The year is 2008. This year, Jan Erik Pedersen ends by slamming his fist on the table at his GP in frustration. This autumn, he has taken five courses of antibiotics to prevent a urinary tract infection. But it doesn’t work. The blood is still visible in the toilet bowl. Something isn’t right. After five courses of antibiotics, he is referred to a urologist. He has to ask for it himself, but it takes four months before the urologist can take him in. news has been in contact with the GP, who does not wish to comment on the matter. In March 2009, he receives a cystoscopy examination, before the specialist delivers the discouraging words: You have cancer. Jan Erik has a yellow bow tattooed on his hand. It’s the bladder cancer ribbon. – I got it tattooed after ten years with the diagnosis, he says. Jan Erik is a board member and peer in Bladder Cancer Norway. Now he spends time ensuring that others who come into the same situation have access to information. On the bench in the hallway is a stack of brochures. – I leave them at the doctor’s office to spread information, he explains. Although Jan Erik has a role in Bladder Cancer Norway, he tells his story as a private person. For the next five years after 2009, Jan Erik is more in the hospital with infections than at home for periods. He has also had several relapses with cancer. Jan Erik has now removed cancer from the bladder a total of nine times. The last was in December 2018. Jan Erik Pedersen when he was admitted to the hospital in May last year. Then with an infection in the bladder. Photo: Jan Erik Pedersen / private – It’s in the back of your mind all the way. It has become such that I look down into the dosing bowl every time I go to the bathroom, to see if I can see a hint of blood, he says. In meetings with like-minded people, he feels that GPs do not think enough about the possibility of bladder cancer. – It is terrifying. My thought is, rather send one time too much for cystoscopy than one time too little, in the case of visible blood in the urine, he believes. – Happens to many The story of Jan Erik is not unique, according to Ranveig Røtterud, who is the general manager and specialist in Bladder Cancer Norway. – Unfortunately, this is not the most extreme story we have. We have carried out surveys which confirm that misdiagnosis by GPs is common, says Røtterud. Bladder Cancer Norway’s internal investigation shows that every third patient had been treated as if they had a urinary tract infection. She emphasizes that it is in no way the association’s intention to single out either individual doctors or general practitioners as a group. – Once we have gained knowledge of this relationship, we owe it to future patients and everyone around them who are affected by illness to go ahead with the information to those who can benefit from it, she says. Ranveig Røtterud is general manager of Bladder Cancer Norway. She is also a cell biologist and has a PhD in Bladder Cancer. Photo: private She has spoken to patients who have spent more than three years with their GP, without being referred, with regular or recurring blood in their urine. The reason may be that bladder cancer generally receives little attention, she believes. – We do not think this is due to carelessness on the part of GPs, or that the disease is not taken seriously. The disease is greatly under-communicated, and we believe that GPs should keep bladder cancer a little further in mind when a patient comes in with visible blood in the urine, she says. It is the fifth most common form of cancer among men, and these make up 70 percent of patients. Figures from the Cancer Registry show that approximately 1,850 new patients with bladder cancer are registered annually. Over 16,500 live with the disease. – On average, one person dies from this type of cancer every single day in Norway. It is a serious illness, says Røtterud. Bladder cancer Urinary tract cancer or bladder cancer is the fifth most common form of cancer among men in Norway. Around 1,850 people are affected annually. Three out of four people affected are men, and smokers are particularly vulnerable. Visible blood in the urine is the most common sign of bladder cancer. Other symptoms of bladder cancer are pain in the bladder area or other changes in urination. Source: Bladder cancer Norway Gets support from urologist Truls E. Bjerklund Johansen is a urologist and professor at the Department of Clinical Medicine at the University of Oslo. He agrees that bladder cancer is under-communicated and recognizes the problems described by Bladder Cancer Norway. – Yes, this is unfortunately a familiar situation for urologists, he says. – Do you feel that GPs can be a little more observant of bladder cancer? – Individual cases may indicate that. But of all patients who come to the GP with symptoms from the lower urinary tract, only a very small proportion need further investigation. If there is visible blood in the urine in patients who have no other obvious cause, such as a kidney stone that is on its way out, the alarm bells should ring, the doctor explains. Have recently informed GPs about bladder cancer Marte Kvittum Tangen is head of the Norwegian Association for General Medicine and a specialist in general medicine. She thinks it’s good that bladder cancer is getting more attention. – It is important that people gain more knowledge about when they should see their GP. GPs have guidelines for how we should investigate blood in urine, and I completely agree that we can always be made more aware of various symptoms and diseases, she says. The Norwegian Association for General Medicine has recently written about bladder cancer in its newsletter to 8,600 general practitioners. – We have chosen to inform based on knowledge, says Tangen. Marte Kvittum Tangen, head of the Norwegian Association for General Medicine. Photo: Anders Fehn / news But Tangen is also concerned that anyone with symptoms of a urinary tract infection must not panic after reading this. Those with visible blood in their urine should contact their GP. – Among those who have symptoms from the urinary tract, very few have cancer. There are many people who have a urinary tract infection during the course of a year. She believes that referring anyone with a urinary tract infection to an examination would do more harm than good. – The art is therefore to select the right patients for examination. We follow our professional national guidelines for when bladder cancer should be suspected and when further referral should be made. If guidelines are to be changed, it must be based on medical knowledge, she believes. – It is important to see the GP if there is blood in the urine or other symptoms that should be assessed, says Tangen. Nero has become important to Jan Erik after the cancer diagnosis. It forces him out, even when things are difficult. – He has been my great comfort since I got him. – I would have been much more withdrawn if it hadn’t been for him. Jan Erik hopes that everyone with the right criteria will be referred on, as Tangen describes. And that his story can help save lives.
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Had five courses of antibiotics for urinary tract infection – turned out to be bladder cancer – news Rogaland – Local news, TV and radio
