With Help from Kaiser Permanente, Patient’s Bladder Cancer Cured

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An innovative operation resulted in a new bladder for Henry Diaz, who after cancer has resumed an active life. Pictured above, Diaz with his surgeon, Joseph Presti, MD.

Henry Diaz of Hayward, California, doesn’t complain.

While some may say that every day is a gift, he believes it. High on his gratitude list is family and friends.

And his health.

Diaz’s glass half-full approach to life is in response to making it through the toughest challenge imaginable — a cancer diagnosis, chemotherapy, radical surgery, and recovery.

A Fast-Growing Tumor

Diaz, 55, began experiencing pain urinating in 2014. His kidneys and back hurt. But he didn’t have any health insurance at the time, so he let it slide.

Diaz’s mother had had kidney stones, so that was his immediate concern.

Eventually, it got so bad he paid out of pocket to go to Urgent Care at a local hospital. Later, referral to another hospital resulted in tests showing Diaz had a 3-centimeter tumor in his bladder. Alarmed about both his health and the potential costs, Diaz told his boss at the time about the crisis.

Diaz was put on the insurance plan for Kaiser Permanente coverage — where he was about to experience speed and integrated care from a whole team of physicians.

Fast-Tracked to Fight Cancer

Diaz first saw Eric Brondfield, MD, Internal Medicine, at Kaiser Permanente San Leandro, who ordered blood and urine tests. A little over 3 hours later, Dr. Brondfield called Diaz, asking him to come in immediately for a CAT scan.

“The reading came back the next day, a Friday,” Diaz remembered. He immediately saw urologist Gregory Chen, MD. “He said the tumor was now 4 centimeters — it had grown a centimeter in a week,” Diaz said.

Back after the weekend, Diaz underwent endoscopic surgery in San Leandro that involved cutting the tumor into small pieces and assessing whether it was invading into the muscle wall of the bladder. That Friday, Diaz returned to Dr. Chen’s office, where he learned a biopsy had confirmed cancer and that it was invasive.

By Monday, he was seeing Derek Shek, MD, an oncologist, who arranged to have a port inserted into Diaz’s body on Wednesday. That Friday, the chemotherapy began.

Chemotherapy — and an Inventive Solution

Henry Diaz had chemotherapy treatments for 4 months, from October 2014 through February 2015. Then, after a 2-week break, Diaz geared up for yet another hurdle: 6 1/2 hours of surgery performed by Joseph Presti, MD, a urologic surgeon at Kaiser Permanente Oakland. It involved removing the prostate, bladder, 9 lymph nodes, and 18 inches of small intestines.

“Dr. Presti was very communicative and frank. He told me I had to have the surgery,” Diaz said.

There was some good news that day, though.

In addition to removing any cancer, Dr. Presti took Diaz’s small intestines and fashioned something called a “neo bladder,” essentially a new bladder that would save Diaz from having to have a bag outside of his body collecting his urine.

Adjusting … Yet Thriving

“Mr. Diaz was in good health and also motivated,” Dr. Presti said of the decision to create a neo bladder for his patient. While the surgery can have some side effects, including an excess of acid in the blood stream or anemia, Diaz recovered successfully and has been cancer-free ever since.

“I had to learn to urinate again,” Diaz concedes. “A normal bladder holds 12 ounces; my neo bladder holds 4.” Undaunted, however, after recovery Diaz drove with his 29-year-old son from California to Tennessee, and back again. He has a new job and is now a grandfather.

“Throughout, Dr. Presti and Dr. Shek have called me just to see how I am doing,” Diaz added.

Dr. Presti is part of a multi-disciplinary team based at Kaiser Permanente Oakland that includes medical oncologists, urologists, radiation oncologists, pathologists, and a urologic oncologist, Andrea Harzstark, MD.

Doctors Presti and Harzstark run a medical review of patient urologic cancer cases and have developed a protocol for bladder cancer that is a model for other physicians throughout the Kaiser Permanente system. Their ability to advise patients and other clinicians, in effect lending their expertise throughout Northern California, benefits people such as Henry Diaz, who is not only alive thanks to his cancer care — but living well.

Discussion8 Comments

  1. What a great news, inspires many to keep up and to lift up the good chi. I feel very lucky to work for this organization in which Thrive* is targeting health for so many. Cheers.

  2. Christopher Chang

    As a new employee of Kaiser Permanente and new insurance holder to Kaiser Permanente, I am so proud to be a part of this company. Workers here are motivated and hard working, I have learned so much from the laboratory department.

  3. That was a very awesome story, unfortunately a very close aunt of mine lost her battle with bladder cancer. After the removal of her bladder and having an external bag for her urine. It was very challenging the short time he had to deal with that. But I am so inspired to work for a company that is making strides in this fight against cancer and making such a quality of life for those who have to fight this battle. Kudos to all the team that took control and came together to help Mr. Diaz. God Bless them all!

  4. Joanna M. Garaventa

    Dr. Presti and his team performed my partner’s bladder cancer operation in April of 2016. She had a similar case of bladder cancer and also received the neo-bladder. Cheryl is back to work and thriving.

    I’ve worked in the healthcare field for more than 35 years (more than 22 with Kaiser Permanente) and have rarely seen such a talented, compassionate and caring physician.

    I thank God each day for Dr. Presti, his team and all of the clinicians and staff who have helped Cheryl recover from bladder cancer.

  5. What a God-sent group of care-givers, how everyone played their parts in saving this man’s life, a little piece here a piece of something there, treatments here all worked together to save this man. I am almost in tears thinking that that could have been me, OMG, Kaiser Permanente, what a medical team.

    God Bless you all and your families and Kaiser Permanente.

  6. I am curious if the Bay Area protocol for bladder cancer includes pelvic health physical therapy services like it does here in the North Valley. I did not see it mentioned in the article.

    • Lynn Mundell

      Joseph Presti, MD, replies:
      Yes, we do have a physical therapy program provided by some of the centers. For example, San Francisco, Santa Rosa, and San Jose have physical therapists who work with men for urinary issues.

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