Kidney transplant patient discovers three cancerous tumours on bladder The patient featured in this article has chosen to share his story anonymously
Since receiving a kidney transplant seven years ago, life has not been all plain sailing for a Scottish man in his seventies.
Living with polycystic kidney disease (PKD), he required a transplant in 2018, and his quality of life improved immensely. However, a kidney transplant is not a cure, and his underlying health has remained complicated.
Just a few months after transplantation, doctors identified a small tumour in his bladder and diagnosed him with BK virus. This common childhood virus usually remains dormant in the kidney and lining of the ureters and bladder. However, it can become active again when the immune system is weakened, such as in patients who need immunosuppressants to prevent kidney rejection post-transplant.
Kidney Research UK funded researcher, Dr Simon Baker, from the University of York, has found a link between BK virus and bladder cancer, which may help to explain this man’s experience of needing three tumours to be removed from his bladder in the last six years.
Inherited kidney disease
The man’s family has been deeply affected by polycystic kidney disease (PKD), which has been inherited by generations of his family.
He says: “When my mum was diagnosed, I knew there was a chance I’d be affected, but it wasn’t until my sixties that I began to have symptoms. I had an extremely painful abdomen which I attributed to appendicitis. However, when I went to A&E, it was discovered that I had a bursting kidney cyst. Doctors revealed that my kidney function was at 20% and I was placed under the care of a renal consultant to monitor my health as my kidneys declined.
“The effects of kidney disease meant that I had to retire from work. I lost weight, was fatigued, slept more and felt general apathy. I lost my enthusiasm for life. Knowing that my body was shutting down was not nice. I kept walking and gardening as much as I could, but would always need to come inside and have a sleep.”
Life-changing transplant
In 2018, he received the kidney transplant he’d been waiting for.
He says: “I was able to receive a kidney through the UK Living Kidney Sharing Scheme, which enabled a transplant to take place as part of a chain, including an altruistic donor.
“I’m in awe of the sharing scheme. Seven operations happened on the same day to make my transplant possible. It’s an incredible thing to donate a kidney.
“After my transplant I felt great. It takes a little while to recover from surgery, especially at my age, but I’m pretty active again now. I still need to take medication post-transplant, but I’m quite fit, everything considered.
“I’m so glad to be here. I’m living my life, having fun, riding my motorcycle and spending time with family. I have a life now that I wouldn’t have had if it wasn’t for my transplant. I know my kidney won’t go on forever, but I won’t go on forever anyway.”
BK virus and bladder cancer
A stent was put into his transplanted kidney – where the ureter comes into the bladder – to keep it open while it healed post-transplant. However, when it was removed nine weeks later, doctors found a tiny tumour.
He says: “Luckily, it was caught early and removed three weeks later. However, within a month, my kidney function declined prompting a biopsy. That led to a diagnosis of BK virus. Although I didn’t experience symptoms, my immunosuppressants had to be reduced to enable my immune system to combat the virus. That left me vulnerable to transplant rejection, but fortunately this was avoided.
“In the past five years, two further tumours have been identified in my bladder through routine appointments. Both were small and successfully removed – one in 2020 and one in 2023. I feel very fortunate these were discovered early because I never had any symptoms. It’s concerning because I wouldn’t have known anything was wrong.
“I never realised there could be a link between BK virus and bladder cancer until I came across Dr Simon Baker’s research. In my experience, the two conditions have been treated very separately by different departments in hospital.”
Ongoing research
Dr Simon Baker is studying DNA from bladder cancers, like Tim’s, to understand more about the risk that BK virus poses in these developing. In addition, he co-chaired the development of the first clinical guideline for the management of BK virus with the British Transplantation Society, with the hope of establishing a national screening process to identify infections early.
Early diagnosis and treatment for bladder cancer has been vital in this case, enabling the removal of three tumours with no long-lasting impact.
Our kidney patient says: “Without past research which has made transplants and other treatments possible, I would not be here. There is plenty more to discover and I’m only too happy to contribute to research. Kidney disease has affected generations of our family and it’s going to continue. The more it’s talked about and the more that can be done the better.”
Is bladder cancer caused by BK virus?
Research from Dr Simon Baker’s group at the University of York, suggests that BK virus can trigger changes in DNA that drive bladder cancer development, which kidney transplant recipients are at much greater risk of.
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