After two months of uncertainty, three ultrasounds, multiple blood tests, a CT scan and a traumatic surgery, it has finally been confirmed.
I have testicular cancer.
Obviously this diagnosis triggers a sea of conflicting emotions but, as odd as it may seem, what I feel most is a sense of relief.
In 2013 I participated in the Ride to Conquer Cancer. I rode my bicycle 260km from Vancouver to Seattle with hundreds of really wonderful people to raise money for the BC Cancer Foundation. I rode in support of my many family members who had battled, or were battling cancer. Cancer had touched my family many times over, but I never imagined that barely more than a year later I would have it myself.
I first noticed something was off about two months ago. I woke up on a Friday morning and noticed that my left testicle was much larger and firmer than normal. The change was enough that it was quite alarming. It had also been, apparently, quite rapid as I had not noticed it before then. I convinced myself that it was probably nothing to worry about, that it would be better by the next day, and I went to work. But in my gut I knew that something was seriously wrong.
When it had not improved on Saturday morning, I made a trip to the nearest walk-in clinic. The doctor examined me and told me I probably had orchitis, but that maybe it was torsion. I knew instinctively that he was wrong, as both of these conditions cause pain, and I had none. He wrote me a note and told to go to the emergency room and get an ultrasound and soon as possible. I spent the entire day at the hospital waiting for the ultrasound, and then waiting for a urologist to see me. The ultrasound was inconclusive, and in the end they told me it was very unlikely I had cancer. They scheduled a follow-up ultrasound for two weeks later as well an office appointment with a urologist, and prescribed two different antibiotics that are usually used to treat bacterial STIs. They did this despite me having no secondary symptoms and having made it very clear to them that I had been in a monogamous relationship for four years. I left the hospital feeling very frustrated.
A week went by and we were preparing to leave for a long weekend camping trip. Having experienced no improvement in my condition, and without a diagnosis, I became very nervous about being a long distance away from a hospital or services. I went back to the hospital at around midnight and was admitted. The ER doctor who saw me was absolutely excellent and I wish I could remember her name so that I could thank her. While she initially wanted me to wait in the hospital until 7am the next morning for an ultrasound, she sensed my distress and arranged for a sonographer to come in immediately. Unfortunately it was yet again inconclusive and I was sent home, very tired, with a new prescription for a different antibiotic, this one typically used to treat UTIs. We left for our trip (better late than never), luckily I was able to sleep in the car, and I had a great weekend, all things considered.
Life went on as normally as possible while dealing with such uncertainty and an increasingly large and uncomfortable testicle in my pants. I saw the urologist at his office a short time later and he was unable to tell me anything new. We then went a road-trip to Oregon and had a very enjoyable time.
When I returned, I had the previously scheduled ultrasound which the sonographer told me “didn’t show anything new”. I had a follow-up appointment with my urologist to discuss the third ultrasound and because of the stress of the situation accidentally showed up a week early. Having taken an unnecessary day off work and frustrated that I wasn’t getting any answers, I panicked and cancelled the appointment.
I ended up seeing my family doctor that day. Having received my latest test results he told me I absolutely should not have cancelled my appointment because cancer was a real possibility. Not only that, he had already booked me an appointment with another specialist for a second opinion. That day was the first and only time I cried.
I managed to get my appointment back. During that visit my urologist confirmed that the third ultrasound was still not conclusive. He was nervous however that it had not improved, and recommended surgery. I was not yet prepared to lose body parts without a more certain diagnosis. I asked that we do a CT scan first, and he agreed. He pushed to have the CT scan done immediately, as well as further blood-work. Surgery was scheduled for a month later, and a further office visit was scheduled for me to see him again in few weeks.
He called me the following week after receiving my blood test results. I was informed that my tumour markers were up slightly, but that there was still not enough to be immediately worried, and that it was still okay to wait until the following month for surgery. I wasn’t exactly relieved to hear this, but at least it was something of a reprieve.
It would be short-lived however, as within a day or two I got another call. He asked me to call the office and speak to him immediately. I’m not sure about other countries, but in Canada if your doctor wants to talk to you on the phone, it’s serious. I called him back and he explained that the CT scan had shown an irregular lymph node. That, combined with the elevated tumour markers meant I needed surgery as soon as possible, it no longer a good bet to wait. My surgery was moved up to the following Monday.
The surgery. Wow. My doctor had suggested I may be able to return to work within 3-4 days after. This was absolutely wrong! I was in so much pain for the first few days I could barely stand let alone walk. I needed help just to sit down on the toilet. When cancer is suspected they cannot simply remove the testicle through the scrotum as you might expect, there is too much danger of accidentally cutting an infected area and allowing the cancer to spread. Instead they make a fairly large incision in the lower abdomen and push the testicle up through there. It leaves a lot of bruising, and in my case numbness due to nerve damage (that I am told will likely heal in time).
I am very lucky to have such an incredibly loving fiancée who, while I was in surgery, purchased me several new video games, moved the TV into the bedroom and laid everything out next to a plate of fresh-baked cookies. She is truly the best.
On day five of my convalescence we attended the Elton John concert at Rogers Arena. I probably wasn’t quite ready to move around that much, but there was no way I was going to miss it. I shuffled into the stadium like an old man, and having to constantly get up from my chair to let people by to their seats was not fun, but it was worth it! What an amazing concert. Rachelle, who is not really an Elton John fan, admitted that it was the best concert she had ever seen.
And then yesterday I saw my urologist once again and finally got the confirmation. Yes, it was a tumour. Yes, it was cancer. Yes, we did the right thing by taking it out. It was a pure seminoma tumour, and huge one, occupying nearly my entire testicle. This may be why it was difficult to see on the ultrasound as my understanding is that ultrasound detects differences in tissue and if all the tissue looks the same…
This was actually the good news. Seminoma is the most responsive to treatment of all testicular tumour types. The bad news is that because the CT scan showed an irregular lymph node I will most likely need further treatment.
Surprisingly, I feel rather zen about all of this. It helps that the outlook for testicular cancer is good, but even so I would have expected to feel much worse. Rather than feeling discouraged or sad, I feel a renewed sense of urgency to live my life to the fullest, and to succeed at doing the things that matter to me and give me joy in life.
Perhaps this cancer is a gift.