Read Time: 4 minutes
PJ and Lexi DiPentino lived most of their married life in Denver, where they raised their five children. But in 2021, they decided to make a change. The couple moved to Livingston, Montana, a small town of 8,900 and home to the northern gateway of Yellowstone National Park.
PJ says, 鈥淚t was a place where you didn鈥檛 think, 鈥榦h man, I鈥檓 going to get sick, and what are my options?鈥欌
He first noticed something was wrong in February 2023, when he saw blood in his urine. After a trip to the emergency room and a CT scan, a doctor came to him with some bad news.
鈥淗e said, 鈥楬ey, you need to get in touch with the urologist immediately. There鈥檚 a mass showing in your bladder, and I believe it could be cancer. So don鈥檛 take this lightly.鈥欌
An orange-sized tumor was cutting off his kidney function, and 59-year-old PJ was diagnosed with stage 2 bladder cancer. According to the American Cancer Society, the average age of diagnosis is 73. Men are four times more likely to be affected by the disease than women.
PJ immediately began chemotherapy in Bozeman, about 30 minutes from his home. Doctors told him he had two options. The first was to continue chemotherapy and radiate the tumor.
鈥淥ption two was taking the bladder, the tumor, and the cancer out, but I鈥檇 have to be on an ostomy bag for the rest of my life,鈥 says PJ. 鈥淎nd when you have bladder cancer, and you鈥檙e peeing once every hour, every single hour of the day鈥 it's painful. And you're miserable. Option two was way more intriguing for me.鈥
His doctor recommended he see a surgical urology specialist at Huntsman Cancer Institute at the in Salt Lake City.
A welcoming experience
Salt Lake City was a world away from Livingston. In PJ鈥檚 condition, the seven-hour drive seemed daunting. Instead, he and Lexi decided to fly.
鈥淭he whole thing about being sick and having cancer is there鈥檚 an incredible amount of anxiety, as the patient and the spouse,鈥 says PJ. 鈥淚t's bad enough that you're sick and facing mortality. You just want to get better. But in order to get better, you have to jump through so many hoops. And then you finally get to the point of getting on a plane and going to Utah. It鈥檚 overwhelming.鈥
The DiPentinos were also unfamiliar with the city and the Huntsman Cancer Institute campus. They were put in touch with Amelia Thelin, a patient navigator. These experts guide cancer patients through the health care system, helping with logistics and any financial or insurance questions. Thelin works with frontier and rural patients, like the DiPentinos, who often need help with travel arrangements.
鈥淥ur first contact with Amelia set the pace for the rest of the trip, that we were in good hands,鈥 says PJ. 鈥淧eople were going to watch out for us, and I was going to be taken care of. And that's exactly what happened.鈥
This support was crucial as the DiPentinos faced an unexpected road bump. PJ鈥檚 surgeon鈥攖he one he had traveled over 400 miles to see鈥攂roke his collarbone in a bicycle accident. Schedulers quickly found another doctor when they heard about the couple鈥檚 limited time in Utah.
鈥淲e did not even meet our surgeon until an hour before the procedure,鈥 says PJ.
Bogdana Schmidt, MD, MPH, urologic surgeon at Huntsman Cancer Institute, stepped in to take over PJ鈥檚 surgery with four days鈥 notice.
鈥淚 believe in the patient-doctor relationship. I believe in building trust in the clinic and walking your patient through their diagnosis and explaining the steps,鈥 says Dr. Schmidt. 鈥淏ut I also knew that I had to be able to meet a person and put them at ease and take good care of them basically in about a 15-minute window.鈥
Dr. Schmidt says that with bladder cancer, there鈥檚 an issue of timing. Patients need surgery around 6-10 weeks after chemotherapy, before the effectiveness of treatment wears off.
鈥淚 knew that PJ鈥檚 surgery had to be within a relatively narrow time slot and delaying it much more would not have been beneficial for him,鈥 says Dr. Schmidt. 鈥淚 had to do a good job for them. They deserved it.鈥
What鈥檚 best for PJ
PJ and Lexi spent two weeks in Salt Lake City, trying to recover from the surgery where doctors removed his bladder and prostate.
鈥淚t was two weeks of hell, the surgery and after the surgery. Being away from the family. Just me and Lexi out there in an area where we don鈥檛 know anything,鈥 says PJ. 鈥淢y body kind of just wanted to be home. And you know, we never felt frustration or anger or anything for the procedure. Just positivity.鈥
The DiPentinos have not returned to Huntsman Cancer Institute, but they do stay in close contact with Dr. Schmidt. Dr. Schmidt says she likes to keep in touch with her out-of-town patients, in particular.
鈥淕etting to Salt Lake City and coming to see me is a real burden, and I didn鈥檛 want PJ to come see me for something I can tell him by phone or email. I wanted to make sure that I could keep in touch with his oncologist so that they can ask me questions, so that PJ can continue to have the benefits of Huntsman Cancer Institute care when he can鈥檛 come to see us for visits,鈥 says Dr. Schmidt. 鈥淭he community doctors are doing a really great job, but we have access to trials and resources here that can be helpful to patients. And if there鈥檚 a way for us to be able to share information, that鈥檚 an important role that we have.鈥
At the end of 2023鈥攕ix months after his surgery鈥攍ocal doctors found that PJ had two cancer . The DiPentinos and his local oncologist reached out to Dr. Schmidt for her opinion. She took the results to her colleagues on a tumor board鈥攁 multidisciplinary team at Huntsman Cancer Institute that analyzes patient cases. After review, Dr. Schmidt urged the DiPentinos to do a course of radiation treatment.
鈥淪he said right after the surgery there were going to be some things we needed to monitor, she was straight up,鈥 says PJ. 鈥淪o, when it came back, it wasn鈥檛 really a surprise. It was more depressing. We went with Dr. Schmidt鈥檚 advice. She was all into, 鈥榯his is what鈥檚 best for PJ, this is what you should look at. The follow-up care was incredible.鈥
Almost a year out from his surgery, PJ鈥檚 condition is now stable. After radiation, his hotspot is now the size of a fingernail.
鈥淭here鈥檚 no new stuff, and the old stuff isn鈥檛 in me anymore,鈥 PJ says. 鈥淭hat's good enough for me. I would take that all day long over the condition I was in one year ago.鈥
PJ will have to continue with for the rest of his life. But he relishes the positives. Some days, it鈥檚 golfing with his son. Other days, it鈥檚 enjoying time with their one-year-old grandson, who was born while PJ was receiving his first rounds of chemotherapy.
鈥淗e was literally born in the same hospital where I've been getting all my treatments. And we share that together,鈥 says PJ. 鈥淭hat's why we went through all of it, so I get more time on this earth to be with my family. Man, people say to me, 鈥楬ey, how you doing?鈥 I'm glad I'm alive.鈥