The Importance of Early Detection

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Editors note: This post has been updated and reviewed as of June 9, 2021

Bellevue resident and Microsoft program manager Brian Constable loves playing chess and spending time with his friends and family. An otherwise healthy man, Brian acted fast when he noticed something wasn’t quite right. This is his story.

Last November, I was going to the bathroom and noticed something unusual – my urine was a brownish color. I had no other symptoms—no pain or burning sensation—but to be sure, I made an appointment and saw my doctor the very next day. She said I likely had a virus or some sort of infection, so she sent my urine to the lab to get tested.

My lab results came back clear, so it wasn’t an infection. Since my urine continued to be discolored, I was sent to have a CT scan. The scan picked up several masses, and at that point, I was referred to a urologist—Dr. Khanh Pham.

Dr. Pham did further testing—he performed a cystoscopy, which is a scope of the bladder, and biopsied the masses. A week later, Dr. Pham said, ‘I’m sorry, the masses are cancerous, and the cancer is in the bladder wall.’

It was a shock to hear that I had cancer. But if there was any good news, it was that the fatty tissue around the bladder appeared cancer free, which meant it likely hadn’t spread. I had several options. One option was to undergo radiation and chemo only and not remove my bladder, but that would only give me a 65% 5-year survival rate. Another option was to undergo chemo and then surgically remove my bladder, prostate and lymph nodes. That would give me an 80% survival rate.

80% versus 65%—this is how I made my decision. 


My 21-year-old daughter wanted all the details on my treatment options and my 16-year-old son wondered: ‘Dad, how are you going to pee?’

That was actually another decision I had to make—how I wanted to replace my bladder. Did I want a bag on the outside of my body [urostomy bag] or did I want some of my intestines reconstructed into an internal bladder [neobladder]? Dr. Pham used a car analogy to help me with the decision. He asked, ‘Do you want a reliable car that doesn’t break down? Or do you want the one that looks nicer but with more maintenance?’ I’m a practical, lower maintenance kind of a guy, so I went with the bag.

After surgery, Dr. Pham told me it went really well and confirmed that the cancer had not spread (and bumped up my 5-year survival rate to 92%). It made me feel really good to know the surgery was even more successful than the doctor thought it would be.

And, because the surgery was done laparoscopically, I recovered more quickly and was back to work sooner than if it had been a traditional ‘open’ surgery.

Throughout it all, I had really great support—from my care team at Overlake to my friends and family. Getting through chemo was the toughest part, but my wife, kids and friends were there for me, every step of the way.

It has been an adjustment to have the urostomy bag, but I’m getting used to it and it’s becoming more routine. It’s not easy sharing these particular details of my story, but I’m grateful the cancer was caught early and want to encourage men to pay attention to their bodies and not ignore signs and symptoms that are out of the ordinary.

—Brian Constable

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