Cancelled surgery

Hello, I hope someone can help me understand what's happening to my best friend

Diagnosed with bladder cancer in the spring, her treatment plan was surgery to remove her bladder plus hysterectomy, with chemo before to shrink the tumour

She had four cycles of chemo up to September, saw the surgeon last Friday with surgery booked tomorrow, 2 Nov and while not exactly looking forward to the experience, we felt that it was a turning point after which she could begin a long, slow recovery

Then a call at the weekend to see the oncologist, who says the surgeon isn't happy to operate as the tumour has not shrunk as expected

She has been in considerable discomfort for weeks and given codeine, this week she's been given steroids which have, to her surprise, made her feel better than she expected

I understand it's now proposed she should have radiotherapy in a couple of weeks, but she isn't clear whether this is as a substitute for surgery or as another attempt at pre-surgical preparation

Is this a recognised course of events to those of you who work with patients all the time? 

Of course I am very despondent that it's the beginning of the end, more as palliative care than any hope of successful treatment

Please can anyone who's seen this progression give me an idea of what is most likely to happen from here on?  

  • Hello Liz M

    Thanks for getting in touch. My name is Helen, I’m one of the Cancer Information Nurses on the Macmillan Support Line.

    Welcome to the online community. I can see that you have joined the Friends and Family, and the Cancer Chat forums, and hope you have found the communities warm and supportive.

    We were sorry to read that your best friend has been unwell with a bladder cancer and that the treatment plan has been changed unexpectedly. As you say, although she was not looking forward to the surgery, she was psychologically preparing for it, so the change in plan must be very unsettling to her and to you.

    Radiotherapy is a recognised treatment for a bladder cancer when surgery is not deemed safe or effective. It is also used as a therapy to reduce symptoms such as pain.

    Without access to your friend’s clinical notes, it is hard to interpret the reasons for the changes to her treatment plan and what this might mean for her. You might feel able to encourage her to speak to her bladder cancer nurse specialist (sometimes called a Macmillan nurse) to help her understand what the changes in treatment mean and what the expected outcome of the radiotherapy is?

    You mentioned your friend is in pain: if she feels regular codeine is not helping manage the pain, do encourage her to speak to the whoever prescribed the codeine as the dose can be amended, or the drug altered to ensure she is comfortable.

    Your friend is likely to be feeling physically fatigued after her chemotherapy, and also confused and worried. She is most welcome to speak to one of our counsellors about her feelings.

    It is very hard to see a dear friend go through such a tough time, but it sounds like you are being a wonderful support to her. But do remember to take care of yourself, won’t you.

    I hope this information has answered some of your questions – if you feel you would like to chat through your concerns, you are most welcome to contact us by webchat or phone. Or simply get back in touch via email or the online community.   

    The Macmillan Support Line offers practical, clinical, financial and emotional support. You can call us free from landlines and from most mobile phone networks on 0808 808 00 00, 7 days a week, 8am – 8pm.


    Best wishes, Helen

    Cancer Information Nurse Specialist 


    Ref HM/MD