John Dougherty – PART 1 - Diagnosis

“All seems good and we have a lot of options on the table. Let me do a quick physical exam before you go.”My wife and I had gone to see my urologist for some guidance on fertility. Up to this point, our attempts were unsuccessful and we weren’t entirely sure why. I was born with a bladder defect that we knew posed a minor obstacle in having a baby. But he quickly reassured us that it shouldn’t be a problem and we have plenty of options on the table. My wife and I breathed a sigh of relief that it was nothing serious.My urologist equipped a pair of latex exam gloves. Just a routine physical before we go. The next sixty seconds I remember so clearly. As he rolled his fingers around my right testicle, he briefly stopped and his head titled. “Hmm,” he uttered. He rolled his fingers into a few different positions, stood back up, and removed the gloves. “I’m feeling something we should take a look at, just to be safe.” When we asked about this mystery lump he felt, he assured us that it could be many things. “Obviously, cancer is the worst case scenario but we only see about 8000 men diagnosed each year, I have to mention it, but it’s highly unlikely.” He scheduled an ultrasound for the following week and we left the office.As someone who always got paranoid about being sick, I had self-diagnosed myself with cancer numerous times with the help of WebMD. My headache that wouldn’t go away: brain cancer. The cough that wouldn’t go away: lung cancer. My knee pain after a run: knee cancer? I’d done this so many times I became desensitized to the idea of cancer. Because it just doesn’t really happen. Only in my head. But this felt different: it was a real doctor, who felt something, and is now scheduling tests. WebMD never felt anything or ordered tests.We met a friend that night for dinner and I was entirely useless, only focused on the ultrasound the following Monday. As we left dinner, I asked my wife, “what if I have cancer?” Knowing my history of being paranoid about my health, she replied, “you don’t have cancer, he even said it’s very unlikely.”Over the next several days, I examined my right testicle every chance I got, trying to feel what he felt. I never did. In retrospect, that is the scariest memory: I could never detect the tumor! They tell you to contact your doctor if you feel a lump…well I never did. What if he hadn’t noticed it? What if I hadn’t gone to see him for a separate issue? Well, the lump I could never feel would not have sent me to the doctor. Despite the many hours I spent rolling the testicle between my fingers, nothing felt strange. In long run, there was a reason nothing felt out of the ordinary: the tumor had enveloped almost the entirety of the testicle. So instead of examining my testicle, I was unknowingly examining my tumor.The ultrasound was on a Monday morning. While I sat in the radiology waiting room, I was wondering what to expect. Maybe a scrotal ultrasound isn’t as awkward as it sounds? Nope, it’s awkward. The female radiology technician called me into the room, then instructed me to lay down and place my scrotum on a towel. Just another Monday, right? The exam only lasted about ten minutes. As she stayed focused on the screen, I tried to read her impressions. Does she know what she is looking at and just can’t say it? I desperately wanted to ask but just couldn’t. The exam ended and she let me know the urologist will have the results in a few days. I went home and was quickly was introduced to the worst part of cancer survivorship: waiting for damn test results.My urologist is always very prompt with results. So I assumed a response would be sooner than the 48-72 hour turnaround suggested by the radiologist. As hours became a day, I assumed the lack of a response spelled good news. I pictured the benign results sitting on his desk; he just hadn’t gotten back to me yet because the results are so uneventful. He’s calling the malignant tumor patients first, and then he’ll get to me.That feeling changed on Tuesday. The results of my blood tests had come back, and they looked, well, not very reassuring. My testosterone and estrogen had doubled from six months earlier. They typically don’t do that. And I tested positive for beta-HCG, a funny little hormone typically found in only two types of patients: pregnant women and men with testicular cancer. The situation was becoming a little clearer. And for the first time I honestly said to myself, “shit, do I have cancer?”On Wednesday, I was working from home. By late morning, I decided to go on a run. I didn’t think sitting around waiting for a phone call was a good idea. The run felt great. After two miles I was finding that awesome runners groove. The music on my headphones began to fade and the phone started to ring. I recognized the number…it was my urologist. I don’t remember the exact play-by-play of the conversation, but I remember a few key points.A large mass in your right testicle. A dominant lesion, likely pure seminoma. Blood tests support this. Surgery in a week. Testicular cancer is beatable. We’ll know more soon. I called my wife and Mom to let them know. I didn’t finish my run. I walked home. I broke down. I was 33 years old and cancer was now part of my life.Stay tuned for PART 2 – Treatment