Liliana’s Story: “Just keep moving forward.”

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While training for a marathon, Liliana Martin first noticed blood in her urine. Despite initial tests showing minimal blood, doctors dismissed it as a side effect of running or a kidney stone. A year later, the blood reappeared more intensely while training for a different marathon. Urgent care led to a urologist, where a CT scan revealed a tumor. After a year of misdiagnoses, she was diagnosed with bladder cancer. She says that her experience emphasizes the importance of early detection and advocating for women’s health. This is Liliana’s story:

I had blood in my urine back in 2021. I was training for the Berlin marathon, so I made an appointment with my primary care physician, but by the time the appointment came, the blood wasn’t visible anymore. It was just a two-day thing, and then the visible blood went away.

I went to the doctor, and they took a urine sample. They said that there was still microscopic blood in it. The doctor thought that it might have been either because of the running or that I had passed a kidney stone. He asked me if I had had any pain and I said no, I hadn’t experienced any pain. He said, “Let’s just make sure and send you to a nephrologist.” Fortunately, I was seen right away, and I also went to the ER that very same day. I just had a feeling that there was something wrong. But at the ER, they saw the notes from the primary care physician, so they focused on my kidneys.

Nobody was looking at my bladder. Nobody thought it had anything to do with my bladder because I’m relatively young and female. It was not on anyone’s radar. I went to see a nephrologist and he said I didn’t have any issues, no kidney stones, nothing. He said, “It’s probably just the running.” I wasn’t comfortable, so I went and saw another nephrologist, and basically the same thing, “You’re super healthy. Your tests are coming out great.” They did an ultrasound of my kidneys and said, “Everything looks great. The blood went away. If it comes back, then we’ll follow up when it comes back.” So I continued just with my training. I was fatigued, but I was training for a marathon, so I didn’t have any frame of reference to compare it to.

I would do my long runs and would come home and sleep the rest of the day. I was so tired, but I always blamed it on the marathon training. I completed the Berlin marathon, and it went great. Then about a year later, almost to the day, I was training for the Chicago marathon, and the blood came back, but it was a lot worse. It was all blood. Then this time I said, you know what? I’m not going to wait to see my primary care physician because it’s going to be the same thing. By the time I get in, there’s not going to be all this blood, and I need somebody to see how much blood there is. So I just went straight to urgent care and I thought, if somebody can see what I’m seeing, maybe they’ll understand why I am feeling so stressed out about this.

Thankfully, I was lucky. My urine was like cranberry juice. The doctor there said, “This is not okay. You need to see a urologist right away.” It took a full year from the first onset of symptoms for me to see a urologist. Actually, when I went, the first appointment available was with a nurse, and I took it. If that’s the fastest I could get in. I asked the nurse, “Could this blood be related to running because that’s what I’ve been told all along?” She said, “No, that’s only for men. Women don’t develop blood in their urine from running.”

At that moment, I felt this massive weight. They did a CT scan, and they saw something in my bladder but weren’t sure what it was. The nurse called me and said it was probably a blood clot, and it was nothing to worry about. Then I went and had a cystoscopy and it turned out that it wasn’t a blood clot, it was an actual tumor. This was now 2022. It took exactly a full year from when I first started bleeding to get diagnosed.

It turned out that I had high grade, non-muscle invasive bladder cancer and it was more aggressive. From what I understood, if it had been diagnosed right away, I would not have had to eventually undergo chemotherapy. By the time it was diagnosed, my bladder cancer was already advanced.

I once met a man in his late 60s. As soon as he presented with blood in his urine, they immediately sent him to a urologist. He was diagnosed within two weeks and had no chemo. I had to undergo 15 rounds because of my delayed diagnosis, so it was hard.

Once I was diagnosed, I had to have surgery, a trans urethral resection of bladder tumor (TURBT) to have the tumor removed. Then they called me back for a second surgery, and they said that it was to ensure that they had been able to remove the entire tumor. They were about a month apart. After the second surgery, it was a little frustrating. I’m really lucky because I live close to a really good hospital, Northwestern Memorial in Chicago, which has good doctors. It was frustrating that even at a good hospital, there was so much miscommunication and misinformation. The original urologist told me that if during the second surgery, they didn’t find any cancer or any traces of the tumor, I wouldn’t need to have any additional treatment, that they would just keep me going back every so often for checkups. If I did need treatment, it would probably be milder than chemo. I didn’t think that sounded too bad.

I went back to the second surgery, and they told me I was clean, so I was extremely excited. They set up an appointment with another urologist who’s also an oncologist. Then the oncologist said, “You actually do need to have chemo.” It was so devastating. If they hadn’t told me before that I wouldn’t need it, I wouldn’t have taken it so hard.

It was very difficult, but the lucky thing is that the oncologist also happened to be training at the same time for the same marathon that I was training for. I asked him, “Do you think I can keep on running?” And he said, “Keep on running. It’ll help you heal, and it’ll help you undergo the chemo treatment a lot better.” I just kept on training, and honestly, that’s what got me out of bed many days because I did not react well to the chemo. I don’t know how people do it. I got really frustrated when I read an article recently about King Charles because they were speculating whether he had bladder cancer in the New York Times, and a urologist said that bladder cancer is more of a nuisance than an illness.

I read that, and thought, “No, this is not a nuisance. It’s more than a nuisance.” I get emotional because you don’t understand how painful this is. They would put this chemo in and my whole body was on fire, and then I would be nauseous for the entire week. I was barely starting to recover, and then I had to start all over again. At some point, they started letting me come home with the chemo. I had to hold it for 90 minutes. I mean, that was better than staying at the hospital, because at the hospital, every minute felt like an hour. So at least when I was home, I could be with my dogs, my cats, and my bed.

I was also new at my job, so I couldn’t tell anyone at work what was happening. I had to switch my schedule around so that I would have Friday mornings free so I could get my chemo, and then once done with chemo, I had to go back to work. I was trying to keep everything under wraps because I didn’t know what kinds of biases people were going to have, or if they were going to think I couldn’t do my job.

I was getting really bad nausea and was wearing armbands that they use for seasickness. Then, I was put on ondansetron. It was a very odd thing, but I had this weird craving for olives, and I never liked olives. My husband would go to Costco and get me the massive jars of green olives, and there just one after the other, I would go through jars and jars.

One of my friends who knew, said, “Let’s plan something for when you complete chemo, and that will give you something to look forward to.” So we planned a trip to Florida to celebrate the end of chemo. That was nice. She bought me two blankets to take with me to chemo to stay warm. It was just those little details like my husband taking off work to take me to my appointments. It was hard because my daughter was in high school at the time, so she had just gone to college. I was kind of glad in the sense that I could be home and be sick and not have to put up a happy face and front because I think that if she had been around, I probably would’ve tended to just play it strong.

I discovered a lot of interesting things, and I even changed my diet. I started Googling whether there were certain types of foods that were beneficial, especially if you were undergoing treatment. I started eating a lot more cruciferous vegetables, stuff that I never liked. I never liked the taste of broccoli but suddenly started liking it, which was unusual for me, but now I love it. My body was guiding me to what I needed. I was able to complete six rounds of chemo weekly and then run the Chicago marathon and continue with chemo afterward. Then it switched to monthly. I ran another marathon while I was still on the monthly chemo, the Paris marathon.

The Paris marathon became my fastest marathon at the time, which was insane. I couldn’t figure it out. That running felt so easy compared to the feeling of being on chemo. Twenty miles doesn’t hurt at all in comparison to what chemo was making me feel. I started doing a lot of research, and I came across the BCAN website and saw a particular story of a woman named Pat who was also a cyclist and a runner, and how her symptoms had been dismissed for a UTI.

It makes me upset that women were not being treated promptly and were being dismissed. I decided that I needed to start talking to people about it. I didn’t tell anyone about my cancer except my family. Now, I want to tell people so that they know that if they present with these symptoms, especially women, they need to push and keep pushing until they get the correct diagnosis.

I completed my chemotherapy in March of 2023. I’m still under observation because, during the second to last cystoscopy, the doctor saw a dark spot on my bladder and said, “We’ll keep an eye on this one.” By the next one, it had disappeared. Since the first time I walked into the doctor’s office, I’ve been a different person. I walked into that office not knowing what was coming and not even thinking about cancer. It was not even on my radar. Now when I walk into a doctor’s office, I’m very, very humble.

It’s going to be okay. Just keep moving forward. That’s what the marathon training did for me. Putting one foot in front of the other, even if slow, just moving forward.