Dear Testicular Cancer

I haven’t posted much in the last week. I guess I’ve been able to start focusing on other things than the treatment and cancer, which is very good. My mind starts to function again on a more normal level. I am more relaxed and I don’t freak out about every little pain I feel. In fact I haven’t even felt the tiny infection in my left testicle anymore. Vitamins A,B, C and E, Isoflavones, Q10 as well as a ton of green tea have become my daily companions. I definitely don’t want to give cancer another chance. I have also started to exercise once a day on the bicycle for 10 to 15 minutes. I’ll move up slowly since I’m quite out of shape as I’ve noticed.

Round two of chemo has gone by like a breeze. The first four days were as expected a little bit unfomfortable with flu-like symptoms, but definitely not as bad as the first round. The doctor has prescribed me some laxative which has helped a great deal with the constipation. It helps to know how the body will react. I again drank tea and water until I could not bare the taste of water anymore then I switched to apple juice and soy milk. Also rinsing my mouth with warm salt water helped with the taste a little bit. Supposedly it’s also good to strengthen the gums.

I am now in the second week. My blood results after week one were good. One more doctor visit and I will head back to New York. I will take things slowly but I have to start getting back into life. I have already my first job lined up with an old school friend in New York. I have not told him anything about the past few weeks. I don’t think I will.

I start to feel completely normal again. Every now and then the incision causes a little bit of trouble if I walk for longer stretches. Last night I had a dream about pain under my armpit which worries me, but I cannot tell whether it is only part of the dream or whether the pain is real. I have not experienced the pain during the day yet so it might just be a dream. I earlier had also a dream that my left testicle has moved up to my groins and that I need to push it back down, aaahhh. How painful. I remember that was the case with my right testicle because it was undescended when I was born. Supposedly those undescended testicles have a higher chance of getting a tumor than the ones that have desceneded on their own.

Anyway I need to keep my head busy in order for these nightmares to disappear. I have to move on. I started a new blog called WAITING FOR CHEMO I’ll be writing an entry every day until the chemo therapy is over and I moved back into my old appartment in New York which will be in approximately 6 weeks. Well who knows maybe earlier. The second dosis of chemotherapy is coming up in six days. I’ll be enjoying my life without poison until then.

It’s roughly one week since the first dosis of paraplatin. All the sideffects seem to be over. It took about seven days for the constipation to disappear. The muscle pain vanished after three days. I was tired for roughly one day. No nausea whatsoever. But yes a major constipation.

I got my blood checked and everything looks fine. I start to feel like a human being again. Walking is also going practically like before. I am still trying to walk carefully but I didn’t feel anything major in about 2 weeks and I have walked about 3 or 4 kilometers a day.

I got the first dosis of paraplatin three days ago. I went up to the hospital with my girlfriend at around 9am. The doctor said I wouldn’t feel anything and I should not prepare anything of any sort. They gave me some anti-nausea medicine and then I had to wait for an hour for the drug to kick in. Then I walked into a room with a bunch of beds with people in them getting their chemo. The last one in the row was mine. A nurse hooked my arm up to the IV bags with more anti nausea drugs and also the paraplatin. The needle barely hurt. The whole process took about one hour then the bags were empty. Two old elder men in the beds next to mine were talking about getting a few beers after the chemo. Seems like they are regulars at this place.

Back home I started to feel tired, so I took a little nap after a very rich lunch. When I woke up I started to feel a slight muscle pain, similar to flu symptoms. I was able to sleep nevertheless. Then it started… not the nausea, as it turns out they gave me enough of those anti nausea pills, but no one mentioned the constipation. I was never so full of shit. I could barely sit. My father got me some laxative. I stuck up 3 dosis of that stuff up my rear end and 2 dosis of the liquid version through the mouth. After 8 hours of tremendous asshole pain I finally was able to extract some junk.

They really could have warned me. Next time I will only eat vegetables and fruits.

Sperm Banks. I was always curious about these places. The one I went to looked like this. “Would you like to watch some DVDs?” the nurse kindly asked me.

They made me release my potential future babies into a plastic cup with my name on it. I needed the help of my girlfriend, the DVDs and the posters on the wall didnt really do it for me. I think I could offer them my pornography consulting services to create a more inspiring atmosphere in there. Although they probably don’t want the people to enjoy themselves too much, or else they’d be lining up around the block. So I guess it requires the right balance between hospital and porn. Tricky.

I called them a few hours later. Looks like I’m fertile. My boys can swimm!!!

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.

One week later I was at the hospital. No food 12 hours and no drinking 6 hours before the operation (Orchiectomy).

7am: Admission to hospital
8am: Switching to hospital clothes
9am: Shaving all pubical hair
12am: Operation

I don’t recall the moment of waking up, but I felt relieved. The nurse said that everything went well. I carefully explored my genitals. One testicle only. It felt a little numb on the right side around the groins and in the leg.

A couple of hours later the doctor came by and said it was indeed a seminoma as expected. He asked whether I was ok with the look of the scrotum like this or whether I’d wanted an artificial replacement for the right testicle? I decided against it because I thought it didn’t look too strange and I have heard about possible sideffects of implants in general:

“[...] The artificial testicle has no function and there have been concerns with some of the artificial testicles made of silicone (because the silicone may leak from the testicle into the rest of the body). [...]“

But yes by now it honestly is hard to tell how many balls are floating around in that little sack. I am definitely not worried about the look at this point.

The first couple of nights past the operation were a little painful, nothing major though. Most of the pain was caused by laughing or caughing. I took painkillers for about a week. I was able to walk again after 2 days. The third day I was released from the hospital.

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.

The next day I went back to work. I told my boss what happend and he was very supportive . The antibiotics seemed to work. The right ball started to feel more normal after 3 days. The scrotum took on a more normal looking skin color and I felt that I was on the way to recovery.

The doctor suggested wearing a jock strap. To this day I am not quite sure where to get this contraption. I asked a girl at the pharmacy around the corner if they carried it but when I noticed that she got uncomfortable I started to feel embarrassed. Any suggestions on where to get these things, maybe online? Does anyone else wear these things? My brother just laughed at me when I showed him the images of it online and asked if I needed to wear these things until the rest of my life…

On the way to our favorite sunday brunch place I felt a sudden sharp pain in my groins. It started to sting in the groins but also in the legs and the lower part of the stomach when I was walking. Needless to say that the eggs benedict were not quite the right medicine at that moment. We took a cab back home and I lay down to take a rest.

The next thing I remember are three doctors checking out my balls at 11pm in a crowded emergency room. Their first concern was that I was suffering from testicular torsion, in which case immediate surgery would have been necessary. A nurse rolled me on a wheelchair into another department where a young doctor took a sonogram of my scrotum. In retrospect I realize that this doctor must have been very unexperienced. It took him almost 30 minutes to do the sonogram and even after all that time he still was not quite able to give me a convincing diagnosis. I just saw him pulling a disgusted face when he looked at the sonogram image. “You picked up one nasty infection” , he said but he didn’t know what it was. I was very irritated and felt somewhat insulted.

After almost 10 hours in the emergency room the main physician subscribed me a dose of antibiotics and a painful shot of Ceftriaxone in the butt. The diagnosis: Orchitis and Epididymitis. “Nothing to be worried about,… I see it all the time here,… follow up on it with your doctor in 4 weeks.”

I bought the medicine at a CVS nearby. I took the first one later that day. The hospital called again and said it might be a little more severe. They prescribed me stronger antibiotics. 10 Days of Doxycyclone, 2 pills a day.

I was less worried than before but the doctors seemed somewhat incompetent. I figure I’ll wait a could of days and see how things progress with the medicine.

The pain did not develop any further so there was no need to be alarmed, I thought. Recently however my right testicle started to feel a little sensitive. Slightly more than usual. I was not too concerned. Its size also seemed a little large than the left one which apparently is not uncommon. Read Dr. David Delvin’s article.

A couple of days later the scrotum started to take on a redish color, subtle but definitely different. The size seemed to have increased and yes they were very touch sensitive. It started to feel wrong. I got really concerned and started to reasearch on the internet for similar symptoms. My head started spinning. I am worried…

Honestly, who really keeps track of what’s going on down there? Are they bigger? Are they harder?  Was the right one always this big? Is it ok that they have different sizes?

One thing that did catch my attention however was this short, sharp pain coming from the left testicle. Really short ones, lasting one to two seconds perhaps in intervals of 2 to 3 months.

I thought that it might be related to my old cell phone that I’ve been carrying around in my left jeans pocket, spending most of the day right next to my testicle.  For a moment I thought it might be worth investigating whether cell phone radiation have the capability to decrease the fertility of men and at the same time I thought it might be a reason to finally get a new phone. It is really old and bulky. (it’s similar to the one on the photo). Either way it sounded like a dumb theory and I was also too lazy to bother going to a doctor and have it checked out, since it really only happend every other month or so. Putting the cell phone in my jacket usually did the trick

I still have the same phone by the way. I like to hang on to things if they work.