Ambassadors

We are incredibly grateful to anyone that publicly shares their experience with bladder cancer. It is a cancer that really can affect anyone, which is why it’s so important for people to be aware of bladder cancer symptoms. 

We are privileged to have the support of high profile individuals, who have personal experience with bladder cancer, and want to use their platform to amplify this often neglected cancer.  

Adam Smith, “The voice of boxing” and bladder cancer patient

My story

by Adam Smith

Some of you may know me from my broadcasting career as a long time commentator, presenter and Head of Boxing at Sky, but for those who do not, I have adored narrating events from inside the sporting arena for over three decades.

These fabulous, yet incredibly hectic years of my life, have seen me travel the globe reporting on world-class sport, whilst also having a beautiful family at home – my wife and three children. I have worked relentlessly, passionately, and loved it, never taking a sick day. Ever. 

Whilst continuing to live out my childhood sporting dream, it was almost inconceivable to think that I would ever find myself reporting on my own, very brutal personal fight, one that in 2023 saw me battling for my life …

… my fight with aggressive and invasive bladder cancer.

As I reflect back – grateful for every single day, incredibly thankful to the doctors who saved me and with a totally different perspective on life, I recognise the fast pace, 24/7 nature of boxing and broadcasting, was beyond gruelling. 

Sky will always be my extended family – I grew up in Sky Sports and I had unbelievable opportunities which I will never forget – but there is no denying the strain these years had placed upon me. I was struggling with both my mental and physical health in the lead-up to my diagnosis. I was burnt out.

Signs and Symptoms

I was shocked to find blood in my urine one day but at first, I ignored it. I presumed it was nothing, having always felt invincible. I hadn’t been near my GP’s office in years – avoiding every letter. Just cracking on.

More blood began to appear in the few weeks that went by until it became severely clotted and painful when I went to the loo. It was awful. I knew it was something very serious but still, I was in denial.  

A few days later and in some pain, I decided enough was enough. I mentioned to a friend what was happening and, although embarrassed, I was thankful I did. Advising me to go straight to a walk-in GP, my friend probably saved my life there and then.

Diagnosis

After examining a sample of ‘bloody urine’ I was told it was a urinary infection and given some antibiotics. I breathed a sigh of relief but something deep inside me told me it was more sinister. 

Over the following days, the antibiotics had no effect and someone told me that I was losing weight. That’s when I just knew it must be cancer. I was becoming very tired around lunchtime and sleeping more and yet another friend told me to go back to see a GP and I am so thankful that I listened.

The doctor confirmed there was no infection but the urine was still bright red. I was sent straight to the Princess Royal University Hospital (PRUH), given blood tests, and a urology doctor told me that my white cells were ‘all over the place’. They said they would send me for a CT scan and told me it could be one of three things – a serious urinary infection, gallstones or bladder cancer …

“What’s bladder cancer?”… I said.

They asked if I smoked, I said “No. Not one cigarette. Ever.” 

They asked me how old I was. “51”. 

They told me that bladder cancer is usually a smoker’s disease, with the average age of diagnosis being 74.

I thought, surely not …

The PRUH was incredible. Within three days I had a CT scan and less than 48 hours later, they asked me to come back in urgently. Obviously I was really worried. 

Another set of blood tests later (I counted more than 150 during my hospital months) and I was asked into a room. The urologist handed me two pieces of paper; one said something about a nephrostomy which I’d never heard of and the other, about a biopsy, which I had. I was shown an image of my bladder on a screen and what looked like a big orange pressed to one side which was actually a huge tumour, one of the largest the doctor had ever seen. 

I needed an emergency nephrostomy (a tube that allows urine to drain from the kidney through an opening in the skin on the back) because one kidney was failing and the other was working overtime to compensate. I was told that I needed the operation within 90 minutes and, had I not been sent to hospital, I would not have made it past the weekend. 

Scary, scary stuff.

As awful as it was, I had to quickly accept that I was in serious trouble. I reached out to my youngest brother who lived relatively near PRUH and he was able to be with me before the first operation. It was Valentine’s Day and he had only recently been married, so I felt as though I was dragging him away. I am beyond grateful – our family is and has been, beyond incredible throughout.

During surgery, the nephrostomy tube was inserted and the first of many bags was attached to me. I was then wheeled into a ward where I met some wonderful characters who I will remember for life.

The biopsy came the next evening and my brother was still with me. We are fortunate that his wife is a doctor so this helped us immensely with all the early difficulties. I was very scared going into theatre for the biopsy but my brother was able to support me throughout, and even wheeled me into theatre. I was told it would be two weeks before the results would be available, however, the very NEXT morning a large group of urologists in purple, led by leading consultant Nick Faure-Walker, descended upon my bedside and whipped the curtain around …

“Adam, I know you have had a rough couple of weeks but we have some serious news to tell you.” Nick began …

At that moment, I thought I was dead. 

“You have aggressive invasive bladder cancer and you will need an immediate operation to remove your bladder and prostate. You will have to have a stoma for life and we will have to check the rest of your body for metastatic spread.”

I was frozen in time. I eventually said “‘What if I don’t do this? What about radiotherapy or something different? …”

There was silence.

There was no choice. 

I was left in my bed, struggling to take it all in. I was of course happy they said there was a chance. I had a little cry before pulling myself together and, alongside my brother, I worked on understanding my diagnosis and telling the family. My brother said to me, “Ads, in four months time you will be MC’ing at my wedding celebration.” I remember thinking ‘I doubt I’ll even be alive’ but I like goals and I desperately wanted to be there for him, like he was there for me.

… I was in and out of PRUH for five weeks which was really, really hard. The waiting, the emotions, the family worries, the sheer tiredness I felt. As well as having a bag attached to my leg and a tube that kept dislodging from my kidney needing to be replaced time and time again. 

Then, as I was waiting for my bladder operation (which was needed within 6 weeks) I was struck with a bout of sepsis which rocketed my temperature into the hundreds and left me shaking and freezing. It was a real nightmare. Despite sepsis though, and being physically exhausted (sleep was all over the place), I waited patiently for the move to Guy’s Hospital and my ‘big’ operation under the life-saving Rajesh Nair.

One piece of brighter news eventually came though (and believe me you will take anything at that stage). The brutal cancer, Stage 3 (advanced) T2, had fortunately not spread beyond my bladder wall and into the rest of my body. Still, there was a very, very long journey ahead. One I had no idea about at the time and one that was going to test my very will to live.

Raj performed the six and a half hour robotic cystectomy at Guy’s Hospital and by that time I had fully committed to both the Serenity Prayer and the amazing doctors and nurses surrounding me. They were in control, the experts, and I just did everything they asked me. I have always had a strong work ethic and I put my head down and fought one day at a time.

The support from my family, friends, and the boxing world was immense. All the fighters you have heard of like Tyson Fury and Anthony Joshua kept me going with messages of support and the scores of visitors, who saw me at my weakest, had no idea how much I needed them.

I have always liked people around me and I am so grateful that my various hospital rooms were filled so much of the time because it was lonely and terrifying – almost an out-of-body experience. 

When I ‘came to’ I remember wanting a pizza as quickly as possible! I was so ‘high’ on the medications that I didn’t really notice the incredible amount of tubes inserted into my body or register the severity of the situation.

Then there was the agonising wait for results to see if they had got rid of the cancer. So, to be told that, once the bladder had been removed, followed by the prostate and 19 lively lymph nodes, there was absolutely no sign of any cancer, was a huge positive.

Still, my wife and I had made the decision that I would have chemotherapy for ‘belts and braces’ after the op (not before) and that I would also have a stoma (and bags), rather than construct a new bladder, so there was a lot going on! The good news was that I felt ok following the life-saving operation. I was eating again and I was told I could go home in a few days. 

Complications 

Then the nightmare really began …

One evening after my wife and three children had been to visit, I felt wrong. Something just wasn’t right. A bit like I had felt when I found the original blood in my urine. My body didn’t feel like it was working properly. I stopped eating and I called for help. 

They discovered an Ileus in CT scans that followed, which basically means that your body is not digesting properly and that the colon area is effectively blocked. A whole new world awaited and I then found myself talking to bowel and colon consultants in addition to my urology team. 

The pain around my stomach began to get really awful, I couldn’t eat anything and before I knew where I was I had a really horrible tube up through my nose and into my distorted body. I was dosed up with fluids and a concoction of painkillers (which didn’t really work) whilst also learning how to change a stoma bag with the amazing stoma nurses.

I have long had hypermobility so I struggle with fine motor skills and trying to put a bag around an opening into my body was bloody impossible! Still I had no choice. When you accept that things are out of your control and that life will forever be different, you can start to mentally get your head around things.

The physical side was unbearable at times – torturous, at best. Despite my work in boxing, I have never had much strength, so I had to find it from somewhere – I was fighting for my life …for the children I adore.

The Ileus issues seemed to go on and on, and one of the most agonising nights was when Raj kindly came in (on a day off) having had a thought about how to reduce my suffering – by re-arranging a metal spiky tube that was sticking out of my stomach. I had never felt an hour of pain like that. Once again, I thought I was going to die!

The next day I shuffled to a bathroom and saw myself in the mirror for the first time in a while. I looked like a skeleton, having lost incredible amounts of weight (I think almost four stone at one stage). I remember thinking I can’t do this anymore … I still don’t know how I came back from that. 

Eventually, after a long month, I was discharged from hospital to go home. Despite my incredible healthcare team, Raj, his brilliant assistant Edna and the incredible physio team’s dedication, I could hardly walk and worse still, I was in acute pain around my scarred tummy. The car journey home was absolutely horrendous. My stomach pain was so bad that every time my wife went over a speed bump I screamed in pain. This marked the start of four days and nights over the Easter break when I was back home, hardly moving from the sofa, crying in agony.

Family love and ‘Carry-on Films’ were mild tonic (I also must have watched every episode of Bullseye in the long nights at Guy’s) but those 96 hours were some of the worst. The metal tube had gone inwards and was utterly dreadful. All I could do was count down until my next clinic appointment.

When that came, the tube was sorted out and I was given a whole new list of medications, before being told to wait outside the clinic room for an hour or so in case I had a reaction. 

Thankfully I stayed because I pretty much collapsed in pain and had to be taken to lie on a bed and be assessed. My ‘vitals’ were going haywire (and after 8 or so checks every 24 hours for weeks you get to know how your body is and start getting good at guessing what the blood pressure will be). I said to the nurses “This is exactly how I felt when I had my first bout of sepsis back in the PRUH”. I thought not again, this time would surely finish me off. 

Yet another important decision to make … should I be readmitted? As my temperature went higher and higher, it soon became a no-brainer.

So off I went again. A return to the wonderful team who saved my life. Maybe it was meant to be?! Like a ‘thank you’ for everything … I was there for three nights while they brought the sepsis under control before discharging me back home once again.

There was no sign of cancer remaining after my surgery, however my urologist and oncologist, the amazing Costi Alifrangis, recommended I have this treatment to ‘triple check’, thus Costi guided me through four rounds of intravenous infusions of chemotherapy. I had some of my scariest moments in these clinics, not because of the treatment itself but because of the realisation of how much more weight I had lost and as the reality of the last few months sunk in.

New Perspectives

During the course of my chemotherapy, my brother’s wedding celebration was marked. It was an incredible day and he and his fabulous wife asked me to speak, which was very emotional and particularly hard, even for an experienced broadcaster! I look back at pictures and barely recognise myself (I looked like a ghost) but I made it, something which I doubted I would do at one stage, and was so pleased to be able to give something back to them both in thanks for their unwavering support.

Rounds 3 and 4 of chemo were hard, there was an unpleasant follow-up colonoscopy under brilliant Jamie Murphy and then a heart check (because of the lymphatic fluids building in my legs) with the excellent Bernard Pendergast. They even found I had a heart that works the wrong way! But it works! 

… So, all in all, I have had everything thrown at me but my family has been sensational. Frightening and confusing for them, they have been on their own immense journey.

I have been given a new perspective on life, waking up grateful for every single day. Before, I was always stressed – now I am just thankful and feel genuinely so privileged to have another day. It is a very different way of living and I love it much more. I am thankful each and every day to the amazing, caring, wonderful medical team I have been lucky enough to have been supported by during the most difficult battle of my life.

I have been incredibly inspired along the way by the extraordinary artist and human being that is Tracey Emin and her similar ordeal (she is someone who I would love to meet) and by going to the lovely Maggie’s Centre in Charing Cross, where I realised both how young I am to have fought the brutality of bladder cancer but also how many lovely people there are who have suffered too.

I have also had help from psychologists and therapists for my mental health to make me calmer, and to appreciate life with more humility and gratitude for the simple things.

Over the last year, I have worked on helping others – from the homeless in Acton, to our local Foodbank; from my friends and family – to the super sportsmen and sportswomen I love so much. I absolutely love my jobs in the Foodbank, which I would do more of if I could, however necessary paid work for my family means I have to balance this part of my life.

Over Christmas, in 2023, I went to see Raj Nair. I said “Thank you for saving my life. I wasn’t sure I was going to make it.” He replied, “Adam, I’ll be honest, neither did I.”

I have been given another chance at life. Yes there is the daily stoma to maintain, a bag that can and does split, is awkward to change, and not particularly comfortable, especially with a night tube all over the place! My medications are being weaned off but they keep me going and my stoma keeps me alive. When I get up in the morning with pain in my legs it hurts but I think ‘here I am again, thank you, thank you’. 

Every day of the last two years has been a bonus, and I shall live one day at a time and make the most of life. I am a lucky, lucky boy!

The Future

With my sister-in-law being a geneticist I was encouraged to be tested for Lynch Syndrome, a condition which can be passed on to the children, so I did. In fact, I do everything I am told now, I don’t run away from doctors! You learn this responsibility and realise the unbelievable care and medicine which is out there. So … if you have any symptoms whatsoever, go and get them checked! Especially men, who don’t tend to act – please do!

Fortunately for me and my family, I was negative for Lynch Syndrome, so that almost certainly puts the cancer down to environment and stress factors. It is what it is. It’s happened and I am beyond grateful for another chance.

I will never be 100 percent, but I have put weight back on, I walk fast now, and on the surface, I guess I look back to normal. Underneath lies a broken and scarred body but one that does still exist! Six-month scans are anxious times but I try not to worry about what might be out there, instead remaining positive and thankful that I am still here. 

I am so grateful and it is an absolute privilege to be asked to be an ambassador for Fight Bladder Cancer … anything I can do to help others I will try my best.

I feel so incredibly fortunate to be afforded the opportunity to ‘give back’ by helping to raise awareness of bladder cancer and supporting new and existing patients navigating their own journey.

Please let me be your warning sign to act upon any symptoms you may be experiencing  and to be persistent. You know your body better than anyone else, and early diagnosis is essential to improving bladder cancer outcomes and survival. 

I guess I am a survivor, some would say a warrior, but I am nothing compared to the boxers I have worked with all my life. They are the brave ones to get in the ring; I just had to dig my very deepest when I had to. I have recalibrated and redefined what is most precious to me. I have had a lovely welcome back by the boxing world but first and foremostly, I will be forever grateful that I am able to have more time with my family, watching my children grow and flourish.