Getting up to speed

As I mentioned on the Welcome Page (you did read the Welcome Page, right?), I was diagnosed with testicular cancer on April 15, 2010, but the story of my TC actually begins several weeks before that. Sometime in early to mid-March, I felt an abnormality in my right testicle. To call it a lump would not be accurate. It was more like a small bulge. I was slightly concerned, but because it did not feel like a lump on the surface and it was awfully small, I did not pay it much attention. I'm a tough guy and this problem would simply go away on its own, or so I thought. It didn't. It got worse, and it started to hurt. I mean that mother really started to hurt.

At this point, I brought the problem to the attention of my loving, beautiful, amazing, best-person-on-the-face-of-the-Earth Fiance, Venessa. She adroitly advised me to go to the doctor. My dumb ass insisted on procrastinating for another week. “If it doesn't go away, I'll go see a doctor,” was my plea. The truth is that I was scared. I was scared that going to the doctor would only confirm my worst fears. I wasn't prepared to face the certainty of having TC. Another week of pain, and a clearly diseased right testicle changed that.

So I went to my primary care physician who thought it might be an infection. She gave me some antibiotics, but she also ordered an ultrasound just to be on the safe side. The ultrasound could not have been more clear. There was a mass in my right testicle.

With this result, I was referred to my urologist, Dr. Greenberger, who took one look and said, “Yup, it's cancer, and it's got to come out.” Now, due to the particular anatomy of the testicle and the scrotum, it is standard operating procedure for the doctor to remove the entire diseased testicle (and the attached tissues) rather than biopsy the tumor. The overwhelmingly majority of testicular tumors are malignant, and biopsying the tumor would only serve to delay treatment.

The procedure to remove a testicle is called an inguinal orchiectomy. Mine was scheduled the day after my first visit to Dr. Greenberger (who was also the surgeon). Not to be too graphic or anything, but to perform the surgery, the surgeon makes a four inch incision in the lower abdomen (think bikini line). The testicle and associated tissues are then pulled up and out of the incision where they are removed. The surgery itself takes about 30 minutes, and they due use general anesthesia. Mine was done on April 16, 2010.

Prior to the surgery, Dr. Greenberger said there would be some mild incisional pain, and I might have difficult sitting up or down. That bastard lied. That shit hurt, like a monkey as Venessa would say. I will forever compare all pain I have in the future to that pain. It hurts because they cut through your abdominal muscles which at least for me, made getting up and down nigh impossible for about three days following the surgery. I also discovered I have a Vicodin allergy, which did not make things any easier.

After the surgery it took about four days before I could walk or stand with any real success. I had to use a walker for awhile, and I was still in a lot of pain at that point. However, here I am a little over a week from my surgery, and I can finally walk, stand, get up and down, with not too much effort. Amazing how the body heals itself.

As I have recuperated nicely from the surgery, the $64,000 question has become, did they get all the cancer. Unfortunately, I still do not know the answer. After the surgery, a pathologist looks at the diseased testicle to determine the type of cancer and whether or not it has spread to other tissues or accessed a vein (this is called vascular invasion). I got the results of my pathology on Friday.

According to the pathologist, I have a type of nonseminoa testicular cancer called embryonal carcinoma. While I am no expert, here's what I know so far. Typically, old guys get seminoma TC, and young guys get nonseminoma TC. Nonseminoma is also typically more aggressive.

The good news from my path report was that the tumor was relatively small (2.5 cm) and had not invaded the spermatic cord or the epidimisis. The bad news is that there was probable vascular invasion, although the pathologist hedged his bet by saying that the vascular invasion could have been a result of manipulation during the surgery.

This brings us back to the big question of whether it has spread. Like I said, I don't know. Normally prior to the surgery, the patient will undergo a bunch of CT scans to look for tumors in the lymph nodes of the lower abdomen (or elsewhere). However, because the first available time for my surgery was the day after my first appointment with the urologist, I have not yet had those scans. For now, I must be content to sit, stew, worry, and wait (and write blogs).

My appointment with the oncologist is on Tuesday. The oncologist will very likely order additional blood work and the CT scans. Hopefully, pray to God hopefully, the blood work will show normal levels of tumor markers (my pre-surgery levels were markedly elevated) and there won't be any tumors in my lymph nodes or anywhere else for that matter.

That's pretty much it. I'm sorry for posting such a long entry, but I just wanted to bring everyone up to speed. If you have any questions about my tc or my treatment, please let me know.

Oh, and in case you were wondering testicular cancer is the most treatable kind of cancer. 90% of men are cured with the initial treatment, so nobody needs to freak out.