Take a frozen bag of peas out of the freezer. Take a single pea out and place on kitchen counter. Cover it with a paper towel, and press/touch it with the pads of your finger tips. That is what my testicular tumor felt like.
I waited two weeks to see Roc Doc Christine. She had me in surgery two days later- only to have another surgery 6 weeks after to have 53 lymph nodes removed from my retroperitoneam- and suffer through high doses of chemotherapy. The good news for me is my cancer was so damn aggressive if I ever recur again from a single errant cell, I’ll know quickly because I’ll be coughing up blood in a month or two.
Testicular cancer is a young mans disease, and April is TC Awareness Month. There are a lot of moms on this team- tell your sons/husbands/brothers– all the boys/men in your life to read the first paragraph, learn how to self exam and don’t wait two weeks.
That was my Team CMMD Post on April First, only it wasn’t an April Fools joke.
Roc Doc’s quick action that day likely saved me from liver, kidney and brain metastases. More than half of testicular tumors get misdiagnosed by family medicine as epididymitis, a scrotal infection. A solid testes tumor is absolutely cancer, and the ultrasound is an unmistakable diagnostic tool. She chose imaging rather than the easy out of antibiotics.
To brag on Roc Doc a little bit- you should know I was 39 when I went in that day- April 17, 2006. It was my FIRST visit to her office. In February that year I was T-boned in my car and spent 7 days in ICU at Hospital at University of Pennsylvania (HUP) trauma. I really thought I was going to die in that hospital- I had broken ribs, collapsed left lung and more. The chest tube draining my internal bleeding was the single most painful thing I have ever experienced. Once HUP released me, they ordered a chest x-ray to track the healing. They told me it was not necessary to return to HUP- they said OK to have imaging done locally and read by my primary care physician (PCP). I was disappointed in my current PCP in Paoli, whom I had seen for years- mainly because no one in his office responded to me or the trauma docs at HUP for my medical background. So I went doc shopping and heard about this brilliant young woman who was going to change the world.
I went in there, she listened to my lungs, reviewed the films and report from the latest chest x-ray – was very nice and refreshing after the chaos of HUP. She asked me if there was anything else I wanted to talk about- I was totally embarrassed and said, “Well, there is this new tiny bump on my testicle.”
After a quick exam Roc Doc wanted to send me out for an ultrasound- it’s probably nothing but could be a problem. What kind of problem? “Well, honestly I want to rule out cancer.”
Cancer, CANCER. CANCER!
I knew it- I had noticed the thing two weeks ago, but waited until my chest x-ray read to discuss it with a doctor. So I did what everyone else does- went to the internet and self diagnosed. It hurt a little, just like the web said it might- but that turned out to be because I was fondling it every 10 minutes for two weeks- enough to bring any man down. I was getting a little cray cray at this point. So nervously I drove to the imaging center in Downingtown with STAT script in hand. I called my wife- she was calming- just take it easy- get the test- see what happens.
So I get there and this is the sign above the door Roc Doc wanted me to go in, “Mainline Diagnostic Imaging and Womens Center”. I was like WTF! Women’s Center?? They don’t do scrots! I started to get panicky- called Majbritt, my wife, back again and told her I’m going to drive to Paoli and see if I can get in with my old male doctor. This new female doctor- I don’t know, sending me to a women’s center for male parts… Maybe she’s a quack.
Majbritt said, “Just go in and bring the script. I’m leaving work now.”
So I go to registration with my insurance card- they said, “We have been waiting for you- come on back.” They were great, very caring and calming.
Then the tech started to get quiet and was concentrating- said, “Wait here.”
The radiologist came in and she said, “We just spoke with Dr. Meyer, she would like you to return to her office.”
Roc Doc brings me into her office with the big leather chairs. “So I got the results, it’s not good news. The testicle has to come out. It’s definitely cancer. You have an appointment with urology in West Chester in two hours. We’re going to get you through this.”
IT’S DEFINITELY CANCER.
That was all I heard.
Fast forward: Surgery went well- had the pathology read at Chester County, then to HUP to see oncology- Onc Doc there said there is another surgery I would like you to have, but we don’t do a lot of them here. Roc Doc back to the rescue- she gets me an appointment at Sloan Kettering in NYC. There they open my abdomen and remove 53 lymph nodes. That world renowned surgeon is a true definition of abrupt bed side manor and NY attitude. When I first went into the consultation room, hesitating on NY or Philly- he said, without sitting down, “Look, I don’t need the money but you need the surgery, make up your mind and tell the nurse.” But he is among the greatest surgeons in the world for the RPLND (Retroperitoneal lymph node dissection) and saved my life for sure.
Another quote from my NY Doc that was kind of funny:
I said, “Doc, do you think the trauma from my car accident caused my immunity system to weaken allowing the microscopic germ cells in my testicle to gain strength resulting in the cancer?” His response: “What’s the difference? You have cancer, it’s my job to cut it out- it’s up to the PhD’s to figure out why. Now get back to your incentive spirometer and stop thinking.” It is a very tricky surgery and not without side effects. I’ve had two surgeries since to correct problems from that RPLND- but I live to talk about it.
Fast forward again: Months later CT Scan showed recurrence in my lungs- new tumors. Onto chemotherapy at HUP. Now my Onc Doc, NY Doc and Roc Doc are all sharing notes- Everyone was copied on all reports. I was in good hands with this dream team. Four months after chemo started I got my first “All Clear”- and have been since.
Thinking back on that first visit on April 17, 2006- when I almost went back to my old PCP- if I did and he did not order the ultrasound, this story might have had a different ending. Thanks Roc Doc!
-Joe Schmidt