Young, Active and Healthy: Never Expecting a Bladder Cancer Diagnosis at 39

Before his bladder cancer diagnosis, Jimi Stewart was living the kind of lifestyle many people associate with good health.

The 39-year-old Austin, Texas, resident spent his time rollerblading, enjoying the outdoors and maintaining an active social life. Cancer was not something he thought about often — especially not bladder cancer, a disease most commonly diagnosed in adults older than 55.

Then one ordinary day, Stewart noticed something alarming.

“It was just like a normal day,” Stewart told CURE. “I just had to use the restroom, and when I urinated, there was an alarming amount of blood. It was pretty dark and scary.”

Although shocked, Stewart acted quickly and contacted a urologist right away. Still, like many younger adults, he initially hoped the symptom would turn out to be something minor.

“I didn’t think this would happen to me,” Stewart said. “Maybe if it did, it wouldn’t be until much, much later.”

As the bleeding worsened and blood clots developed, the seriousness of the situation became harder to ignore. Soon after, Stewart learned he had non-muscle invasive bladder cancer (NMIBC).

Processing a diagnosis at a young age

Receiving a cancer diagnosis at 39 felt surreal for Stewart, who said the news was initially “numbing.”

At the time of his diagnosis, his best friend accompanied him to appointments and helped him process the moment through humor and support.

“My best friend and I, we kind of have a little bit of dark humor,” Stewart explained. “On the way home we were making weird dark jokes about it, I guess just as a way to cope.”

However, as treatment discussions became more serious, the emotional weight of the diagnosis began to settle in.

“It wasn’t until much later when I started getting treatments and going over treatment plans that it really started to sink in,” he said.

Stewart underwent treatment with bacillus Calmette-Guérin (BCG), a standard first-line option for many patients with NMIBC. But like approximately 40% of patients with this disease type, his cancer became BCG-unresponsive, meaning the therapy was no longer working effectively.

That development led to one of the most difficult conversations of his cancer journey: the possibility of bladder removal surgery.

Facing the possibility of bladder removal

For Stewart, the thought of losing his bladder was frightening — not only physically, but emotionally and socially.

“That was probably the scariest part that I’ve experienced so far,” Stewart said. “I rollerblade all the time. I love being in the water. I’m still actively dating. It was really scary because I felt like even though I know that I’m strong and would adapt, it was just something I did not want to have to do.”

Like many patients facing bladder removal surgery, Stewart worried about how the procedure could impact his independence and quality of life long-term.

Still, just as his options seemed to be narrowing, a new opportunity emerged.

Becoming the first patient in Texas to receive Inlexzo

Stewart ultimately became the first patient in Texas to receive Inlexzo (gemcitabine intravesical system), a newly Food and Drug Administration-approved bladder-preserving therapy option for certain patients with BCG-unresponsive NMIBC.

The treatment represented a major advancement in bladder cancer care — one of the first significant developments in the space in decades — and offered Stewart an alternative to bladder removal surgery.

“It meant everything,” Stewart said. “I really did think that I was out of options.”

Although the therapy was still newly approved and unfamiliar to him, Stewart trusted his care team and was eager to move forward.

“When this fell on my lap, I was very eager and ready to try it,” he said. “I didn’t even need to know too much about it. I was just willing to do whatever.”

Stewart credited both his doctors and advances in medicine for helping make the treatment accessible.

“I do credit God and my urologist and my care team,” he said. “I really relied on my doctors to give me information for whatever options are out there.”

Today, Stewart has no evidence of disease and continues treatment while remaining active and closely connected with his medical team.

The importance of shared decision-making and support

Throughout his experience, Stewart said strong communication with his providers helped him feel confident navigating a newer treatment approach.

“My care team is awesome,” he said. “The nurses, my physician assistant Holly — they’ve been super supportive.”

He also described receiving overwhelming support from family and friends during treatment.

“I’ve always focused on having deep connections with people,” Stewart said. “So the support from friends and family has been overwhelming.”

Stewart believes those relationships — along with finding the right medical team — were critical parts of his experience.

“I think it’s important to communicate,” he said. “And if maybe the care team you’re originally paired with doesn’t work out, then maybe seek a second opinion until you find the right connection and the right help that you want.”

Encouraging younger adults to listen to their bodies

Now sharing his story during Bladder Cancer Awareness Month, Stewart hopes younger adults understand that cancer can happen even to people who feel healthy and active.

He also wants others to recognize the importance of paying attention to symptoms and seeking medical attention early.

“I think it’s really important to pay attention to your body and not to wait,” Stewart said. “If something doesn’t seem right, take action.”

Although there were moments when he felt discouraged, Stewart said maintaining hope became essential as treatment progressed.

“There are advancements in medicine all the time,” he said. “It’s important to just keep living your life.”

For Stewart, that perspective now shapes how he approaches both survivorship and everyday life.

“We could die in a car accident today, or it can be a long-term disease,” he said. “It’s important to live each day to the fullest.”

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