New York City actor Mark McIntosh was diagnosed with bladder cancer after he saw blood in his urine. MSK urologic surgeon Bernard Bochner ultimately removed Mark’s bladder and gave him a substitute that wouldn’t require an ostomy bag. Today, Mark is disease free and back to work on the stage and screen.
- Mark McIntosh was diagnosed with bladder cancer in 2009.
- He had planned to see his urologist for cancer care until his parents urged him to go to MSK.
- At MSK, urologic surgeon Bernard Bochner confirmed the diagnosis and started Mark on a medicine that eliminated the cancer.
- When the cancer returned a few years later, Mark had his bladder removed, and Dr. Bochner created a neobladder in its place.
- Today, Mark is healthy and back to work as a film, television, and theater actor.
At first, Mark McIntosh thought he had imagined the blood in his urine. It had only shown up once in the few times he had gone to the bathroom that night in November 2009.
“I could have ignored it,” recalls the 54-year-old New York City–based actor. But that didn’t sit right with Mark when he thought of his parents, who are a doctor and a nurse.
“[When I was] growing up, our kitchen table conversation was always about medicine, so I instantly knew this was not good,” he says.
Getting Checked Out
The next day, Mark set up an appointment with his urologist. He had been seeing one since earlier that year, when a painful bladder infection sent him to the emergency room.
Mark’s doctor did an ultrasound but wanted to perform a cystoscopy, which uses a camera to examine the bladder and urethra, the tube leading from the bladder through the penis. During the cystoscopy, the doctor found a tumor. Mark was soon diagnosed with early-stage bladder cancer.
“You have an idea of what track you’re on in life, and suddenly, you’re on a completely different road,” Mark says. “In a matter of minutes you’re a completely different person.”
Mark hadn’t yet told his family or his husband, Edgar, what was going on because he didn’t want to worry them. But with a diagnosis in hand, Mark knew it was time to talk. He had planned to see his urologist for care until he spoke with his mother.
“She said, ‘Mark, what the heck are you doing? You don’t need a urologist. You need an oncologist,’ ” he remembers. “That’s when it all became very real for me.”
Coming to MSK
At his father’s urging, Mark researched doctors at MSK and made an appointment to see urologic surgeon Bernard Bochner. At their first meeting in January 2010, Dr. Bochner discussed a plan to confirm Mark’s prior testing to make sure the diagnosis was correct.
“Mark’s tumor was stage I, but even within stage I there is a big variation in how these tumors can act,” Dr. Bochner says. “At MSK, we are very focused on providing the best staging information and overall characterization of each tumor to better assign the appropriate treatment options for each individual. The restaging procedure is a very important part of that.”
Mark knew he was in good hands.
“There was something about [Dr. Bochner] that made me think, He knows what he’s talking about,” Mark recalls. “I could just smell it. I will never forget he said, ‘Mark, your urologist knows a little about a lot. I know a lot about a little, and the little is what you have.’ I was like, ‘OK, sign me up.’ What else can you say?”
Mark was thankful for the second opinion. Dr. Bochner confirmed the diagnosis and even found two additional cancerous areas.
Fortunately, the cancer had not spread past Mark’s bladder, so Dr. Bochner thought he would be a good candidate for a medicine used to treat early-stage disease. The drug, called bacillus Calmette-Guerin (BCG), is a form of immunotherapy inserted directly into the bladder via a catheter.
“By putting the medicine inside the bladder, we were trying to stimulate Mark’s own immune system to prevent the tumor cells from growing back,” Dr. Bochner says.
Over six weeks, Mark did six cycles of BCG therapy. At his next checkup, he received good news: He had no visible signs of cancer. However, there were still cancer cells in his urine, so Dr. Bochner put him on another round of BCG to wipe out any lingering traces.
“That time, I passed all my tests,” Mark says.
A Recurrence — and a New Plan
Mark remained cancer free for a number of years. Unfortunately, during a routine cystoscopy in 2017, Dr. Bochner saw that the cancer had returned, which is common in people with bladder cancer. This time, Dr. Bochner thought the best course of treatment would be surgery to remove Mark’s bladder.
The conversation made Mark nervous — he didn’t want an ostomy bag or an internal pouch that he would have to drain manually. But Dr. Bochner said there was another option. During the operation, he could make a substitute bladder for Mark using a portion of his intestine. The substitute is called a neobladder.
“Mark was very active, he’s young, and he’s onstage a lot, so it’s important for him to maintain that physicality and body image,” Dr. Bochner says.
Mark decided to proceed with the surgery, which took place in April 2017. Shortly after starting the procedure, Dr. Bochner sent a sample of Mark’s tissue to MSK’s pathology department for immediate analysis. If the urethra was cancer free, he could continue creating a neobladder. If not, Mark would need an alternative form of reconstruction of the urinary tract.
“So my husband’s sitting there in the waiting room, and an hour later, a nurse comes out and says, ‘We’re good to go,’ ” Mark says. “The first words from my husband when I woke up were, ‘It worked.’ ”
After the four-hour procedure, Mark devoted himself to rehabilitation. While he recovered at Memorial Hospital, he took advantage of MSK’s inpatient integrative medicine services, opting for acupuncture to relieve postsurgical pain. He credits his nurses — who he calls “angels from heaven” — with helping him leave the hospital in just four days.
“They made me more proactive in my own healthcare,” he says. “My experience made me feel capable, and I found myself being much less afraid. I started to relax.”
In the past, says Dr. Bochner, people having their bladder removed would usually spend ten or more days in the hospital recovering. But thanks to enhanced recovery protocols in MSK’s Department of Surgery — such as walking sooner after surgery and a reduction in prescribed narcotics — people are able to get home faster.
Still, the experience wasn’t without its challenges. But as time passed, Mark felt more comfortable and confident in his decision. He also had a goal in mind: returning to the stage for a play in July.
“I set that date because that was my lodestar,” Mark recalls. “I said, ‘I am getting to that first rehearsal. However we get there, it’s going to happen.’ And it did.”
Paying It Forward
One year after surgery, Mark is cancer free and back to his regular activities. He’s since started giving his time to MSK as a patient-to-patient volunteer, guiding other men with bladder cancer through their experiences. Edgar, too, will be volunteering in the caregiver-to-caregiver role.
“I just knew that I couldn’t have all this information that I never wanted to have and not turn it into something useful and helpful for someone else,” Mark says.
Dr. Bochner, who sees Mark for a follow-up every three months, is thrilled that he’s living life to the fullest.
“Mark has done perfectly,” he says. “To see him back to all the things he wanted to do, looking the same, is the goal we hope to attain with all patients.”