Dr. Michael Callister finished a quick — yet surprisingly painful — exam, he pushed back the wheeled stool, peered up at me over his glasses and said, “Dave, you have testicular cancer.” My worst fear was realized. It was only the Saturday before when I noticed a difference — one side was harder than the other. Now it was Thursday, September 3 and my life has changed.
Callister immediately took me down the hall to the ultrasound lab and said to the tech, “I don’t know what you have going on, but you need to check this guy, right now.”
To even my untrained eye it was clear something was wrong. Callister stayed for the test (I’ve never had a doctor present for any lab test in my life). Both he and the tech clearly could see the problem. Then Callister said the most comforting thing I’ve ever heard, “Dave, if you have to get in line for cancer, this is the line to be in. It’s the most treatable form of cancer in men.”
According to the Wikipedia article, “Testicular cancer has one of the highest cure rates of all cancers: in excess of 90 percent; essentially 100 percent if it has not metastasized.”
I had a choice. I could come in the next day and have the surgery to remove the tumor or I could wait a week. Callister highly recommended coming in the next day because “the what-ifs will drive you crazy if you wait.”
It was sound advice. The next day, Friday, September 4, at 11:00 AM I was in the surgical center at the Budge Clinic in Logan, Utah. The procedure — called an Orchiectomy — is actually considered a minor surgery and I would be going home the same day.
Now the men reading this have a single question on their mind about the operation. All I’m going to say is this, thank heavens we are given two. There is a spare and everything works as it did before.
They rolled me into the operating room around noon and as I lay on that narrow table I had only one thing to say before they knocked me out, “Everyone please remember it’s the right side.”
I thought I felt pretty good considering. During the operation, Callister found I also had a hernia so he fixed that, too. It’s not often you get a two-for-one special in surgery. The pain was handled well by the medicines and as long as I held real still, it wasn’t that bad.
But I was also foolishly optimistic about my so-called state of mind. Every day I felt I was doing really well, only to wake up the next day and realize that I was mentally rubbish the day before. My sister Rebecca told me, “Don’t do anything important for at least two weeks after the surgery.”
It’s good advice.
Frankly, the whole month of September is a blur for me. Later in the month I did get some important work done, but I’ll bet a was a little out there during my conversations.
There are two types of this cancer — seminoma and non-seminoma. In other words, the seminoma type is the most common followed by a bunch of other types lumped in as non-seminoma. Non-seminoma cancers — which usually come as a mix of tumor types — are considered more aggressive than seminoma cancer.
Callister called on Wednesday, September 9 with the pathology report. It was all very “favorable”. The tumor was a seminoma and it didn’t appear to have metastasized. It was the best possible report.
The next Thursday (September 17) I went for a chest x-ray and a CT scan. These types of tumors have a very specific path they follow if they spread. First it can move to the lymph nodes in my back and then it can move into the lungs and even into the brain.
Following the scans I had an appointment with Callister, again. This time he pulled up both scans and went over them with me, in real-time. He even called the radiologist and reviewed it with him over the phone. Everything was clear. There was absolutely no evidence that my cancer spread.
It was official — I had a stage I seminoma. For all practical purposes, I was probably already cured by the surgery.
I really didn’t understand until after my CT scan what it meant to have the cancer spread. It turns out that it can move into the lymph nodes that lay along the spine between the vena cava and the aorta and in-between the kidneys. The surgery to remove those lymph nodes is called an RPLND. It is a major surgery with serious complications if a mistake is made.
I’m glad I didn’t know about it until I learned I didn’t need it.
These are the types of “what-ifs” the doctor had warned me about before surgery.
Lance Armstrong had symptoms of testicular cancer for three years before he was diagnosed. He said, “I always had the size difference there, but I didn’t know…I would’ve still been waiting if it hadn’t started hurting, it just got so painful I couldn’t sit on my bike any more.”
He had a non-seminoma mix of tumors that, by this time, had spread to his lung and brain. Although he didn’t require an RPLND, he did have to go through four cycles of chemotherapy and eventually had brain surgery.
Armstrong’s recovery is proof of how well testicular cancer can be fought with modern cancer treatments. He went on to win the Tour de France an astounding seven times after having testicular cancer. But it didn’t have to be this way for him.
So now we come to the reason why I’ve decided to share this publicly. To all my male friends who read this, please do a self-exam. It’s fast and very important. You cannot wait until something begins to hurt.
I can tell you that I was in no pain from my tumor. It’s just that one day I noticed the difference. The doctor said it was probably growing for a year or two to get to that hardness. Even then, I might have not gone to the doctor except that I told my wife. She insisted I go and in less than a week I had the diagnosis.
Just one more reason I’m glad I married Jennifer. There are no words to describe how much her support meant to me through this experience.
Even after the successful surgery there is still a chance that cancer cells exist in my body that can restart a tumor. To insure against this they used to give six months of radiation therapy (every two weeks) for seminoma patients. Or you could choose to come in every three months for CT scans, for three years. It’s a watch and wait approach that leaves you always wondering if it will restart. It’s also a lot of work.
However, now there is a third alternative. Recently they’ve found that a single dose of a chemotherapy drug, carboplatin, is equivalent to six-months of radiation therapy. Further study says that two doses are even better and can push my success rate from 97 to 99 percent. In other words I have a only a tiny chance that this will come back within ten years. And even then, it is still very treatable.
I had my first round of carboplatin two days ago on Thursday, October 3. It was painless. I just had to sit in a recliner for a couple of hours with an IV in my arm. First they gave me a few preparation drugs to reduce possible side-effects. That took a half hour. Then they gave me the carboplatin for an hour.
I won’t lose my hair. I haven’t had nausea. The most I’ve felt from this is more like I have a slight case of the flu where I’m somewhat tired and I get that tingly sensation — like I have a fever — that runs like waves in my body. Of course, I don’t have a fever.
By Monday, I should be completely over it.
There is only one more round scheduled for the Thursday before Halloween.
It is so worth doing as an insurance policy.
After this, I still go back for annual chest x-rays and biannual CT scans. The first few years are critical. Every year afterwards, the risk of it returning drops. By ten years the risk goes to virtually zero.
Action Beats Fear
I’ve never had a doctor act so swiftly and so personally to any medical condition in my life. Dr. Michael Callister, his staff at the Budge Clinic, and the staff at the surgical center are real heroes to me. They took a frightening situation and turned it into the most impressive display of medical skill I’ve ever seen.
Callister never wasted a minute of time to take care of this. From diagnosis, surgery, and follow-up, I was never left hanging on what my results would be. The real-time review of the CT scan was when it hit me. Normally the doctor would have me go home and they would call me in a few days. Not this time, I knew within an hour exactly what my results were.
Had they been bad, he would be there to explain what would happen next and make it happen. Since it was good, I could leave the hospital that day with an incredible sense of relief.
It many ways the experience was surreal. Although I lost a month of my life to this, it was worth every minute.
To all my friends and family, thank you for your support. And to all my male friends, get yourselves checked out. Do it now.