Jake’s prostate cancer, diagnosed 16 years earlier, was finally catching up with him. Surgery and radiation therapy, then hormonal treatments and a series of investigational drugs, had each worked for a time. But lately nothing seemed able to stop the relentless growth of his tumor.
It hadn’t spread to his bones, as is common with advanced prostate cancer. Instead there was a progressive increase in size. The tumor had filled much of the space inside Jake’s bladder, blocking the flow of urine through the urethra. His urologist had had to rearrange his plumbing, surgically diverting the ureters (the tubes connecting the kidneys to the bladder) away from his bladder and out through his abdominal wall to a bag that collected his urine. A plastic tube had also been placed in his now-nonfunctional bladder, draining any secretions out to another bag. Despite all this, 90-year-old Jake remained robust and fully in command of his business, a successful manufacturing company.