Boomcast username: HUGO
Hugo is a 24 year old Lieutenant in the Australian Army. After 4 years of training, he graduated from the Royal Military College in Canberra in December 2013. He was a generally a young, fit and healthy person, so the thought of getting cancer never crossed his mind. This is his story...
"It was in June 2013 when I noticed a small, pea-sized lump on my right testicle. Luckily, I have always been aware of my body, and eager to get things checked out when something doesn’t seem right (something a lot of young males unfortunately don't do). My initial thought was that the lump was probably nothing more than a benign cyst, but it was recommended I have an ultrasound to make sure. It wasn’t long before I received a call from my doctor to meet with him right away… I knew it wasn’t good. When I heard the words ‘you have cancer’ roll off his tongue, I didn’t really understand what he was saying. I don’t think I really processed it. It wasn’t until I rang my Mum when I realized what I was saying. ‘Mum, I have cancer’. As soon as I said it, I started crying. I didn’t know what to expect. I didn’t know what it all meant. Would I be alright? Would I need chemotherapy? There were so many questions… and breaking the news to my parents just confirmed to me how real it was.
After doing some reading, I was at least reassured in the fact that out of any cancer, this was one of the “best” ones to get - with the most successful cure rates (thanks to Dr. Lawrence Einhorn, who was the one who incorporated platinum based substance into the chemotherapy regime in the 1980s, improving TC survival rates from around 10% to 90%). Within 48 hours however, I was booked in to have my testicle removed. I wasn't exactly sure how to react to the fact that not only did I have cancer, but I was going to lose one of my testicles. I decided to opt for a prosthetic as I felt as though having a bit of symmetry down below would make me feel a bit more normal. I did find it mildly amusing when I met with my Urologist to discuss the different types available. He said it wasn’t uncommon for some guys to ask for a bigger size… I just told him the same size as the other guy would be fine. The surgery itself went quite well, and after a few painful weeks, I was pretty much back to normal. My initial CT scan showed that there was no sign of metastases, and the cancer was confined to the testicle. The pathology from the surgery showed non-seminoma (100% embryonal carcinoma). Although this is one of the more aggressive types of testicular cancer, I was told there was about 70% chance that the initial surgery alone had cured me of cancer. I am known to like having the occasional bet myself, so 70% seemed like pretty good odds and I did not see the need to have further surgery or precautionary chemotherapy. So I went onto what is known as surveillance - which consists of blood tests and CT scans every 3-6 months for the first few years.
Life generally went back to normal, and I continued with my Army training. My first follow-up CT scan showed that I was still cancer free. It wasn't until my second CT scan in November 2013 which unfortunately showed a 23mm 'abnormality' in the para-aortic region (the area most typical for my type of cancer to spread to). There was still the chance that it may not be cancerous so I decided to have a PET scan which, to my disappointment, confirmed that the cancer had spread to my abdominal lymph nodes. It was too late to have surgery as the type of cancer I had can often be unpredictable, so my only option was to have chemotherapy.
After 4 years of Army training, I was only a few weeks out from graduation, so I decided I wanted to graduate with my mates and commence my chemotherapy treatment in early December, back in my home town of Adelaide. I must thank the Army for all their support, as they have been incredible throughout the whole process. I was posted to Adelaide on what the Army calls a ‘compassionate posting’. I knew having the support of family and friends whilst enduring chemotherapy would make it just that little bit easier. I did a lot of reading about the chemotherapy ‘cocktail’ I was going to have, and I tried to prepare myself as best as I could. I was under the 3 cycles of BEP (bleomycin, etoposide, cisplatin) regime which would last for 9 weeks. But I wasn't having the best of luck, and due to some lung complications with the bleomycin, I had to endure a further round of just ‘EP’ - which meant treatment went for 12 weeks.
Besides the exceedingly good looking bald head accompanying my rather off-colour physical appearance and the constant feeling of being fatigued, I generally handled the side effects of chemo quite well... It was by no means a walk in the park, but it was better than I expected. Each cycle consisted of one week in hospital receiving the treatment, and 2 weeks to essentially rest up and prepare the body for the next cycle (which is more potent than the previous one). The week in hospital was rather draining due to being hooked up to an IV drip for the better part of 8 hours a day. One thing I learnt throughout my 28 days in hospital is that nurses are truly wonderful people. Their uncanny ability to always have a smile on their faces, and their dedication to their patients is something I will always appreciate. Another thing that helped, was no matter how bad I felt, I always forced myself to get up and go for a walk outside everyday. Although initially quite manageable, the hospital food eventually got the better of me. Just the smell made me feel sick, so I got Mum and Dad to bring in some food elsewhere instead. It was a matter of trying to stay positive and tick off each day as it came. I knew that it would all eventually be finished.
So in early February 2014, the day had come for the follow up CT scan to see if the chemo had done its job. Unfortunately, there was still an abnormality that remained in my abdominal lymph nodes, and I required post-chemo RPLND (retroperitoneal lymph node dissection) – which meant all my abdominal lymph nodes had to be removed. After doing some reading and watching a video of the surgery (which probably wasn’t the smartest idea) I knew I was in for a very full on operation. Typically, the surgery is very invasive and usually necessitates 6-8 hours in the operating theatre. Possible complications such as retrograde ejaculation and bowel blockages did not sound very comforting, but I figured it was just another bump in the road, and I knew it had to be done.
I was far more anxious heading into the surgery than I was with chemo. My surgeon, Dr. John Bolt is a highly regarded urologist, so that did make me feel better about the operation. After about 6 hours on the operating table, the good news was that the surgery was over - with no significant complications.
I remember lying in the Critical Care Unit (CCU) with a rather uncomfortable catheter, IV drips in both arms, oxygen assistance through my nose, a drainage tube into my stomach, massage controlled bandages to ensure I didn’t get any blood clots and an epidural which is essentially a needle inserted into the back of my spine which was ‘meant to’ numb my entire abdominal region. I say ‘meant to’… because unfortunately I fell into the minority of those who don't respond too well to the epidural pain killers. This was subsequently followed by what I can only describe as the most painful 12 hours of my life!
After a 6 hour operation with a 30cm vertical incision down my abdominal area, pain killers were always going to be my best friend. Initially the epidural was great. But when it stopped working, there had to be a 12 hour ‘transition’ period before moving to another source of pain relief. This was to ensure it indeed was not working and they could remove it… (I don’t know why they needed 12 hours to work that out)! When asked what my pain was out of 10, I responded with a 9…as I can only assume that being burnt alive would be a 10. Now I think about it, maybe I was only an 8 or an 8 and a half… either way, it wasn’t pleasant. I couldn’t move for that entire time, as even the slightest twitch would result in excruciating pain. Finally, I was put onto the more conventional morphine controlled pump. I certainly used up my quota as I pumped in as much morphine as I could. The old saying “time heals all wounds” seemed very accurate as each passing day I felt better and better. I tried to get up and walk as much as I could. I knew that as uncomfortable as each step was, it would help with the overall recovery.
After about a week in CCU, the tedious beeping coming from the machines, being woken up every hour for close monitoring and being fed only ice chips (as I had to give my intestines time to settle back into my body), I was ready to move into a private room. I had spent close to a month having chemotherapy in these rooms, so it almost felt like home. Subsequently, the pathology from the surgery confirmed that I was in remission with the lymph nodes containing no active cancer - i.e. the chemo did its job - finally some good news! There is no better feeling than hearing the words ‘you are cancer free’. I knew I would still have an extended period of recovery and rehabilitation, but I didn’t care… I was cancer free.
Besides from having to spend another week in hospital earlier this year for a completely unrelated burst appendix, I am feeling as good as I have felt in quite some time and I am looking forward to my new Army posting next year. I have my next CT scan in December - but with the odds well and truly in my favour; I expect the clear scan results will only continue.
I write this exactly 2 years to the day after my initial diagnosis, and it sure has been a rather emotional and physical journey. That being said, I like to think that I am one of the lucky ones- as unfortunately there are many people who are diagnosed with terminal cancers and those who eventually succumb to the terrible disease.
It is fair to say that my perception on life has changed a bit. I look back over the last 2 years, and as cliché as it sounds, I feel I am a better person for going through what I have. I have learnt to accept that everyone has their own problems in life, and everyone handles their emotions differently. Emotion is simply apart of life. We shouldn’t see it as a sign of weakness, rather to embrace it. Yes at times it seems as though it can tear people apart, but I like to think it can also bring people closer together. I am fortunate enough to have very supporting and loving family and friends, and it is to those who I am truly thankful. Rather than focus too much on the negatives in life, try to look at the positives…life is special, let’s not take it for granted."
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