Alright -- those of y'all who have made it this far have implicitly consented to wanting to know all the gory and intimate details of testicular cancer -- and all the specific details of my own personal adventures. If you get grossed out, or wind up knowing me better than you would like . . . well, it's your own damn fault, at this point. Here goes -- with nothing left out.
Note: this will get long, so for easy navigating,
you may jump ahead to any subject that interests you:
DIAGNOSIS | FERTILITY | SURGERY | RADIATION | ONGOING HEALTH
Sometime in late August, I discovered what I thought might be a lump in my left testicle. It's hard to know that kind of thing for sure cause, to be honest, testicles are a little lumpy and irregular on their good days. But we love them anyway, unconditionally -- and we hope there's never anything wrong with them. And like any loving parent, we tend to ignore their idiosyncrasies because we want for everything to be ok all the time. So I ignored mine for a month.
By the end of September, I couldn't ignore it anymore. Something seemed to be wrong -- and it seemed to be getting worse. So, thankfully, I broke through my denial and went and saw a doctor to have myself checked out.
He looked me over and ordered a sonogram of both testicles -- the left side, to see if there was, indeed, a growth -- and the right side for comparison's sake. Turns out, both sides had growths. And he referred me to a urologist for further consultation.
This was the hardest part of the whole process cause, it turns out, testicular cancer appearing bilaterally (simultaneously in both sides) is almost unheard of. So, while it couldn't be ruled out definitively -- it appeared more likely that it was an advanced lymphoma or leukemia that had spread to my testicles -- which isn't unheard of, at all. And which would've been really hard to deal with.
But after a battery of blood tests and cat scans -- and a real shitty weekend of waiting around for results -- we were able to determine that it wasn't either of these two extreme and terrible possibilities. At this point, it appeared most likely that it was testicular cancer, afterall -- and I was one of the rare and unique individuals who had contracted it bilaterally. I'm told I'm one of 200 reported cases all time -- which, frankly, makes me feel pretty damn special.
It also made the preparations for surgery much more complicated. Typically, for testicular cancer, the procedure is this: You have a tumor . . . then you schedule surgery soon as you can to have the testicle removed -- no questions asked. My situation was more complicated because . . .
[back to top]
The testes serve three purposes: 1) They make sperm, 2) They make testosterone, and 3) They serve as targets for women's knees when you've not acted gentlemanly enough at a bar. Typically, if you have to have one testicle removed, the other one can step up and do the job of both, admirably and sufficiently. If, for some reason, though, you need both removed, you must consider fertility issues and hormonal issues ahead of time -- and you must have various surgical contingency plans which include the possiblility of trying to save some of the healthy tissue, rather than removing the whole thing.
So, before I was able to have surgery, we needed to deal with the possiblility of future fertility. We needed to "bank some sperm" -- a term I loved right from the start. The sperm banking process was much more involved than you might think -- including a series of tests, and a methodical system of abstinence periods and "deposits." The whole thing took a couple weeks -- but ultimately I was able to stash away millions of potential selves in deep freeze storage.
So, fortunately, I'm still able, through the miracle of scientology, to father children -- though it would take pretty involved cutting-edge fertililty procedures. At least it's a possibility. For more info on sperm banking (not recreationally):
[back to top]
Meanwhile, two weeks later, I had surgery. It was a procedure called an orchiectomy -- or, for me, a bilateral orchiectomy. Basically, it's a very careful removal of the testicles. They enter through an incision in the lower abdomen/groin because that's where the vessels and cords orginate, that attach and nourish the testicles. This is key, because the most important element in the success of this operation is that the doctor is able, immediately, to restict the flow of blood to and from the testicles -- thereby ensuring that no cancerous cells are able to migrate from the scene and enter any other system of the body. So the vessels are clamped, and the testes ascend and are removed. Actually, they're removed one at a time, and a pathology analysis is done on each one while the operation was still in progress. It's not really unitl this point that they know 100% for sure, no doubt, that the growths are what they suspect. For more info on the orchiectomy procedure:
One more element of the operation which -- since I've decided I'm just gonna lay everything out here shamelessly, rather than try and figure out what's appropriate, and what's not, to say. During the operation, they installed implants -- which are basically designed like breast implants (which we're all sooo familiar with). I asked for the big brass ones. Instead, I got the silicon ones, filled with saline. Less impressive than brass ones, in barroom and boardroom situations, the ones I have, nonetheless, are supposed to be much safer and much more likely to be accepted by my immune system. Frankly, they're pretty good. They're not the real thing, but they're pretty good. For more info on falsies:
The recovery from surgery was remarkably easy. It was an out-patient procedure, so I was released to my parents recognizance that same afternoon -- and really, once the groginess wore off, I felt shockingly fine. I could walk around pretty well, that same day -- just a little slow. And peeing was fine. And I could sleep comfortably. And there was a marathon of West Wing episodes on Bravo. And my mom made me a giant pot of homemade chicken soup. And I had orders from the doctor to just lay there and stay off my feet and don't do anything. So I was loving it. Just a little sore for a few days. And then I was told to take it pretty easy for about a month, and not lift anything over 15 pounds. That was the hardest part of the whole thing.
[back to top]
So now, at this point, they know for sure that what I had is called Seminoma. And they consider my recovery prognosis, with this kind of cancer, to be at 85% following the surgery. From past cases, they've determined that there's a 15% chance that a cancerous cell might have strayed from the testicles and into the lymphatic system, either in the days before the surgery, or during the procedure itself. So to squelch that worrisome 15% -- and to bring my recovery prognosis up to 100% -- they've recommended a light course of radiation treatment, which I will begin soon.
Radiation for Seminomas is relatively short and relatively light, and the side-effects are relatively easy to manage. The course of treatments involves short (15-minute) daily appointments where they blast a specific series of lymph nodes with X-rays. The logic behind this seemingly barbaric approach to "health" is that my healthy cells will be able to recovery and reconstruct themselves in the time elapsed between sessions, whereas the cancerous cells (which are slower to heal themselves) will slowly be broken down more and more, until they can't recover at all, and die. Die cancer, die!!!
That's the idea. And it seems to be a good one, I guess. Cause the success rate is pretty much 100%. And the only real side effects of the treatments are 1) fatigue, as your body expends a lot of energy trying to heal its cells back up every day, and 2) nausea. Apparently, X-rays to the abdomen make some people want to throw up. Fortunately, there's a relatively innocuous pill you can take prior to each session which cures you of this ill. So I'm not sweatin' it.
I just want to make it clear, too -- this isn't chemotherapy. Chemotherapy is a much more extreme and difficult process to undergo -- and has much more unpleasant side effects. I feel for anyone who has to go through chemo. It sounds really awful. Radiation is really much easier. For more info on radiation treatment:
[back to top]
Ongoing health considerations. Once I finish up with radiation, I will be pronounced good as new, and I will go out and drink tequilla. They will want to see me every few months for a year or two, just to check back up with me, and run a few tests. And then they will want to see me once a year. There's no statistical evidence to suggest that, because of this cancer, I'm more or less likely to develop any other cancer in the future -- and probably, since I'll be having more regular check ups and tests, I'll actually be better protected against some other fluke unfortunate development.
So that's it for the cancer. There are a couple other considerations, though. Remember way back up the page when I was talking about the three purposes of the testicles? Well, #2 was the production of testosterone, which is a mightily important hormone affecting the proper functioning of many intricate systems in the male body. And my body doesn't make it anymore. So a few days after surgery, I started hormone replacement therapy with a drug called Androgel. It's a daily dose of testosterone administered through the application of a small packet (ketchup sized) of gel to my chest and abdomen. I rub the stuff on everyday, and testosterone absorbs through my skin and makes me strong and mean and healthy. As with most hormonal treatments, there is a trial and error period to try and get the dose just right. Different people need different levels of testosterone -- and different people absorb different amounts of testosterone from the Androgel packets. So I've gone through a few menopausal moments the last month -- but we're getting it straightened out. For more info on hormone replacement (they have a funny logo of a gas tank running on full!):
One more thing I guess I want to mention -- cause my friends have asked, and so I suspect it's a question others would have, and would just be too polite to ask. Sexual function. Sexual function is fine. The testicles, it turns out, don't really have anything to do with sexual function. Their only input in the matter is to inject some sperm into the semen at the very last second. I don't honestly know where the semen is made -- I shoulda been able to learn this by now, given how much time I've spent in my urologist's examination room looking over wall charts of the whole reproductive system. But I know the testicles don't make semen. And they don't have anything to do with the ability to become aroused or to function properly sexually. So, everything's checking out ok. And in the end, when the doctors pronounce me 100% cured -- I'm gonna insist that they go ahead and pronounce me 100% stallion, as well.
That's the whole rundown about my adventures in testicular cancer. For more information about testicular cancer, in general, please check out this very thorough and reader-friendly site:
For information on ways you might be able to help me
through this whole thing . . . follow this link HERE.