Marilu Henner: Acknowledging Symptoms is the First Stop on the Road to Health

It’s a good thing actress Marilu Henner doesn’t shy away from difficult conversations.

When she had one with her husband of 14 years, Michael Brown, during the early stages of their relationship, she may have saved his life.

“During our first month, we went on a trip, and I noticed that there was a little bit of blood in the toilet,” Henner says in an interview with CURE®. “He said, ‘Oh yeah, I’m fine. I’ve had blood in my urine for two years now.’”

Brown’s doctor at the time explained that it was probably just a kidney stone, but Henner wanted more answers.

“I said, ‘I don’t think that’s right. I think blood in the urine means something,’” Henner recalls.

Brown made an appointment with a urologist, who performed a cystoscopy; this allowed the doctor to view the inside of Brown’s bladder. During the procedure, the doctor found papillary carcinoma of the bladder and removed it; a week later, he explained that lab results seemed to indicate early-stage disease, and he asked Brown to return in four months so he could check for any recurrences and perform more surgery if necessary.

Henner was not satisfied with that approach, and took Brown to see another doctor for a second opinion.

Creating a Treatment Plan

The doctor found that Brown not only had papillary carcinoma, which a pathologist speculatively diagnosed at between stages 2 and 3, but also carcinoma in situ, stage 0 bladder cancer.

Together, Henner, Brown and the physician decided to further treat the cancer with six rounds of an immunotherapy known as Bacillus Calmette-Geruin (BCG), often administered as an intravesical treatment for earlier-stage bladder cancer.

Brown’s diagnosis and treatment started the couple on a journey for health — and remission. In addition to seeking second and third opinions before agreeing to the BCG treatment, Brown and Henner put together a protocol for healthy living.

“We experimented, and we went to some really great doctors,” Henner says. “But it wasn’t just dealing with the bladder cancer.”

The two also tackled aspects such as general health, nutrition, stress management and the mind-body-spirit connection, whose importance, Henner says, is just beginning to be recognized.

“There were so many little things that he could do, just to feel better as a person,” she says. “You can’t just isolate the body. Everything is connected together, and health is a total picture.”

New Agent Offers Hope

While Brown underwent standard treatments for bladder cancer in addition to his holistic efforts, he still didn’t have all the options available to him that exist now. In fact, Brown’s diagnosis came right in the middle of a three-decade dry spell in bladder cancer drug approvals.

That changed in May 2016, when an immunotherapy that targets the protein PD-L1, Tecentriq (atezolizumab), gained approval from the U.S. Food and Drug Administration for the treatment of patients with locally advanced or metastatic urothelial cancer whose disease has progressed during or after platinum-based chemotherapy such as cisplatin, or within 12 months of receiving such chemotherapy, either before or after surgery. Bladder cancer is the most common type of urothelial cancer. Then, nearly a year later, in April of 2017, the drug was approved in the frontline setting for people with metastatic urothelial cancer who are not eligible for cisplatin chemotherapy, which is a standard treatment.

Meanwhile, in February 2017, a second inhibitor in the class known as checkpoint inhibitors, Opdivo (nivolumab), was approved for the treatment of bladder cancer. Imfinzi (durvalumab) and then Bavencio (avelumab) were approved in May.

“I think that this has been a massive sea change in how we treat patients, what we can offer them and what we can expect their outcomes to be,” Arjun V. Balar, M.D., assistant professor in the Department of Medicine and director of the Genitourinary Medical Oncology Program at NYU Langone Medical Center said in an interview with CURE.

“What is different is that these drugs are exceptionally safe, so compared to chemotherapy, the portion of patients who can receive this type of treatment is much larger,” he said. “I would say the vast majority of patients are eligible for this treatment.”

Balar explained that there are far fewer side effects with Tecentriq than with chemotherapy, and the responses he has been seeing are usually quite durable. He also predicted that checkpoint inhibitors will eventually be the norm in treating most bladder cancers.

“Essentially, immunotherapy is here to stay in bladder cancer treatment, and I think will become an increasingly standard of care for more and more patients,” Balar said. “Perhaps chemotherapy may be preserved for the minority.”

Conquering Cancer Together

Even without the latest treatments and advancements, Brown and Henner managed to overcome not one but two cancer diagnoses: Shortly after he started treatment for bladder cancer, it was discovered that he also had stage 1 non-small cell lung cancer that would need surgical resection.

He has been in remission from both cancers for more than a decade.

“It’s so important to know that everybody has got a story. Everyone has something that isn’t perfect about them,” Henner says. “Don’t be afraid to be with your partner or share intimate details with your partner. That’s not going to turn your partner off, it’s only going to bring them closer to you.”

In fact, Henner quoted a statistic from a recent study conducted by the drug company Genentech, that found that 54 percent of men would be afraid to mention blood in their urine to their partner.

“That’s a lot,” Henner says. “Those are lives that could be saved sooner.”

Speaking Out for Survivors and Caregivers

Henner teamed up with Genentech, the maker of Tecentriq, during the month of May — Bladder Cancer Awareness Month — to share her husband’s experience with cancer, as well as what it was like taking on the role of the caregiver.

“A lot of times, the patient is just like a deer in headlights. The worst day is the first day,” she says. “They get the diagnosis and it’s so shocking to them that they don’t even know how to talk to their doctor, much less ask questions. They just see ‘death ahead’ rather than a process that their body can really heal.”

Tips Henner offers to fellow caregivers include taking notes, staying healthy, having a list of questions ready before each doctor appointment, and, just like when talking to a spouse or loved one, learning to ask those tough questions of the doctor and health care team, as well.

“You have to develop that fearless muscle,” she says.

A difficult conversation can strengthen a relationship — or save a life.

“If we could go through this,” Henner says, “we can go through anything.”