Last Updated February 7, 2006
My name is Shawn and I was 31 years old when diagnosed with testicular cancer. I am providing this information to help other men who will be diagnosed with this illness in the future. The stories submitted to the Testicular Cancer Resource Center helped me through this ordeal, and I am telling my story to return the favor.
Part I: The Diagnosis and Operation
My story begins with a visit to my primary care physician on December 23, 1999. I had been aware of an abnormality in my right testicle for several weeks and decided I better get it checked out. I explained to the doctor that my right testicle was considerably larger than the left one and it felt very hard (it is important to note that I did not have the typical “lump” on my testicle; the entire testicle was enlarged and extremely hard relative to the other testicle). The doctor performed his examination and agreed with me, but didn't think it was unusual. However, he went ahead and gave me a referral to a urologist, just to be safe.
It was two days before Christmas and the last business day of the week, but the urologist was able to see me the same day. His exam was very brief and definitive: I had a testicular tumor that had to be removed ASAP. Before leaving his office, I was scheduled for a CT scan, chest X-ray, and AFP, beta HCG, and testosterone blood tests on December 27. A right inguinal orchiectomy was also scheduled for January 3.
The CT scan, X-ray, and blood tests all came back relatively good. The only abnormality was a slightly elevated HC beta level; I had a level of 5.5 where the normal range is 0 to 5. The AFP level was 1.7 in a normal range of 0 to 10, and my testosterone level was normal.
January 3 came and the surgery went without a hitch. I arrived at the surgical clinic at 7:30am and was home watching TV by 11:00am. Aside from the usual soreness, my recovery was very quick, and I returned to work exactly one week later. The pathology report confirmed a 5 x 3 x 3.5 centimeter tumor that was pure seminoma with no indication of metastases (on a staging scaled of I to IV, it was I). I had a follow-up visit with the urologist on January 12, at which time he referred me to a radiation oncologist.
Part II: Radiation Therapy
I met with the radiation oncologist on January 19. He examined my remaining (left) testicle, surgical incision, and internal organs, and discussed post-surgical treatment options. He explained that I had an 85% chance of staying in remission and that radiation therapy would raise the odds to better than 99%. He offered the surveillance-only plan to me, but strongly recommended radiation therapy. I had already decided that I was going to have radiation therapy. I was scheduled for simulation on January 26, and blood tests were performed to establish a baseline CBC before radiation therapy began. They also performed another round of AFP and HC beta tests. The AFP level had dropped to 1.6 and the HC beta had dropped to less than 0.5, the detection limit of laboratory equipment. Very encouraging! Radiation therapy was scheduled to begin on Monday January 31. The total prescribed dose was 2500 rads to be given in twenty doses of 125 rads; the whole process taking four weeks.Day 1: Monday January 31, 2000
I reported to the hospital at 2:00pm. The radiation technicians took a couple of X-rays to confirm the accuracy of the set-up and then the treatment began. I was zapped on each side for 15 seconds and then sent on my way. I picked up my compazine prescription on the way home and took one immediately. I wasn't feeling nauseous, but I wanted to be safe. My stomach began to feel a bit unsettled about four hours later, but I didn't vomit. The compazine made me drowsy, and I went to bed at 9:00pm.
Day 2: Tuesday February 1, 2000
I woke up at 6:30am and was at the office by 8:00am. I was just a bit queasy, but it was bearable. I was able to eat normally and never felt the urge to vomit. I was able to avoid the compazine, also. The remainder of my treatments are scheduled for 4:15pm. I was home watching TV by 5:00pm. I still had the persistent queasiness, but managed to eat a good dinner. I began to feel nauseous around 8:00pm and took a compazine. They really knock me out! I was in bed asleep by 8:30pm.
Day 3: Wednesday February 2, 2000
Again, I was up at 6:30am and at the office by 8:00am. The persistent queasiness stayed with me through the day, but I was still able to eat and work without trouble. I received the daily zap at 4:15pm and headed straight home to the TV. I ate a good dinner, and the nausea set in around 8:00pm. Four hours after treatment seems to be the magic number. I took a compazine and was in bed by 9:00pm.
Day 4: Thursday February 3, 2000
Another ordinary day with the same routine. I have been drinking Carnation Instant Breakfast but today it almost came back up. I choked back the urge to vomit for five minutes and then everything was fine. Oddly, I was a little less queasy for the rest of the day than I was the previous days; maybe my body is adjusting. I have been fortunate enough to be able to eat relatively well, and I think this is what's saving me from feeling more nauseous. I had a very large dinner after therapy and felt pretty good all night. I took a compazine at 8:00pm for safe measure and went to bed at 9:30pm. It's worked so far, so why ruin a good thing?
Day 5: Friday February 4, 2000
I felt almost normal today - no queasiness. There seems to be a correlation between the amount of food I eat and how well I feel. I'm afraid to miss a meal for fear that I will topple the first domino and not regain control. I've never been a big eater, but I've never had this kind of incentive! I followed the same routine after therapy - a big meal, compazine at 8:00pm, and bed at 9:00pm - and called it a week.
Weekend #1: February 5-6, 2000
I woke up on Saturday morning feeling incredibly good. I made breakfast, did a few chores, and spent most of the day shopping with my girlfriend. We went to a comedy club with some friends that night and then watched some TV (no beer for me, though). It was quite a big night since I managed to stay up until 1:00am! I got another good night of sleep and felt even better on Sunday. Oddly, I had diarrhea later that afternoon and evening. I guess the treatment has finally caught up with the intestines. The doctor gave me a prescription for lomotil, but I'm hesitant to take it at this point because the diarrhea isn't that bad, and the pharmacist says it will really make me sleepy. I'll take one before bed.
Weeks #2, 3 & 4: February 7-25, 2000
In the interest of saving space, I have condensed my journal entries. Nothing of consequence happened through the remainder of my treatments. I had some mild, persistent nausea, but I never had to vomit. And aside from a couple of isolated incidents, the diarrhea wasn't too bad, either. I had a CBC performed every Monday, and the cell counts went down as expected. They leveled off after about two weeks and remained low, but normal.
I was very good about eating well and getting plenty of sleep (about 9 - 10 hours a night), which I believe were the key elements to feeling relatively well. I always took it easy on Friday nights, and I went out with my friends for a bit on Saturday nights (no drinking, of course). It seems strange, but I always felt the worst on Sunday evenings and perked back up on Mondays. I joked with the doctor during one of my weekly visits that I thought I might be addicted! He assured me that this was very unlikely.
Conclusion
It is now Tuesday February 29, 2000. I have been finished with radiation therapy for four days and feel much better than I have in a month. The radiation techs explained to me that the lingering effects of radiation interrupting cell replication cycles (normal and cancerous) will last up to two weeks. After that, I should be back to 100 percent. Again, I seemed to feel the worst on Sundays, which didn’t make much sense. I may have been a psychological reaction on my part.
I have an appointment with the radiation oncologist this coming Thursday. He will have the lab do another CBC to make sure I am recovering well, and then I go into a follow-up monitoring program. He will have CT scans, chest x-rays, and tumor marker tests performed every three months for the first year, and then every six months the second year. This is a bit conservative for a Stage I seminoma, but it's perfectly fine with me. I'm not sure what comes after two years, but that's so far down the road it doesn't concern me right now. I'm just thankful that the worst is behind me now and I can resume a normal life.