Bowel Obstruction & Ca. of Bladder

[Jay-Jay]

My husband has just been dx with Ca. of the bladder (urothelial carcinoma). He's also had 2 bowel obstructions, both of which resolved spontaneously. I've seen this sort of thing happen with Ca. of the prostate in advanced stages...bowel obstructions come and go, but eventually the bowel shuts down completely, and the end comes fairly quickly after that.

Are bowel obstructions common with urothelial cancer? So far, the doctors have said it was a psuedo-obstruction, but that was before they knew he had Ca. He has no appetite to speak of, and feels nauseated when he eats.

[DMB FAN2]

Sorry Jane- I guess I was off base a little......I am no expert on cancer by any means.....it was just a thought.....I hope things will start to look up for him and I will keep you both in my thoughts...

Best Wishes,

Lucy;)

[canoehead, BSN, RN]

So they haven't confirmed cancer, or any diagnosis that would spell certain death? Get him some TPN, and be aggressive! Either they treat him as a precious LIVING person, or they give you a reason why not! Bowel obstruction or an ileus would be completely understandable considering how sick he has been, and he will recover faster with good nutrition. Tell your husband you need him home and healthy- not to give up on you.

We are all here for you, and you know we'd be cleaning your house and making your meals in shifts if we could.

[leslie :-D]

i'm not sure about the tpn or hyperal would be indicated in the presence of bowel obstxn. jane, get your dh walking around, even if he doesn't feel like it. ambulating will be the best thing for his lungs and pseudo bowel obstxn. once some decent peristalsis returns, get him on an appetite stimulant like megace or remeron. for all you know, he might being having those bleeds from the renal cysts themselves. my goodness, what a deck you've been dealt. did you get me email?

[Jay-Jay, RN]

Yes, Earle, I did. Thank you very much! :kiss Sorry I didn't respond...I'm a little stunned these days. :imbar:

[Jay-Jay, RN]

Tina, they HAVE confirmed Ca. of bladder (see first post.) But I can't see it being advanced enough to be causing a bowel obstruction, as he's been followed by a urologist since 2002. I think he had a cysto done sometime in 2003, along with cytology study, and it was okay, except for showing some inflammation.

[leslie :-D]

jane, i just thought of something. is your husband taking any anticholinergic or antispasmodic agents for his bladder? either or both could cause profound constipation.........just grasping at straws here.

[aimeee, BSN, RN]

A course of steroids will sometimes decrease the inflammation enough to allow passage again, and the added benefit is that it stimulates the appetite too. Might be worth a try. ((((hugs)))) Jane, you've been through a lot.

I'm not much of a believer in megace as studies show that most of the weight gain is not in the form of lean body mass. An EPA fish oil supplement might be of benefit though.

[Jay-Jay, RN]

Earle, he's having diarrhea. Good theory, though. He's also been on morphine for bladder spasms, which would be another likely cause....those have eased now the catheter's been removed. They're using a condom cath instead. He wouldn't use one while at home, and I wound up changing a lot of wet bedsheets, clothing and soaker pads (he'd either soak right through his Depends, or not pull it up all the way after going to the bathroom.) NOW, he thinks the condom cath is a great idea. Go figure....

Aimee, I'm working with a fellow who's an expert in nutraceuticals and nutrition. He's got him on a whole bunch of natural supplements to fight the cancer, and heal his brain. One of them is an omega-3 fatty acid capsule (horse pill!) Unfortunately, Roger is having some lingering problems with swallowing due to the stroke, so he bites the capsule open, then grimaces at the taste. "YUCK!! Tastes like cod-liver oil!"

Well, DUUH! Yeah, it's FISH OIL! Whad'ya expect??

His appetite has improved a bit, but his weight has dropped from 190 to 145 lbs (since the end of January). From what I saw yesterday, he still doesn't have sufficient intake to prevent further weight loss. But, I'm cautiously hopeful that things WILL continue to improve....

We also have him on Psyllium and a probiotic to restore normal bowel function (the probiotic contains lactobaccillus and acidophilus bacteria, plus a supplement called Florastor.)

[leslie :-D]

have you read the latest articles on vitamin e PREVENTING bladder cancer? i don't know vit e's role in slowing its' progression but it has been in the news for the past couple of weeks. and actually, i love the idea of steroids, if used cautiously. they definitely would decrease the inflammation and increase the appetite. please keep us informed, we want to follow this so we can support you.

[TMnurse]

Very,very sorry to hear of your challenging situation. Stay strong as your husband needs you now more than ever. I was reading this thread and noticed that you mentioned that the urologist was out of town and nothing could be done until he gets back. To me, it indicated you are in smaller or more rural area if there is only one urologist. If so, it might be in your best for your husband to have a full work up at a university or more advanced center. I recently started working at a major academic hospital and everyday am amazed at what we can do and the second chances we provided where rurual and even suburban docs weren't yet aware of new treatments and/or have access in the newest interventional or diagnositic devices. God speed my thoughts are with you.

[Jay-Jay, RN]

No, TMNurse, this is a Toronto area hospital. I COULD have had another urologist look at him, but there was no point...I have since found out they can do NO invasive procedures until 6 weeks post-MI. A very sensible precaution, IMO, given what happened this time around!

Urologist is now back, and plans to schedule a biopsy for 6 wks. post-MI.

[canoehead, BSN, RN]

It's going to be hard to wait I think.