Margo’s Story: “When Not Dying Is Enough to Keep Fighting.”

Margo Wickersham’s story is a powerful reminder that listening to your instincts can change everything. What began as a fleeting, easy-to-dismiss sign led her down a path she never expected. Through uncertainty, difficult decisions, and moments of profound isolation, Margo found strength, community, and a renewed purpose that now fuels her commitment to helping others facing bladder cancer. This is her story:

I had one symptom prior to my diagnosis, and it was blood in my urine on one morning and then not ever the rest of the day, blood in my urine the next day, and then never again. That’s all I had to go on.

After I discovered the blood in my urine, I went and had a lab done, gave a sample to see if it was a UTI, kind of hoping it was a UTI, and the lab called back and said, “Congratulations, it’s not a UTI.” I didn’t like what I knew “Doctor Google” said about the other options. So I did what I think a lot of women do: I called my OB. She has sort of been my general practitioner because GPs come and go. I called the nurse at my OB/GYN’s office, shared what had happened, and she said, “OK, well, let’s just keep an eye on that.” My gut instinct said nope, we’re not doing that.

Listen to Margo’s Podcast with BCAN

I didn’t have a urologist, but I found one who had a good reputation and made an appointment for two weeks after that. When I had the appointment with the urologist, he said, “Let’s do a cystoscopy and let’s also order an MRI.” It was this time of year, five years ago, right over Christmas, when all this was happening. I remember getting the MRI and it came back with nothing. I called the urologist and said, since the MRI didn’t show anything, I guess we don’t need to do the cystoscopy. They said we are going to continue and move on with the cystoscopy because sometimes it sees things the MRI doesn’t.

My birthday is the 28th of December, and I had just had the cystoscopy the day before. During the cystoscopy, I could look over and see a little willowy thing in the image, like a little flower, a little cauliflower, soft and wispy. The urologist called that a lesion. I told a friend of mine, who has the same birthday and is also a doctor, and she said, “Well, that’s a tumor, probably.”

What we needed to do was schedule a TURBT, the transurethral resection of bladder tumor, and we scheduled that for the first week of January. I had the follow-up on January 16th, and that is when the urologist said, “You have stage 1 aggressive bladder cancer.” Then followed plasmacytoid in the bladder. I was scared. I didn’t know what to do next.

The doctor explained that with stage 1 aggressive, high-grade urothelial carcinoma, the protocol is BCG therapy. There was a worldwide shortage. I knew to get a second opinion, and I did. The second opinion suggested that I get a blue light cystoscopy because 20 to 30% of the time, the staging is wrong. There was no blue light cystoscopy available where I live in Austin.

I found out there were three hospitals within driving distance, and MD Anderson was the one that started booking appointments as soon as they received my images. The first appointment at MD Anderson was March 2, 2020. I had not started treatments with BCG; they didn’t have any available.

At MD Anderson, it was Dr. Ashish Kamat. He said, “We’re not going to do a blue light cystoscopy,” because not only did I have stage 1 urothelial carcinoma, I also had plasmacytoid. Plasmacytoid doesn’t respond to BCG. It always comes back and it’s fatal. He said, if you do that, you probably won’t be here in a year. I asked, “What do we do?” and he said, “We throw the kitchen sink at it.” Chemotherapy, radical cystectomy, maybe a trial if I qualified.

We scheduled chemo to start the following week: four rounds of MVAC (methotrexate, vinblastine sulfate, doxorubicin hydrochloride and cisplatin). One of them is called the Red Devil. It was miserable. For me, each round took 30 hours. In the first round, my husband was with me, and then never again, because we were in the era of COVID. All my treatments and the eight days in the hospital for surgery were alone. It was awful, the most terrible experience I can remember having.

But today, here I am, 2026, and I’m still showing no evidence of disease. So it worked.

I had love and support from my husband, my grown children, and my friends, even during quarantine. People left meals in a cooler on the porch. Every nurse and employee at MD Anderson tried hard to pour extra love and support into us because we were there by ourselves. I was scared and sad and grieving my body the way it used to be. BCAN was a lifeline for me. They connected me with another woman with plasmacytoid who had survived, and that helped.

It is really hard to deal with this cancer. People don’t talk about it, and it is not anything to feel personal shame about. I decided that if I survived, I needed to help spread awareness and normalize the conversation. I wrote a book about my story, Gratitude in the Storm – When Not Dying Is Enough to Keep Fighting, as a sort of field guide and to inspire hope for others facing this disease. A portion of book sales revenue is donated to BCAN.

I encourage people to get support wherever they can, and to grab even the tiniest sliver of gratitude—clean water, eyesight, access to doctors—because the hardest days don’t last forever.

If I could talk to my newly diagnosed self, I would repeat what Doctor Kamat told me: most patients say that life after a radical cystectomy with a bag is not that big a deal and they wish they hadn’t worried so much. That has been true for me. Once you accept your new reality, it’s really not that different. I scuba dive. I do all the same things. My husband says, “I think it’s sexy because it means you’re alive.” Alive me with a bag is way cuter than not-alive me.