To Stay On The Sidelines, “Coach Prime” Deion Sanders, 58, Says He’s Changed Rituals After Bladder Cancer Surgery

“I gotta make sure I pee before I go out there,” Sanders shared candidly on the Colorado Coaches Show, describing his new pregame ritual.

Sanders revealed earlier this summer that he had been diagnosed with bladder cancer and underwent surgery to treat it. While the procedure is often life-saving, it can leave lasting effects—especially on urinary control.

“Sometimes, before the games, I use a catheter, so I can make sure my bladder’s empty,” Sanders explained. “Because when you feel it, you’ve got to use the bathroom, or you start leaking. I’m sorry. But I’m getting explicit. But you start leaking. You gotta take care of it.”

His openness is striking—and important. Incontinence is a common but rarely discussed consequence of bladder cancer treatment, one that can deeply affect a person’s confidence and daily routine.

Dr. Arjun Balar, Director of Genitourinary Medical Oncology at NYU Langone Health’s Perlmutter Cancer Center, underscores the reality many patients face.

“Surgery (for bladder cancer) is highly curative, but it’s associated with substantial impact on quality of life, and that impact is permanent,” Dr. Balar told SurvivorNet.

Sanders’ willingness to speak publicly about these challenges helps dismantle stigma and normalize the conversation around survivorship. His story is a reminder that healing isn’t just about beating cancer—it’s about adapting, advocating, and showing up, even when the path forward is complicated.

What to Expect from Bladder Cancer Surgery

When bladder cancer is diagnosed, surgery may be recommended to remove the bladder and surrounding cancerous tissue to prevent the disease from spreading. Your treatment path will depend on several factors, including your overall health, the stage and grade of your cancer, and your personal preferences.

Understanding the Surgical Options

Bladder cancer surgery typically involves removing the bladder (a procedure called cystectomy) and nearby tissue. In many cases, a urinary diversion is also needed—this reroutes the flow of urine through a new pathway.

There are two main surgical approaches:

• Open Surgery
  • This traditional method involves a single, large incision from the belly button downward. The surgeon uses their hands to access and remove the bladder directly.
  • “Open surgery means making a cut on the skin and using our hands to do the operation,” explains Dr. Jay Shah, urologic oncology expert at Stanford Cancer Center.
• Robotic-Assisted Laparoscopic Surgery
  • A minimally invasive technique using several small incisions. The surgeon operates robotic instruments to perform the procedure with precision.
  • “Instead of one big cut, robotic surgery uses keyhole-size incisions and robotic tools,” says Dr. Shah.

Comparing Open vs. Robotic Surgery

Both approaches are effective for bladder cancer that hasn’t spread. The choice often depends on your surgeon’s expertise and your own preferences.

Open Surgery: Pros & Cons

Advantages:

• More surgeons are trained in this method
• Direct access to the bladder in emergencies

Considerations:

• More invasive, with longer recovery
• Higher risk of bleeding and infection

Robotic Surgery: Pros & Cons

Advantages:

• Less pain and blood loss
• Lower infection risk
• Shorter hospital stay and recovery
• Minimal scarring

Considerations:

• Not all surgeons are trained in robotic techniques
• May require travel to a specialized center
• Slightly higher risk of urinary tract infections

“What matters most is that your surgeon is experienced in the method they recommend,” Dr. Shah emphasizes. “You don’t want robotic surgery from someone who’s only trained in open techniques—or vice versa.”

Urinary Reconstruction & Diversion

If your bladder is removed, your surgeon will create a new way for urine to exit your body. This can be done using a portion of your intestine or an external collection system. These procedures are complex and often performed using open surgery.

Three common options include:

• Ileal Conduit: Urine flows through a stoma into an external bag, which is emptied throughout the day.
• Indiana Pouch (Cutaneous Continent Reservoir): A pouch made from intestine collects urine internally. A catheter is used to drain it through a stoma.
• Orthotopic Neobladder: A new bladder is constructed from intestine and connected to the urethra, allowing urine to exit the body naturally.
  Your surgeon will recommend the best option based on your anatomy, health status, and lifestyle.

Making the Right Decision for You

Robotic cystectomy offers benefits like reduced pain and faster recovery, but open surgery may be better suited for complex cases. Studies show that long-term outcomes are similar between the two methods.

The most important factor? Choosing a surgeon who is skilled in the approach they recommend—and who takes the time to understand your needs.

Coach Prime’s Bladder Cancer Diagnosis

Deion Sanders played 14 seasons in the National Football League for several teams during his career, including the Atlanta Falcons and the Baltimore Ravens. The all-star athlete also played several seasons with Major League Baseball and the New York Yankees. Now, he is the head coach for the Colorado Buffaloes at the University of Colorado Boulder.

Despite his resilience on the gridiron, Sanders, a father of five, says his battle with cancer was one of his toughest.

In July, Sanders revealed that he had been battling bladder cancer. While specifics of Sanders’ cancer journey have not been fully disclosed, he shared that his experience “was tough” and said it “was a fight, but we made it,” according to the Associated Press.

Since 2021, Sanders has had 14 surgeries and dealt with blood clots, resulting in the amputation of two toes. A routine checkup helped lead to the discovery of his cancer diagnosis.

When Sanders’ doctors told him he had bladder cancer, the football star admits he was shaken by “the C word,” but remained steadfast; his diagnosis would be different, and he would survive.

Sanders’s bladder cancer was considered a “very-high-grade, malignant tumor” despite having no symptoms.

One of the things that kept Sanders’ headstrong during treatment was his desire to return to the football field and be the coach he dreamt of being.

“It was never in my spirit, in my heart, that God wouldn’t allow me to coach again,” Sanders said.

Sanders also admitted that he didn’t want to stress his sons with his health issues, as he didn’t want it to distract them.

“My sons, to this day, don’t know what transpired. I just told them it was something with my foot, because I wanted to give them the focus on making the team and not focus on dad,” he explained.

As part of his survivorship, Sanders is also using a urostomy bag [a medical device used to collect urine after bladder surgery].

Understanding How Bladder Cancer Impacts Patients

Your bladder is a hollow, muscular, balloon-shaped organ that expands as it fills with urine, an essential component of your body’s urinary system.

Bladder cancer begins when the cells lining the inside of the bladder start growing uncontrollably and form tumors. “Smoking is a leading risk factor,” with smokers being three times more likely to develop the disease than non-smokers.

Common symptoms of bladder cancer may include:

• Frequent urination
• Pain or burning during urination
• Flank pain (discomfort in the sides of the lower back)
• A sudden, urgent need to urinate
• Blood in the urine, which may appear pink, red, or cola-colored

Risk Factors for Bladder Cancer

Smoking is one of the most dangerous contributors to bladder cancer. In fact, the National Institutes of Health reports that roughly half of all bladder cancer cases are caused by smoking.

Why? The toxic chemicals in nicotine and other compounds found in cigarettes remain in the bladder for extended periods before being flushed out through urine—giving them more time to damage bladder tissue.

WATCH: Understanding bladder cancer risk factors.

“The first and foremost thing for a healthy bladder is, don’t smoke,” advises Dr. Arjun Balar. “I think that’s an obvious suggestion for a number of reasons. But if we can eliminate cancer risks that are related to smoking, that’s probably the most important thing you can do.”

Tobacco smoke is a toxic mix—the Centers for Disease Control and Prevention (CDC) says that it contains over 7,000 chemicals, with at least 70 known to cause cancer. While most often linked to lung cancer, smoking is also a major driver of other cancers, including bladder cancer.

Cigarette smoking is responsible for 80–90% of lung cancer deaths, and smokers are 15 to 30 times more likely to develop or die from lung cancer than non-smokers. Even exposure to second-hand smoke significantly increases risk.

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