Philip Botha – From preparing for death to living in wonder

Philip Botha was preparing for death until his medical aid approved a new immunotherapy drug to treat his bladder cancer. He shares his phenomenal story with us.

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Philip Botha (60) lives in Randburg, Gauteng with his wife. They have two adult children and three grandchildren.

In May 2023, when Philip first encountered signs of bladder cancer: blood in urine, frequent and burning urination, and loss of appetite, he was on a holiday in Zanzibar, and spent five days in the hotel room while the rest of his family were on the beach. 

Once Philip was back home, he stalled in making an appointment with his GP. “You don’t really want to face the truth,” he says.

Once at the GP, a protein urine test was done, and Philip was referred to a urologist, with his GP telling him to not take this lightly. A scan was ordered which identified a tumour in the bladder and Philip was then booked in hospital for a biopsy and scope.  

“I was expecting it to be cancer from what the GP said, and family members have passed away from cancer, my mom – leukaemia, my dad – stomach, and my sister – lung,” Philip says. “My whole life I always thought I would get cancer.”

The proposed treatment was to surgically remove the whole bladder, leaving Philip living with a urostomy pouch for the rest of his life. Philip wasn’t happy with this course of treatment and took time to go for a second opinion. “I didn’t want to live with a bag for the rest of my life. I needed to look at all of my options,” Philip explains.

Change of treatment 

After seeing an oncologist, Philip was told that the cancer is serious, but he doesn’t have to have surgery and that her aim with chemotherapy was full recovery. She also referred him to a new urologist who became part of his cancer care team. “I would rather have five good quality years of living than living with a urostomy bag forever,” Philip adds. 

In October 2023, chemotherapy commenced. The side effects were fatigue and nausea. “I’m a carpenter and have my own business so work couldn’t stop,” Philip explains. 

Unsuccessful treatment

In May 2024, once chemotherapy was completed, Philip went for an MRI scan and unfortunately chemotherapy didn’t work; the tumour had grown in size and had spread to lymph nodes. One ureter from his kidney to bladder was completely blocked by the tumour so that kidney wasn’t functional. At this time, Philip only had 30ml space left in his bladder which meant he constantly went to the bathroom. “I noted how many times I went; 38 times a day,” Philip says. 

“I saw the urologist and I asked him to not sugar-coat the news; he told me that I have three to six months to live. My wife was in tears and I didn’t know what to do,” Philip says. “Another patient overheard this and asked if he could pray with us, which he did. His name was Len which was my father’s name. To me this was reassurance from God.”  

Preparing for death 

Philip was referred to a palliative care doctor. By this time, he was in excruciating pain as he couldn’t urinate due to blood clots in his urethra. “The palliative doctor rushed me to hospital and a catheter was inserted which relieved the pain. I was in hospital for four days; my family and friends came and said goodbye. My minister was even there, and I asked him to bury me, which he agreed to”

Philip went into palliative care at home, spending four to five hours in bed a day. He looked at options of where he would die. At first, he wanted to die at home but then reconsidered as it would be too traumatic for his family. He found a tranquil hospice where he was comfortable to die at and that his medical aid would pay for. He asked the urologist to explain how he was going to die, and it was explained it would be from kidney failure. The palliative care team reassured him that they would be by his side and make it painless. 

Surprise immunotherapy approval

Philip went to see the palliative care doctor and to his surprise she told him that his medical aid had approved pembrolizumab, an immunotherapy drug. 

Philip knew about pembrolizumab as his friend in the USA who had lung cancer had told him about it. Though, when hearing the price (R82 000 per one treatment) and that the chance of his medical aid covering it was slim, Philip knew he wouldn’t even be able to cover the co-payments, if the medical aid covered 50%. The nest-egg money he had, he wanted to keep, ensuring his wife could survive when he passed away. So, he chose the chemotherapy route.

“I was so confused when I heard it was approved. I went back to the oncologist and asked her if it was true and she said yes, the medical aid was willing to pay 100% of six treatments. It turns out that the oncologist’s assistant motivated my need for pembrolizumab once chemotherapy was unsuccessful and sent it off to the medical aid.”

Within that week, May 2024, Philip had his first IV pembrolizumab treatment. Thereafter the remaining five were every third week. An MRI was done after the six sessions and the tumour had shrunk by 75%. 

A new motivation was sent in and another six cycles were approved by the medical aid, which started in October 2024. When an MRI was done in January 2025, there was no sign of the tumour.

Third time’s a charm 

Philip had the catheter removed in February 2025 (which he says is like heaven) and is urinating normally. 

“I saw an improvement in the colour of my urine after week three on the new drug.” He adds that he is feeling on top of the world and is in full recovery. Philip is waiting to find out if maintenance therapy is needed and the next steps. His concern is that if more pembrolizumab is needed that his medical aid will not continue paying for it.

Philip says after this ordeal, he has seen the hand of God clearly through friends and strangers, as on two occasions payment for pembrolizumab were offered. “Four school friends of mine put R2 million together when they heard I couldn’t afford pembrolizumab. However, I couldn’t accept it. Then my wife’s client, who doesn’t even know me, also offered to pay for treatment but I wasn’t comfortable with that either,” Philip explains.

Third time’s a charm, Philip could accept that his medical aid would pay for treatment. He bought the oncologist’s assistant a gift, hugged her, and thanked her for saving his life.

“Throughout this my perception of God has changed. He feels so near and it’s such a peaceful place to be in with Him.”