Duke’s Story: “It all comes down to the choices that we make in life.”

Duke Dahlin never imagined that traces of blood in his urine would later lead to a diagnosis of stage two bladder cancer. After a challenging recovery and with the support of family and BCAN, he navigated this journey and has returned to doing the things he used to love. Duke’s journey highlights the importance of a positive mindset and resilience. He says it is important to advocate for yourself and stay strong. This is his story:

The initial symptom that I had of bladder cancer was that I started to urinate blood.  Being an athlete, I’ve had things that happened to me in the past, like chronic fatigue, and you think, “Okay, this is just a passing phase. This will just pass.” Then about a week later, it looked like it was getting better, but it got worse. Suddenly, I started to urinate little chunks of blood, and that caught my attention. As a veteran, I figured I’d better call the VA hospital and tell my primary care provider what was happening. I called and they told me to come in right away. This was May of 2023.

See a list of VA Hospitals by state

I was initially sent to urology, and they did X-rays, an ultrasound, and CT scans. They said they saw something but weren’t sure what it was but suggested it could be cancer in my bladder. I was told they would have to perform another test to be sure. Come July, they did a trans urethral resection of bladder tumor, a TURBT, and that is when they confirmed that I had stage two bladder cancer.

I had organized a swim team to swim the English Channel in 2023 and didn’t want this to interrupt our swim.  I was told I could keep training and that it would be taken care of when I got back from England.  Our team had a successful swim and now has the record of being the oldest American mixed relay team of two women and four men to accomplish this feat.

I got back from England at the end of August in 2023, and I started systemic chemotherapy the first week of September. I had five treatments of chemotherapy.  Initially, I was scheduled for eight chemo sessions, and by the fifth, they said there was something else that was going on at the time, and said, “Okay, we’re looking at you to see if you need any more chemo, and we decided that you don’t.”

They inserted a PICC line in my arm and kept it there for the whole period that I was getting chemo. They had also inserted an IVF filter because they found a blood clot and wanted to make sure that it wasn’t going to affect the chemo, and then later on, the operation.

They never tell you what can happen when you have chemotherapy, and I wasn’t ready for all the side effects. The chemo didn’t affect me until after the second session. I had nausea and a hard time eating. It took away my energy. I just felt so tired all the time, and that was something I wasn’t familiar with.

After my first treatment, I ended up back in the hospital for three days with pancreatitis.

The chemo had triggered some side effects.  After a few more treatments, I had a low white blood cell count, and then I also had low potassium. I thought, “What is going on?” I always prided myself on healthy eating and exercising a lot. Then to have bladder cancer happen, I felt like my body had betrayed me.

Originally, I was told I had non-muscle invasive bladder cancer. However, when they went back and looked at it later on, they said it was protruding right through the muscle. So I had muscle invasive bladder cancer.

Because of this diagnosis, I was scheduled for surgery in December of 2023.  I had a radical cystectomy with an ileal conduit which means they removed my bladder and prostate.  The surgery took eight hours.

I was told it was going to take me six to eight weeks to fully recover.  Every day, I would get up and try to exercise as much as I could. One day, my husband and I went for a walk, and then suddenly, I found myself short of breath, and having a hard time while walking up a hill. I thought to myself, “Okay, just take your time and relax. You’re going to be fine.” As we were getting closer to home, I blacked out and fell. My husband tried to catch me, but he fell backward and ended up injuring himself.

We both got up to walk back home and I blacked out again. We finally made it home, but my husband had an eight-inch gash in the back of his head. We’re both veterans, so we Ubered to the Veterans’ Emergency Care Hospital where he got 22 staples in his scalp.  In the meantime, I was still thinking about why I had blacked out.

When we got home that day, the surgeon called and said I needed to come back in immediately. I was extremely tired, so I went in the morning the next day, and that was the beginning of five sessions of a liquid infusion, but it turned out that I was dehydrated which is why I blacked out. Ever since then, I’ve been hydrating.

Overall, my recovery period was about three months. It wasn’t easy but when I look at myself and how I’ve recovered, I think I’ve done really well.  I joined a bladder cancer support group from the University of California San Francisco, so I’ve been doing that for the last five months. Every month they have a session and I get to talk and listen, to other men and women, about their situations.

About a month after they took my bladder out, they did a biopsy and the oncologist told me I was cancer free. It caught me off guard. When I got home, I thought about it and wondered why they removed my bladder if I’m cancer free. They told me if they didn’t remove my bladder, chances are that the cancer would come back. Listening to the people in my support group helped me understand that better.

However, I found myself angry at times because of how it affected my body image. Not being able to urinate the way I used to; it changes your whole life.  For the most part, I’m pretty positive about things. What I found is that if you don’t have a positive mentality, there is no way in hell you can get through anything in life. Having a positive attitude has gotten me through the worst times.

Things did get better after the surgery.  More recently, my husband and I had scheduled a cruise to the South Pacific, and we just got back a few weeks ago. We had a great time. We flew into Auckland, New Zealand and stayed there for a few days.  We caught our cruise ship in Auckland and began our trip to Teranga, NZ then to Fiji, French Tahiti (Papeete and Moorea), Hawaii, and back to San Francisco.

After the cruise, I was feeling a little more hopeful, but it took time. I wanted to return to swimming.  I just started swimming again.  I’m up to 2,000 yards in the pool.  I plan to start swimming in the San Francisco Bay soon. For now, just short swims.  Getting back into the pool was great!  However, getting back into the bay will be more difficult.  Before we left on our cruise, I was able to do a couple of short swims in the bay.  I noticed that I no longer have the same tolerance for cold water.  I need to listen to my body.  One thing I’m learning is to be patient and don’t push myself too much. 

When I was in the military, I was stationed in Vietnam.  I often wondered if my exposure to Agent Orange had caused any effects on me.  There is no “test” for Agent Orange, but there are effects and finally, after being diagnosed with sleep apnea, severe hearing loss, a stent in my left artery, and now bladder cancer, I’ve been awarded a 100% disability.

See BCAN’s list of resources for veterans

It all comes down to the choices that we make in life.