News

Operation involves making new bladders

John Daniels

Caption: John Daniels at home in Birch.

9 January 2013

Colchester General Hospital has become one of only a handful of hospitals in the UK to carry out neobladder surgery.

The highly technical operation involves using bowel tissue from a patient with advanced bladder cancer to create a new bladder.

The new bladder (neobladder) is connected onto the urethra (water pipe) in the same operation in which the original bladder is removed (cystectomy) in order to allow the patient to urinate normally.

So far, Mr John Corr, a consultant urological surgeon based at Colchester General Hospital, has carried out five neobladder procedures at the Essex Urological Cancer Centre which was established at the hospital in November 2006 for patients from all over north and mid Essex needing highly-complex procedures.

He learned neobladder surgery at the world-renowned Memorial-Sloan Kettering Cancer Centre in the New York, where he had previously spent two years on a fellowship.

The best-known person to have neobladder surgery is Dame Mary Archer, wife of novelist Jeffrey Archer who had the procedure in 2011 at Addenbrooke's Hospital, Cambridge.

The first person to have the operation at Colchester General Hospital is John Daniels, aged 58, of School Hill, Birch.

He decided to go ahead with the operation, which lasted five hours, after Mr Corr explained the alternative would be that he would need a bag (urostomy bag) on his abdomen to collect his urine for the rest of his life.

"For me, it was a no-brainer and now when I look back I know I made the right decision," he said.

"It hasn't left me with any restrictions at all and I'm now looking forward positively to the year ahead.

"Mr Corr has asked me to talk to other bladder cancer patients who are thinking of having the procedure and it has been my pleasure to recommend it to them wholeheartedly.

"During all the time I spent in hospital, including at Essex County Hospital where I had chemotherapy before the operation, the staff I met were brilliant. I know that if I had gone private, it could not have gone any better."

Mr Daniels, who with his wife Lyn has twin sons and seven grandchildren, has gone back to running his WOW Travel business, including driving clients.

Mr Corr said: "The main advantage of the operation is that there is no need for an external bag - which makes a great difference to a patient's quality of life - and they can urinate naturally.

"It is important to stress that only a minority of patients with advanced bladder cancer are suitable for the neobladder procedure.

"I spoke to Mr Daniels about it extensively beforehand and from the very beginning he had an extremely positive attitude.

"It is a major operation but I am sure that his attitude has contributed to the excellent recovery he has made."

The operation involves removing a length of bowel tissue (small intestine) and then fashioning it into the pouch-like shape of the bladder and then carefully stitching it to the position of the original bladder.

Bladder cancer is the sixth most common cancer in the UK, with more than 10,000 cases diagnosed every year. About 3 in 10 bladder cancers, including Mr Daniels', have grown into the muscle layer of the bladder and are known as "invasive bladder cancers".

Colchester Hospital University NHS Foundation Trust, which includes Colchester General Hospital and Essex County Hospital, has a long track record of participating in national and international cancer studies, including for urological cancers.

For example, last year (2012) Dr Bruce Sizer, a consultant oncologist based at Essex County Hospital, who was also involved in the care of Mr Daniels, co-authored a research paper in the prestigious The New England Journal of Medicine (NEJM) that is giving new hope to patient with advanced bladder cancer. In an accompanying comment piece, the NEJM described it as a "landmark study".

It found a 13% increase in the survival rate of patients who are treated with a combination of radiotherapy and chemotherapy rather than radiotherapy alone.

A total of 35 patients with advanced (muscle-invasive) bladder cancer were recruited to the clinical trial from Essex County Hospital between August 2001 and April 2008 - almost 10% of the total number of patients in the trial (360) and more than from all bar two of the 45 centres taking part.

Mr Corr was involved in a research project that looked for new biomarkers - a term used to refer to a protein measured in blood whose concentration reflects the severity or presence of a disease - for prostate cancer.

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