Movember: #CheckEmLads

Ministry of Defence Police Inspector, Dan, reflects on his experience of testicular cancer.

The dreaded C-word, the moment any person dreads… The period from February 2018 to November 2019 will forever be ingrained in the recesses of my mind. During that time, I had cause to deal with a series of life changing events.

On reflection, I realise that each of these events, even in isolation, would inflict great pain and trauma on any person, but the distraction caused by these together created an odd emotional anaesthesia effect on the event which is the subject of my recollection here today.

Early signs
In August 2019, during a routine training session, I became conscious of a dull pain in my groin area which, although not excruciating, registered as mild discomfort. At the time I remember dismissing the pain as being caused by ill-fitting underwear. I soldiered on and the pain eventually receded.

The following week, whilst on annual leave, I was again running and experienced the same pain. I carried out a self-examination of my testicles to see if they felt normal. At this point in time, I did not believe it could be anything sinister, although I thought I could feel a slight lump on my left testicle. I had visited the doctor with a similar issue some years in the past and this had been written off as a vasectomy scar, so I didn’t want to waste my GP’s time and I quickly dismissed it.

The next week I participated in Personal Safety Training and my annual fitness test. I managed to reach the required standard, but again experienced the dull pain. I could no longer ignore this sensation. Ironically, during this session, a colleague experienced a kick to the groin, which doubled him up in pain. Knowing what I now know, I probably owe him one for partnering with the world’s clumsiest ninja and sparing me his pain!!

Initial diagnosis
I booked an appointment with my GP for the following morning and on attendance, several routine tests were carried out, including an examination of my testicles. I was in a lot of discomfort — both mentally and physically. The doctor said they thought the pain and slight swelling could be associated with an infection. I was prescribed a 3-week course of antibiotics and asked to return if the swelling and pain did not reduce.

During the preceding three weeks the pain continued and towards the end of September 2019 I revisited my local Doctor’s Surgery. I relayed the history leading to my attendance, and a physical examination was again carried
out.

I remember wincing in pain as the doctor appeared to locate an area and spent far longer than I was comfortable with squeezing and prodding. During what was becoming a frequent experience, I learnt the value of going to that special place in my mind!! On completion of his examination the doctor said that he believed I had cancer on the left testicle, requiring further exploration via an ultrasound to confirm it.

The doctor asked me how I felt about the suspected diagnosis. If I am honest, I remember feeling completely numb and this may have been reflected in my body language. I recount telling him what I thought should be said in this situation and that was, that I felt completely shocked and worried. I was instructed to take pain killers and wait for up to 14 days for an ultrasound scan.

Confirmed diagnosis
Whilst at work the following week, the pain had started to become unbearable, and I walked with a wide gate like a seasoned cowboy. In excruciating pain, I left work early and attended an emergency appointment with the doctor. It was obvious that I needed to be urgently assessed and provided with stronger pain killers.

During this examination by a different doctor, I was informed that testicular cancer was extremely rare, and this was more likely to be an infection. I cannot thank this doctor enough though, as they ensured that I was promptly sent to hospital and examined, on the basis that this might fast track an ultrasound. Blood samples were obtained, and I was sent home and asked to return the following day.

From the ultrasound the doctor confirmed I had testicular cancer, with the tumour situated on my left testicle and measuring in at 9cm in diameter. The subsequent blood tests also revealed a high tumour count. I was told that the treatment plan would require the immediate removal of the offending testicle and further scans to determine if the cancer had metastasized in my body.

Treatment and coping mechanisms
The cancerous testicle was removed within the next two days. Despite the operation being a lot more physically intrusive than I had anticipated, I still felt emotionally numb and my obsession was dealing with the other issues in my life at that time. I remember thinking this operation was mildly inconvenient and preventing me from doing what I needed to do to
rectify those other issues.

At this time my mind was distracted and my methods for coping were to evaluate the worse-case scenarios and accept these as being my fate. I felt if I could deal with this, then anything else moving forwards would be a bonus. Sadly, one thing I didn’t take into consideration was that my wife chose an alternative and opposite approach which was clinging to positivity and hope. I realised that I had become understandably withdrawn, as it felt like my issue and my issue alone. I learnt that this wasn’t wrong but, despite it being my illness, I needed to communicate and accept my wife’s alternative perspective.

Post operation, at my follow up appointment, the doctor said that I had a seminoma type cancer and he believed the scan evidenced a possible metastasis to my lymph nodes. At this point it was probable that I would require a full course of chemotherapy rather than the routine flush, and I was transferred to specialist care at the hospital as an outpatient. Whilst in hospital, the oncologists examined new scans to compare with the old and in consultation informed me that they believed the swollen node was on the wrong track to be linked to the cancer, so they would monitor this via surveillance.

Returning to work
I returned to work within 8 weeks on light duties and began building up to a full return before Christmas 2019. During the time preceding my operation and subsequent return to work I was informed of a colleague who, after hearing of my plight, found a lump on his testicle in a self-examination. Subsequent tests led to doctors diagnosing cancer of the kidney, which resulted in a lifesaving operation. I cannot express in words how humbled I feel that my own experience triggered a positive chain of events that saved the individual’s life. This was all the more poignant to me, as the individual is someone with a young family, for whom I have a lot of respect too.

Further monitoring, scares, and checks
In the following January I was called back to the hospital, where I was told the lymph node had grown and was causing some concern. After a period of months, I again underwent a complex operation to abstract a tissue sample from the rogue lymph node located in my lower intestine. Thankfully, this turned out to be benign and I was again given an all clear some 12 months after my original diagnosis.

Eradicating testicular cancer doesn’t end the journey for those who find themselves unfortunate members of this club. I am currently cancer free, but I have frequent scans and blood tests to monitor my situation. Cancer could return at any time and my chances of this are now far greater than for someone who hasn’t had cancer. The testicles are crucial for producing the male hormone testosterone, and my surviving testicle is a power station taking on the role once shared. My testosterone levels have, however, continued to drop, and this may lead to further treatment to counter this.

Every scan or test brings with it raised anxiety. A hole has been left by the removal of what I perceive as being a part of my masculinity, but I know the scars I now bear will also forever remind me of how I am able to still live and be a father and maybe one day a grandfather. I am a survivor and this journey has made me more resilient and battle hardened.

#CheckEmLads
I cannot stress enough, from the lessons learned in my journey, to ‘check ’em lads’. No matter how trivial you may think it is, any changes in the testicles, including increases in general size, lumps or bumps or general pain or swelling, should be examined expeditiously. Time is of the essence with some forms of testicular cancer, and the earlier it’s caught the greater the chances of survival.

Further information
Check ‘Em Lads is a free support group for men and their partners living with testicular cancer. The group was a huge support to me when I was going through my initial journey and they continue to support me to this day, as I also do for those who are newly diagnosed.

For further information on testicular cancer visit: www.nhs.uk/conditions/testicular-cancer/

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