MTCJ — How it all started
4 May 2022: As I’m sitting in my hospital bed, having fluids run into my veins, preparing for my next round of chemo, I’ll tell you how I came to find out about my testicular cancer.
I decided to prefix all story headings about my cancer journey with the acronym MTCJ, that’s short for My Testicular Cancer Journey. That way, it’s easier to identify the different stories that belong to this experience.
Taking you back a bit, to let you know who I am, how I see myself, what’s important to me. Some of it was shaken up quite severely with my diagnosis, this is why I think it’s important I give you the background.
I’m 50 years old. I always considered myself quite healthy and fit. I used to cycle for transport, both in the city where I lived as a student (Munich), and for holidays (going bikepacking from Munich to Italy, southern France…). Fast forward a few years, now in England (Greater London), and with work and family, I wasn’t doing much sport anymore. A bit of yoga, and cycling to the train station to get to work, nothing more. Until my company published that they were sending a couple of teams to the UK Challenge (then called Microsoft Challenge), a multi day adventure race for corporate teams. I signed up, tried out, got selected, and ended up captaining one of the 2 teams they sent. We did quite well and had a blast, and I was hooked on sports again. I was 36 years old then, and this is what got me back into endurance sports. I started running more regularly, and aged 39, I ran my first marathon (Le Marathon du Grand Toulouse, France), a couple of days before my 40th birthday.
When I got a severe injury (proximal hamstring tendinopathy), which took me out of running and cycling for a couple of years, I started swimming instead. And when I finally managed to overcome this nasty injury and was able to go back to running and cycling, the step to triathlon was almost a natural one. I did a couple of sprint and olympic races, and then took the plunge and signed up for Challenge Roth, the biggest long course triathlon in the world. 3.8k swim, 180k bike, and a 42.195k marathon. I finished the race, did better than I ever expected, and I was hooked and signed up for 2022. I also followed up the long course triathlon with a stand alone marathon, 2 weeks before my 50th birthday, where I bettered my marathon time from 10 years earlier by 35 minutes. I was getting serious about this stuff.
With my interest in playing sport, and with injuries, came an interest in finding out how the body works, what can go wrong, and how it can be fixed. I learned about biomechanics, experimented with running styles (I went from heel striker to forefoot runner to midfoot runner), and I also got interested in nutrition, and how it impacts your health and performance as an athlete. All in all I was keeping fit, eating healthy, and feeling invincible (well almost — as you approach 50, little niggles come up more frequently then they used to, but at least nothing serious.)
Training for Challenge Roth 2022, with an ambitious finish time in mind, I started to feel discomfort in my testicle in late February of 2022. It came and went, and I didn‘t think much of it. I’d had it a couple of times before. It came again, went again, I thought this was odd, a bit too soon, within just a week or so. And as time passed, the discomfort was there more than it was absent. It wasn’t affecting my training (I could still sit on my tri bike in aero position without discomfort, and I was able to run pain free), but I did feel it sitting at my desk, or at night in bed. I thought I should have it checked out, but life was busy with work, family, plans for building a house… Eventually, the discomfort didn’t go away anymore at all. I told my wife, and she made me call all the urologists in the area (I’d never seen a urologist before), until I found one that saw me the very same day — that was on Friday, 1st of April.
I went to see the doctor at the agreed time, explained him why I was there, and he asked me more questions, listened attentively, and checked me out — touching the sensitive side (quite painful, to put it mildly), as well as the healthy side (less painful), followed by an ultrasound scan of my kidneys, lower abdomen and testicles. I was expecting that there was some kind of infection and inflammation there, that I might need to take antibiotics. The kind of stuff that happens once in a while, nothing serious. So I thought.
And then came the diagnosis: there is a tumour in my left testicle! It’s about 1.8 x 1.6 cm in diameter. It may be harmless. But then, it may not be harmless. And he made it quite clear that the less desirable outcome was the most probable one.
This is where I started to realise that things were serious. That things would change for me. That I wasn’t invincible and nothing serious would ever happen to me. On the contrary, something very serious had just happened to me. I had cancer! I remembered the book I had finished reading just a few weeks earlier, “Dead Man Running: One Man’s Story of Running to Stay Alive” by Kevin Webber, where the author talks about being diagnosed with terminal prostate cancer, being given 2 years to live. Not a good background for a conversation with a doctor about having cancer! My head started spinning, worst case scenarios were illustrated in vivid colours. The rug had been pulled out from underneath me! I tried to keep it together and not break down in tears while talking to the doctor. I’m quite good at keeping a straight face, but I’m sure if my wife had been with me, I would have collapsed there and then.
She wasn’t, so the doctor was spared the drama and probably didn’t notice the tsunami under the surface of my straight face and firm voice, as we continued to talk. Technically, I was too old for this type of cancer, usually it occurred in younger men, average age 36, some as young as their late teens. And here I was, aged 50. This was rare, but not unheard of. He explained me that testicular cancer was one of the types of cancer that responded best to treatment, that there was a 90–95% cure rate, and that we were not talking about life extending measures, but about eradicating this cancer once and for all from my body. If he had to choose a tumour, he said, this would be the one of his choice.
I tried to handle this information. Rationally, it made sense, made me think that I would be able to get through this and be OK, get back to my usual, strong self. Emotionally, I was in turmoil! What if it was more serious than the doctor expected? Would I be amongst the 5-10% who aren’t cured? Did I leave it too long and thus allow it to grow and spread? Why did I not call the doctor much earlier? Even if i was cured, would this leave me permanently changed, worse off, less healthy, less able to do things? Would I be able to be there for my family, as I have been thus far, support them, always have energy left when needed? Would I ever do a triathlon again? Most of all: I had cancer, of this I was sure, even though there was a small chance that it wasn’t cancer. Me? Cancer? I didn’t get seriously ill! I was fit, healthy. And yet, here I was. This was a hard pill to swallow!
I would definitely need surgery, the doctor continued, and soon. They would open me up, take a biopsy of the affected testicle, have it checked immediately while I was still in surgery, and if it was bening, they would just scrape out the tumour, leave the rest of the testicle in place, and stitch me up again. However if it was malignant, they would remove the entire testicle and send it to the lab for a detailed autopsy. Then they would do what is called “staging”, meaning checking if the cancer had already spread to any other part of the body. This is usually done via a CT scan. Further treatment, if any, would be dependent on the outcome of the biopsy, and the results of the CT scan, as well as the so called tumour markers — these are blood markers that indicate the presence of tumours in the body (that’s my ignorant and simplistic interpretation).
He put his receptionist to call the hospital immediately, and not let up until she had an appointment for my surgery. They work with 2 hospitals in Frankfurt, I was told, and they would refer me to one of them. Wow, this sense of urgency reinforced the feeling of doom that had gripped me. They stayed through their lunch break, until finally the hospital called back and gave them an appointment for me for a pre op talk and prep on Tue 5 April, and another one for surgery on Thu 7 April — 6 days after the initial diagnosis! Wow, that’s very soon! I wasn’t sure what to think of it, if to be grateful that I would get treatment very quickly, or to be worried what this rush indicated. Intense times were ahead of me, ahead of us.
