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Vasectomy/Testicular Cancer

3,880 Views | 34 Replies | Last: 10 days ago by 88Warrior
CrawfordAg
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AG
Crosspost from a post I made in Facebook today


Men's PSA

Ignorance is not always bliss, please keep an eye out on your boys below the belt.

I have had slight swelling on my right side off and on for 3-4 months and just attributed it to a 3 year old who likes to jump off the top ropes and an 18 month old who crawls over and through and back over again.

Over the last few months I have kayaked 28 miles on a 3 day camping trip down the South Llano, lifted and run 3-5 miles a few days a week. During this time I had no noticable lumps or any pain so I just blew it off and thought it'd get better.

Fast forward to Friday where I have scheduled my vasectomy now that my Hattie is 18 months and perfectly healthy with no plans of additional kiddos. The urologist took a look down below and took no longer than 30 seconds and said " This thing needs to be removed now before Thanksgiving". Words definitely hit heavier with a wife and two kids 3 years old and under and felt as if we were in a vacuum of reality.

Friday morning I had an ultrasound and Monday morning I was at the hospital at 5 in the morning to have my right testicle surgically removed which I happily surrendered. Today I will be in San Marcos for a contrasted CT scan to ensure the cancer did not spread to my kidneys, liver,
etc...

I am not one to get on the socials and air out my daily life , frustrations, grievances,etc ... Ignorance and procrastination can be one of my strong suits when looking at the possibility of bad news due to my cautious optimism. Please send good vibes or say a little prayer for me today as they take a deep look into my future.

***TLDR Cliff Notes***

Men, self inspect your balls and take quick action if you notice any differences. It does not always mean a lump or pain. Per my urologist, firmness and the lack of pain is tell tell sign of testicular cancer.

Please love and look out for one another.

God Bless!!!




AggieOO
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Good Vibes/luck/thoughts/etc.

And **** cancer.
The Grinder (99)
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AG
Best of luck
Jbob04
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AG
Prayers for you brother. Fight the good fight for your beautiful family
MRB10
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AG
Thanks for the reminder.
CrawfordAg
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Anytime, if my wife didn't schedule my vasectomy I never would have had it looked at. I am very stubborn. If it's not falling off or shooting pain I brush it off and assume it will go away. I had my contrast/CT scan yesterday and should have a lot more info on a diagnosis today. The unknown and waiting is the toughest part.
wangus12
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AG
Praying for you man.
7yrplan
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AG
Good post.

I had testicular cancer 10 years ago. I finished chemo the week of thanksgiving 2014. After the orchiectomy and chemo, that took care of it for me, fortunately.

We all have a lot to be grateful for. We should all do a better job of taking care of ourselves so we can be around for those we love.

Best of luck to you!
DannyDuberstein
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AG
Good luck to you; glad the doc found it. I had testicular cancer in 2009. Had just a bit of discomfort for about 6 weeks that, like you, I am physically active and thought maybe I just tweaked it. But then I caught a thanksgiving cold that put me down for a week or so and the occasional discomfort remained, so I decided to get checked. I called the urologist at 8am, they had a 10am cancellation, sent me for an ultrasound, and by 1pm my doc had me added to the end of his surgery schedule the next day to have it removed. Quite a whirlwind

Thankfully it was Stage 1. I did have 4 weeks of radiation to reduce the chance of spread from 20% to essentially 0. The other option was 10 years of CTs as "watchful waiting" and chemo if something popped up. So I went for radiation and certainty.

Now 15 years and still all clear. I actually do credit Lance Armstrong and his effort to raise awareness. He may be an ahole, but without his story, I am 100% sure I would have waited longer

Get yourself checked, gentlemen! Can save your life!
DannyDuberstein
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AG
Btw - when my doc told me the diagnosis, one of the things he said to me was "Lance Armstrong was no miracle. His outcome was what I would have expected. That is how far we have come with our ability to treat this."

So praying for you, but even if those scans aren't the news you want to hear, have faith. This type of cancer is very responsive to treatment.
CrawfordAg
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AG
Everything is definitely moving like a whirlwind. I got my CT scans back yesterday and at first glance it appears to be positive although one lymphnode is fairly ominous. My doctor won't go through the scans with me over the phone to calm my nerves. He prefers to do it on Tuesday whenever we meet for our surgery follow up.

I have sent the results to my sister in law who is an ER surgeon and she said it was fairly good news. She said when you have it in the right testicle this area is generally where it spreads to first and can be treated with chemo/radiation.

Any docs on that can decipher for me to set me a little at ease while I wait to talk to the doc?


DannyDuberstein
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AG
The usual progression is abdominal lymph nodes then lungs then brain. On the lymph nodes, anything over 1cm is suspect, which is why that 2.5-3cm one is getting called out. Very good news that your lungs are clear. May have some chemo in your future as it seems to potentially be early stage 2, although only radiation can sometimes be an option in early stage 2. Good news is this responds extremely well to both. My guess is part of that conversation will be options and likely hooking you up with an actual oncologist to go further into options and the plan. That's what happened in my case
7yrplan
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As had been mentioned, this typically goes to the lymph nodes first.

That is exactly what happened to me. As i recall, depending on the pathology it could be a couple different treatment options.

Mine was also in the lymph nodes and I ended up with chemo.

The chemo for testicular cancer is very very effective. It will make you sick, you won't like it, but the prognosis is excellent.

After I finished chemo and my scans came back clear, I had a completely different attitude towards chemo. It saved my life, and I was immensely grateful for it.
CrawfordAg
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AG
How quickly can you start in chemo once you meet with an oncologist? Hoping to start as soon as possible.
7yrplan
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AG
Mine was Quick. Like your surgery, they didn't wait around.

Following my surgery and the CT scans showing it had spread to my lymph nodes, they got the pathology report from the surgery showing which specific testicular cancer I had. We had all the info at that point needed to make a plan. Chemo was my best option so we moved forward quickly.

That chemo regimen started with 5 straight days of getting infused, then one day the next week, and one day the week after that. Then the cycle starts over again. Since it started with 5 straight days they essentially had me starting the following Monday.

I'm sorry you and your family have to go through this, I really am. The silver lining here is the treatment for testicular cancer is incredible. It's essentially curable in most cases. That's rare with cancer, as we all know.
Happy to answer any questions, the best I can, as you get more information about what you are dealing with.
Aries
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I'm an oncology nurse. Like the others have said, chemo will be hard but it is usually only 4-6 cycles & is extremely effective. I have not had one of my testicular guys having to come back for more once their treatment is completed. I'm guessing, from looking at your results, that is what they will recommend for you....but just a nurse.

You'll lose your hair. You'll feel like crap starting around day 3 of your week of daily treatments. Your treatment days will be all day. Weed is your friend.
RockOn
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DannyDuberstein said:

Good luck to you; glad the doc found it. I had testicular cancer in 2009. Had just a bit of discomfort for about 6 weeks that, like you, I am physically active and thought maybe I just tweaked it. But then I caught a thanksgiving cold that put me down for a week or so and the occasional discomfort remained, so I decided to get checked. I called the urologist at 8am, they had a 10am cancellation, sent me for an ultrasound, and by 1pm my doc had me added to the end of his surgery schedule the next day to have it removed. Quite a whirlwind

Thankfully it was Stage 1. I did have 4 weeks of radiation to reduce the chance of spread from 20% to essentially 0. The other option was 10 years of CTs as "watchful waiting" and chemo if something popped up. So I went for radiation and certainty.

Now 15 years and still all clear. I actually do credit Lance Armstrong and his effort to raise awareness. He may be an ahole, but without his story, I am 100% sure I would have waited longer

Get yourself checked, gentlemen! Can save your life!
Fairly similar to my experience. Diagnosed in October 2008 with stage 1-B nonseminoma (age 24).

My tumor marker (AFP) had dropped immediately after surgery. The doc at MD Anderson told me it was a 50/50 chance that it would spread, so I opted for the 'watchful waiting', got lucky, and they cleared me after 5 years.


OP, if you're curious what the nationally "recommended" treatment protocols are - they are published online by the NIH (?). It all depends on what Stage and whether is seminoma or nonseminoma, etc.
fc2112
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OP - I'm just an aerospace engineer, so nothing constructive to add other than we'll include you in our prayers.
FightnFarmerUSMC
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AG
I was diagnosed in Feb of 2023. Orchi in March. Watching and monitoring for a year and then they found a mass on my periaortic lymph nodes in May 2024. Did 4 rounds of EP chemo over the summer into September. Just got a good report back and my AFP was below 6.0 for the first time since diagnosis. You can beat this! PM me for any questions or just ask on here. I literally just finished a few months ago. Hair just starting to grow back.

FYI, my oncologist said the normal treatment is BEP or EP chemo. The B in BEP will fry your lungs and make recovery much harder. I went with the EP and have been back in the gym for a few weeks. Took about 6 weeks post my last round to start feeling like being truly active again without getting fatigued too quick.
CrawfordAg
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AG
Heading in for my checkup now, they should have my biopsy report back so hopefully I can fast track to treatment options

Are there any questions I should ask?
FightnFarmerUSMC
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I would ask about the types of chemo that are being recommended and the side effects of both. Like I said, the BEP seems to be the most routine course of treatment, but every patient is different. I would do your best to minimize the side effects on your lungs. Good Luck!
aggieengineer15
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How did your check up go?
Aries
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The treatment for testicular is pretty straightforward. BEP or EP. B=bleomycin. Can cause lung side effects but they would do a pulmonary function test before you were to start treatment. P=cisplatin. Can cause kidney damage & ear damage, so be aware of ringing of the ears. They wouldn't DC it over this but would dose reduce, which won't have an effect on your response rate. Your kidney function will be motored closely.

Either way you will lose your hair & have nausea/vomiting issues.

Ask for marinol. Get a port of they don't require it. Since you're done with kids, no need to ask about sperm saving.

High complete response rate.
CrawfordAg
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Hi All,

Sorry for late response here, still trying to get family out the door from the Thanksgiving holidays. Below is a good rundown of the update my wife sent out. Overall good news as I was sweating bullets awaiting the biopsy report thinking it may be the super aggressive form of tc. I lucked out there, now it's time to meet and make a decision on what I want to do to eradicate. All 3 options offer their pros and cons so we want to ensure we are fully educated.

I have an appointment scheduled with the oncologist tomorrow around noon but the surgeon is backed up until 1/7 and we are out on the wait-list. I appreciate all of the feedback and everyone sharing their own personal journeys. Thanks and Gig'em!



The good news we received is that the biopsy determined the cancer is seminoma which is the "good" kind / the one we wanted it to be. (other would be non-seminoma which is the rapid, fast-growing one).

The bad news is that the cancer did move into some lymph nodes in the aortacaval region (area between the abdominal aorta and the inferior vena cava). The largest one measures 2.9cm & there are a couple of other much smaller ones. Because of this, he is diagnosed at stage 2B. (A would have been lymph nodes <2cm. B is between 2-5cm).

He did have elevated tumor markers (which we also knew) but because of their half-life we have to wait at least 5 weeks to retest to see if the levels are going down.

The next steps for managing the cancer in the lymph nodes would be these options
1. Chemo
2. Radiation (I think we've already ruled this one out bc of where the lymph nodes are)
3. Removal of the lymph nodes by an experienced surgeon (RPLND) - A retroperitoneal lymph node dissection (RPLND) is surgery to remove the lymph nodes in the back of the abdomen (retroperitoneum). The lymph nodes in the back of the abdomen are called retroperitoneal lymph nodes. An RPLND is also called a retroperitoneal lymphadenectomy.

We have been referred to 2 oncologists
1. Dr. Mike Lattanzi (medical oncologist)
2. Dr. Aaron Laviana (urologic oncologist) - this would be the person that would do the RPLND if we decided to go that route

We do not have the above appointments scheduled but will be calling tomorrow to set up the appointments if we do not hear from the schedulers today. The urologist said we should probably make a decision in the next month of what route we want to go.

Interestingly enough, the urologist said Josh is actually on the later side of being diagnosed. It's typically seen in men in their 20s-30s & then again in 60s-70s. & that the most common cause is genetics.

As far as recovering from his surgery, he is feeling pretty good. But he is still not supposed to lift more than 10#s for another ~3 weeks. Also no running but can walk on the treadmill. Basically, take it easy & listen to his body.
Mr Mojo Risin
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AG
Prayers for complete healing and a clear and unified vision between you, your wife, and your medical team as a means to that end.
America was built on speed, hot, nasty, badass speed.
7yrplan
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AG
Glad you got some good news with it being seminoma.

Just for some reference and hope I went back and looked at my records.

Mine was non seminoma. It was 95% embryonal carcinoma. Bad news was that form is very aggressive, good news, as my oncologist explained, is the chemo is very affective with the aggressive types. My tumor markers were extremely high post orchiectomy as well.

Mine was also stage 2B. There are only 3 stages for testicular cancer. Stage 1 is it stays in the testes. Stage two is its metastasized to the lymph nodes. Stage three is it's metastasized past the lymph nodes, typically the lungs are next. ( lance armstrong).

Because of the type I had, we went with chemo first. RPLND surgery would have been the next treatment. Fortunately I did not need it as the chemo did the trick.

You got this. It's a worrisome and stressful time but you got this.


My unsolicited advice is to just stick to the protocoled treatment. (You outlined it above) Testicular cancer has a very high survival rate. It's still cancer, though, just as any other form of cancer. It's just as dangerous. The reason it has a high survival rate is because the protocol treatment is extremely effective. No reason to stray from what works.

Muscle through whatever that means and you will come out the other side counting your blessings and living the rest of your life with this in your rear view mirror.
CrawfordAg
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AG
I am heading to meet with my oncologist today at 3:30 to talk chemo treatment options. Any questions I should ask?

This visit will follow meeting with the urology oncologist who would do the RPLND surgery if I decide to forego chemo and go that route. The thing that worries me is where the lymph node is enlarged which sits right between the two largest arteries in the body. Prior to being educated in either I am 80% leaning the chemo route.

Thanks again for checking in!

I am starting to feel old when I look at the specialist who I will consult with, they all look like they're 30.

Oncologist

https://www.texasoncology.com/oncologist/mike-lattanzi


DannyDuberstein
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I would mostly probe to understand the recommended protocol and roll with that, which it seems chemo is. If you just do the surgery, I would ask about the length and frequency of monitoring (ie how often would you get CTs vs a chemo situation that shows full resolution after treatment). You may avoid chemo, but you may be signing up for many years of CTs and hassle. Chemo sucks, but you may spare your body from absorbing a lot more CT radiation over time. In my case, choosing treatment was ultimately 2-3 years of monitoring vs watchful waiting would have been 10 years. Other than making sure it was gone, that was a motivator for me.
7yrplan
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Agreed, I'd get a good sense of protocol in terms of order of operations (chemo vs surgery). Sounds like you have it, hopefully they give you clear direction based on the protocols.

Take your wife if you can. Fighting cancer is a team sport.
I can not stress that enough.

She is more worried about this than you are, I bet. Make sure she gets her questions answered as well.

The chemo route here is a very old school, well established chemo routine. It's well documented what to expect. Hash as much of that out as possible. Part of the difficulty of the cancer life Is living with uncertainty, always waiting on the next set of tests etc. there are no dumb questions. They have heard it all a million times. This is not the time to be shy or bashful about any concerns you or your wife have.

One other food for thought. My wife would voice record our sessions with the oncologist. Emotions are high. It's easy to not hear everything. It was helpful to go back and listen if we couldn't recall something. May seem dumb, but it helped my wife a lot.
FightnFarmerUSMC
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Update?
CrawfordAg
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Appreciate you bumping this thread as I feel you all need another update.
After a lot of thought and conversations with medical folks in our inner circle I made the tough decision to go the robotic RPLND route. Prior to making the decision I had another CT scan to check the growth of the lymph nodes in my peritoneal area and it had grown from 2.9 to 3.0 cm. All of the trials previously were based off sub 3cm lymph nodes. That along with the fact I was born with gastroschisis (born premature with intestines on outside of stomach cavity) This created a lot of unknowns with abscesses and unruly scar tissue that has built up over 43 years of life.

The decision wasn't easy knowing how complicated the surgery would be versus time tested chemo (EP x4) that had a 90% cure rate. Along with the high success rate I had to also figure in the after effects of chemo including neuropathy, tinnitus, loss of vision/ hearing and the possibility of secondary cancers like leukemia down the road. I am an older dad with a 4 & 2 year old at 43 so I had to look at the risk factors that far out.

I hit the operating table yesterday with first cut at 730 AM and was rolled into recovery at 1345. My surgeon was able to retrieve all 3 of the nodes that were concerning as well as others surrounding for good measure. I am still in Dell Seton's care but may have the chance to go home this evening. I finally had the catheter removed along with my drain line. I am fairly sore but trying to move around. The gas pains are pretty brutal because they hit out of nowhere and feel very odd. They said that they gas up your stomach cavity like a balloon to allow room to operate and that it takes time for the gas to release.

I am extremely grateful for the Dr Aaron Laviana and his team here at Dell Seton. I should have a post op follow up in 2 weeks and need to follow another fat/ low fat diet to hopefully avoid a potential chyle leak.

Prayers up and Gig 'Em for anyone following along my on my journey.
Jbob04
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Continued prayers brother. You've got this!
FightnFarmerUSMC
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Lots of prayers, my friend. Keep strong!
CrawfordAg
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Things are looking up today, took a little walk up the drive and made about a quarter mile down and back. It was nice that the sun poked out for a little bit as it's been pretty dreary out since I went into surgery Tuesday morning. The gas pain under my upper ribs was pretty unbearable as it was constant for half an hour at a time before letting up. Hoping moving around during the day will shorten my recovery time.

I will likely have another scan in a month to check for any new growths. Now that I am on the other side I know that it was absolutely the right choice before leaning on chemo to do the job. That is always in my back pocket if I need it.
88Warrior
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CrawfordAg said:

Things are looking up today, took a little walk up the drive and made about a quarter mile down and back. It was nice that the sun poked out for a little bit as it's been pretty dreary out since I went into surgery Tuesday morning. The gas pain under my upper ribs was pretty unbearable as it was constant for half an hour at a time before letting up. Hoping moving around during the day will shorten my recovery time.

I will likely have another scan in a month to check for any new growths. Now that I am on the other side I know that it was absolutely the right choice before leaning on chemo to do the job. That is always in my back pocket if I need it.



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