotics. When that didn’t work, I was referred to a urologist.

Getting an appointment with a urologist took time.  Then she had me track my fluid intake and urine output for almost a month. By the time she performed a cystoscopy in February, a tumor the size of a quarter was found in my bladder. She performed my first TURBT in March 2020. Unfortunately, she wasn’t able to remove all of the tumor. The pathology report from the surgery confirmed T1 high grade bladder cancer.

At that point, I decided to return home to Pittsburgh and sought care from the UPMC Hillman Cancer Center, an NCI institution. There, I underwent another TURBT that was successful. I was fortunate that UPMC was performing this surgery during COVID.  I subsequently had BCG treatment; it wasn’t successful.  This was shocking to me.  I thought my active, healthy lifestyle (I was cycling 100/miles per week that summer) would have helped BCG to be successful. So, another TURBT was needed and performed in July 2020.

After more consultation with my urologist in Pittsburgh, I made the difficult decision to have surgery. In September 2020, I underwent a cystectomy and hysterectomy with an ileal conduit. That was a major turning point, the first big phase of my journey.

The first problem occurred just months later in November 2020.  An omental evisceration occurred through the vaginal wall.  This is a very rare problem taken care of by surgery.

Things were stable for a while, but in May 2022, during a routine scan, I was diagnosed with stage 4 urothelial carcinoma that had spread to my lymph nodes. A biopsy confirmed it. I immediately began chemotherapy, which I completed successfully.   I then began two years of maintenance therapy with avelumab. Thankfully, I tolerated it very well and was able to live a very active, healthy life. I completed that treatment in October 2024.

Just six months later, with no ongoing treatment, my cancer returned. In May 2025, I started on the newest treatment available at the time—Padcev combined with Keytruda.  Another unexpected turn occurred. The cancer metastasized to my adrenal gland, which I’ve learned is extremely rare for bladder cancer.  The chief endocrine surgeon at UPMC in Pittsburgh, who performed the surgery to remove the gland, told me I was the first patient she had ever seen with a metastasis caused by bladder cancer.

The good news: I’m cancer-free again.  This was confirmed by a CTdna blood test and a CT scan.  I’ll continue the Padcev/Keytruda treatment for approximately two years.  Hopefully, it will knock out this cancer once and for all.

Looking back, this journey has truly been filled with both emotional and physical challenges.   Expert treatment, support from family and friends, research, and staying positive have helped me along the way.

Hearing the word “cancer” for the first time was terrifying, but hearing “stage 4” was overwhelming. The day I got the biopsy results confirming stage 4, I was sitting on my patio at home. I remember reading it on my health app, breaking down in tears, and then, almost immediately, turning to a BCAN webinar to learn everything I could. I’ve always been someone who researches before meeting with my doctors. Knowledge gave me mental strength as I walked into appointments.  My sister was so helpful in finding the right articles during my journey that I called her my “VP of Research”.  And I stay abreast of new developments with bladder cancer, especially since this disease has a high rate of recurrence.

Finding the best healthcare you can is critical.  Don’t ever be afraid to get a second opinion or change doctors if you feel you’re not getting the right care. You’re not insulting a professional—you’re advocating for yourself.  I’ve been fortunate to be treated at Hillman Cancer Center, and every issue in my treatment has been coordinated by my oncologist, Dr. Roby Thomas.  He’s my quarterback!

Staying positive, though, has been just as important for me. When I was diagnosed with stage 4 bladder cancer in June 2022, I leaned on something that had always been a personal measure of my health: cycling. I’ve been an avid cyclist for years, and every September, around my birthday, I would ride the number of miles in one day that matched my age—60, 61, 62, and so on. Facing cystectomy in 2020, I worried I wouldn’t be able to complete my 67-mile ride. But my husband gently reminded me that I was ready for the ride and should do it before surgery.  I did!

Two years later, though, at age 69, I knew I couldn’t manage the full ride because of the chemotherapy treatment.   I came across an online fundraiser for the Children’s Cancer Network, which lets you set your own cycling mileage goal while raising money for pediatric cancer research. I remember when I was first diagnosed, I often reminded myself that, as much as I wanted to keep living, children with cancer hadn’t even had the chance to live. That perspective helped me avoid self-pity.

So, I set a goal: 69 miles across the entire month of September. As it turned out, chemo kept me from reaching that distance—I only managed about 50 miles—but the effort gave me something positive to focus on. Through social media, family, friends, and my community in Florida, we raised $14,000 for children’s cancer research. It was such an uplifting experience and reminded me that staying positive isn’t just an empty phrase—it truly matters. At the start of my journey, I didn’t believe positivity mattered, but now I do.

And the small gestures of support from friends and family during my journey have been incredibly important to staying positive.  One cannot imagine how an unexpected greeting card, phone call, or in-person visit can lift the spirits.

I’ve also leaned heavily on BCAN throughout these years. In fact, my urologist in Pittsburgh handed me BCAN’s Bladder Cancer Basics when I was first diagnosed with T1 high-grade bladder cancer, telling me it was the best resource out there. He was right. Every step along the way, BCAN has given me information that prepared me mentally for what was coming—whether it was TURBT, BCG, cystectomy, or stage 4.

What I’ve come to realize is that cancer is not automatically a death sentence. You can still live a healthy, active life. I bike, I kayak, I travel—and I continue to move forward.