Click here to watch Coach Prime’s full press conference At a routine checkup this spring, doctors noticed something unusual in a CT scan of University of Colorado football coach Deion “Coach Prime” Sanders. The scan showed a mass on his bladder.

He was immediately referred to the CU Anschutz Medical Campus where he met with Janet Kukreja, MD, director of urologic oncology at the CU Cancer Center and UCHealth University of Colorado Hospital. After a thorough examination, Coach Prime was diagnosed with a malignant tumor in his bladder.

 It was the most common form of bladder cancer, yet it was serious. The tumor hadn’t reached the muscle layer but was considered “very high risk” with a 50% chance of recurring or even progressing after treatments in the bladder. While Coach Prime could have gone anywhere for his medical care, he chose CU Anschutz to continue his treatment and care. 

The sprawling academic medical campus, which includes two world-class hospitals and thousands of University of Colorado researchers, is a national leader in cancer care including bladder cancer.

Treatment advances: robotic surgery, new drug therapies

 Using advanced robotic surgery, doctors at the CU Cancer Center can now treat bladder cancer in ways that are less invasive and traumatic for the patient. They have also developed innovative drug therapies and treatments for the disease. 

Kukreja is one of a small group of surgeons in the U.S. who not only perform robotic removal of the entire cancerous bladder – called a radical cystectomy – but also robotic reconstruction of the organ. Kukreja performs over 150 radical cystectomies annually, using the Da Vinci Surgical System. UCHealth and the CU Cancer Center lead the nation in the number of procedures.

 Kukreja, aka “Dr. K,” and Coach Prime come from different professional worlds yet share things in common. Both lead dynamic teams in high-stakes arenas. Sanders presides over Xs and Os and inspires weekend warriors to game-changing performances. Kukreja also operates in an arena of precision and collaboration aimed at delivering decisive outcomes for her patients. Intense, yet low-key, Kukreja focuses on the science. “Most of what I see is cancer that’s still limited to the bladder and possibly including lymph nodes in the pelvis. The way we stage bladder cancer is based on how invasive it is into the bladder wall,” she said. “So, there’s a surface layer, a small fatty layer beyond that and then the muscle layer. We stage it as non-muscle invasive bladder cancer or muscle-invasive bladder cancer.” Surgeons who specialize in extremely tight spaces of the body, including the brain and organs within the pelvic cavity, have debated for the past couple decades the virtues of robotic vs. open surgery. “Everybody trained one way thinks their way is the right way,” Kukreja said. “I can do both open and robotic, but I much prefer robotics. There is less blood loss, less transfusions, smaller incisions, less hospital stay (three to four days vs. seven to 10) and quicker recovery.” 

Options for urinary diversion

After removing a cancerous bladder, the surgeon must also create a urinary diversion. They have three choices:

• A neobladder. A new bladder is created by stitching together a section of the small intestine called the ileum.
• A urostomy. The surgeon routes a section of the ileum to an exit point near the belly button. Urine collects in an external bag.
• An Indiana pouch, or continent cutaneous diversion. An internal pouch is created that is emptied by catheter through a small opening in the skin. 

Kukreja said the Indiana pouch requires being emptied regularly and sometimes leaks. The urostomy requires an external bag, so, increasingly, patients are opting for the neobladder. (Kukreja is leading a pilot project that helps cystectomy patients decide on their preferred urinary diversion). 

Outstanding news for Coach Prime

 Sanders’ surgery took place in late spring, and the news was outstanding. “He’s fully recovered and cancer free,” Kukreja said. “We’ll do periodic scans according to the National Comprehensive Cancer Network guidelines.” Men account for about 63,000 of the estimated 83,000 new cases of bladder cancer in the U.S. each year. Bladder cancer is the fourth most common type of cancer in men behind prostate, lung and colon cancers. It’s less common in women. Studies show smoking is associated with about 50% of the bladder cancer cases. The disease is not typically hereditary.

To learn more about the ground-breaking work on bladder cancer research being done by Dr. Kukreja and the CU Cancer Center, please visit:www.news.cuanschutz.edu.  

More from CU Anschutz: What you need to know about bladder cancer.