Dear Testicular Cancer

Alright I don’t like any of those three options. Who would. Making a decision is stressful especially when there is no good option available.

After long dicsussions with my girlfriend, my family and my doctors, I came to the conclusion that chemo was the least worst option for my case.

My Beta HCG Values have dropped from a 14 to a 2 after 4 weeks which is a great sign that things are going better. There is a chance that the values could drop to zero but it might not which would mean that some micro cancer cells could be still floating around my lymph system.

So I will receive two dosis of about 700mg Carboplatin (Paraplatin for IV). And a bunch of antinausea medicine. The second dosis will follow three weeks after the first one.

There is a slight chance of infertility caused by the Chemotherapy. For this reason I will need to have my sperms checked to see if there’s enough skilled swimmers in there. That should be interesting

Read Article on urotoday regarding the new carboplatin option for seminoma stage I patients.

The probability that the removal of the testical has healed me completely is about 80-90%. Another doctor gave me a relapse rate of 70% and 80% because of the size of the tumor being slightly larger than average. It’s all statistics anyway and it boils down to whether I’m a half full or a half empty kind of person:

20% Chance that the tumor will come back within the next 5 years
80% Chance that nothing will ever happen again…

I was given two options for post surgery treatments to lower the relapse rate to ~5%:

Option 1) 10 Days of Radiation Therapy or

Option 2) Chemo Therapy : 2 Dosis 700mg Carboplatin (=Paraplatin)

Interesting Video found on google talking about the chemotherapy option

[...]the latest research shows an early stage of one type of cancer—seminoma–can respond just as well to a single dose of chemotherapy after surgery, rather than needing a three week course of radiation therapy. (source: www.empowereddoctor.com)

Honestly I am a bit overwhelmed with having to make this decision. I am worried about exposing my body to toxic medicine that could potentially cause more damage. On the other hand I am not convinced that the tumor has not spread a little bit, it has been in there for quite a while after all…

I signed up with this online support group:

TC NET Support

I have received great help and mental support from them. I highly recommend signing up (free) and telling your story.

I have met with the radiotherapy specialist. The options for post surgery treatments of testicular cancer are all a little confusing and irritating right now. Every option seems to affect the probability of a reoccurence of the tumor and at the same time also the probability of causing another, secondary type of cancer further down the road (10-15 years from now). I will post more once my clears up a little and I have done more research.

About one week after the operation my urologist set up a ct-scan meeting for me. The ct-scan takes x-ray slices of the body and allows the radiologists to examine the lymph glands which could have been affected by the tumor. The seminoma tumor spreads almost exclusively through the lymph system.

The main purpose of the ct-scan after the operation is to determine the amount of spreading of the tumor across the body, this is referred to as staging.

The ct-scan procedure took about 10 minutes total. I lied down on the platform, the nurse hooks my arm up to some contrast liquid which allows the ct-scanner to highlight the blood and the lymph system. Then the platform goes back and forth about 4 times and a recorded voice tells me when to start and stop breathing. At one point the voice says: “… and now the contrast will give you a warm feeling across your body.” I felt the liquid pumping through my entire blood system in about twenty seconds… what an uncomfortable and unexpected feeling. I guess I was not prepared for it even though they have explained it to me.

My scan was clean! No apparent spreads visible. Yes! The doctor said that I was lucky. Loosing a testicle is not the most pleasant thing in the world, but if he had to pick a tumor he’d probably pick mine.

So I am officially a seminoma stage I patient.

Two weeks after the antibiotics ended, the symptoms returned: Reddish color, slightly bigger, uncomfortable to touch. I also noticed the stinging pain in the groins, legs and stomach at various intervals (every three to five hours).

I went to another urologist for the followup. He checked my prostate and thorougly examinated my testicles and my penis. He was not very gentle. I asked him whether there was a chance that orchitis or epididmitis would reoccur? Holding my right testicle between his thumb and index finger he replied: “We have to make sure that this is not a cancer.”

Now I was really concerned and the more I worried the more I started to feel the pain. My girlfriend told me to relax and helped me find some distraction. We went out for a dinner with some of our friends. I did not tell them anything about the desease. I just wanted to have a good time. The distraction worked. The pain disappeared for a couple of hours. I now believe firmly that relaxation and happiness are a very positive medicine for the body.

The next day I was turned down for another ultrasound and ct-scan examination by the receptionist at the hospital, I did not have enough money in the bank account (welcome to America!), I gave up on my search for an acceptable urologist in New York. I returned back to my home town in Switzerland where my parents have found a lead to the best urologist in town.

He gave me a spot a few days later. The sonogram diagnosis took less than twenty seconds. He predicted with 95% probability that there was a tumor in my right testicle. The elevated beta-HCG values indicated that we’re most likely dealing with a seminoma. A highly treatable tumor. The left testicle showed some slight irritations in the epidimis, otherwise it looks like it is in good shape. He signed me up for surgery one week later and told me not to worry. “We can help you and you will be 100% healthy again.” Despite the tumor diagnosis and the slight fear of having a testicle removed I felt relief for the first time.