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The Road Less Travelled

At the time it didn’t process. Shock. Plain and simple. It felt like an out of body experience, happening to someone else. Cancer. Testicular cancer. Shit. The speed at which it happened changed me in more ways than one. Physically maimed and psychologically damaged. I was supposed to be living the high life – 18 years old, enjoying University life. I’d made friends, started rowing, joined the Mountaineering Club; life was good.

It reared its head as a deep dull ache. I thought nothing of it and competed in a rowing race. The morning after, my left testicle had swollen to twice its size and I struggled to get out of bed. A trip to hospital turned into a series of appointments which did nothing to alleviate my anxiety. After seeing a multitude of professionals and being prodded, poked and scanned it was confirmed that I had a diagnosis of testicular cancer. Before this could sink in a procedure was booked for the following morning and cold harsh reality hit. I still remember getting changed in the cold accessible toilet, looking at my reflection and trying to imagine what one ball would look like.

Compartmentalise, open-up, let family know, don’t catastrophise. I did catastrophise. But hey, that’s normal – right? Part of planning for the future required my sperm to be stored. This was a major trough in an all-round seriously low ebb. Especially as my Mum insisted she came with me to all my appointments to provide emotional support. I had to provide my sample in a tiny clinical room with my Mum waiting in the hall outside – seriously?! Talk about off-putting! I’d like to say the whole experience changed my outlook on life.

That after the procedure, healing, the all-clear, it would make me grateful. Enjoy the simple things in life. But it’s hard to get into that mindset when you have regular check-ups as reminders; an illusory sign attached to you ‘cancer patient coming through’. A panic inducing tap on the shoulder with ‘Hey, did you know you had, and may get cancer again?’ for FIVE YEARS. I struggled with these check-ups, and it was incredibly embarrassing as they performed a clinical check-up of the remaining lad. It required a lot of resilience to continue at all. That 5 year period was difficult, I tried to just crack on and ignore my feelings, and I neglected my mental health. The relief of being signed off after five years was palpable. I was given the all clear; no spread, no sign of further cancer. I was lucky, I’d caught it early. The regularity of clinical check-ups, blood tests, X-RAYS, CT scans were replaced with an annual blood test – it was like a weight off my shoulders. It took a while, but I did genuinely forget and just cracked on with life. Fast forward a decade and a half and my wife and I are planning on expanding our family. This was a lot harder than we anticipated (I’d been told losing one ball shouldn’t affect my fertility) and after realising we’d not used contraception - for a very long time – we reckoned we’d better get checked.

Cue a second visit to a weird little room of requirement to provide a ‘sample’, made slightly less awkward this time without a concerned parent hovering in the waiting room! A few weeks later and a rather blunt phone call from the GP revealed that I had ‘no sperm detected’. A cold inhuman sum up of my situation, it came as a shock. I knew something was up, but I’d assumed there might just be some lazy or confused swimmers, not a complete lack of them – pool closed permanently, not even a rubbish doggy-paddler in the shallow end! Further tests were required. Following an ultrasound on my remaining lad I was told by the Sonographer that ‘something was not right’ and that she had ‘found something’. Here we go again: A series of quick-fire appointments and referrals I was staring at my second cancer diagnosis. Not good.

Immediate questions flooded my brain. Had it spread? What did this mean? Testicular cancer had attacked my remaining testicle and caused me to be infertile; shit. SHIT! I was angry, frustrated and deeply aware of my stripped biological abilities to share in the creation of life. I felt already castrated, unmanly and pathetic. In hindsight I realise these patriarchal ideas of ‘masculinity’ are outdated and based on a lot of bullshit societal conditioning: Manhood and masculinity are not determined by the presence, absence, or function of your meat and two veg. But that was difficult - if not impossible - to see at the time. So much of our culture and language conflates the presence of testicles with things like bravery and sporting ability; it’s hard to avoid soaking this up and although I did my best to have a thick skin, throwaway comments or turns of phrase still hurt. I’d always catastrophised about the possibility of cancer coming back and what I’d do in that situation. Some of the thoughts were dark. Too dark to dwell on here. But survival mode kicked in; it was shit luck. Unbelievably shit. My second diagnosis led to an inevitable downward spiral, but I managed to get through it basically just by putting one foot in front of the other and getting on with the days.

I put my ability to "keep on keeping on" down to a very healthy support network around me, and I will be forever grateful for my family and friends who helped me navigate a crap situation with humour, warmth, long walks, and tea – lots of tea. So yeah…ball-less but still alive! A new life awaited me, a third chance if you will. Again, I’d like to say this experience made me awaken to the wonders and magic of life and how lucky I am, etc… But it just sent me on a long, complicated, anxiety ridden tour. I’d been here before, I kind of knew what to expect with the regular check-ups and cancer admin. But what I struggled with most was how to get my head around the testosterone problem, the big elephant in the room. What did having no natural testosterone mean? How would I manage day to day? What about my relationship with my wife? What about sport and exercise? Will I ever be the same again? You get the idea. I’d like to say I was sat down and taken through these questions in a structured and systematic way and my options laid out clearly. However, this didn’t happen and I’m still not really any the wiser. My second cancer diagnosis and operation happened in the midst of the Covid Pandemic, so I reckon the NHS had one or two higher priorities. But I did feel a bit like I’d been through the NHS whirlwind and spat out blinking at the other end: Tumour removed, immediate threat neutralised – off you pop and crack on with your life… I have synthetic testosterone injections at my GP practice every 10 weeks, but I have no idea what my testosterone levels are like month to month and my attempts to get a referral to an endocrinologist to go through this in more detail haven’t got very far – other than a few perfunctory phone calls.

Because adjusting to my new life on synthetic hormone replacement wasn’t enough of a curveball: Life was about to become even more complicated. Time was ticking and it was sort of now or never for our journey through IVF (ICSI). I had zero understanding at the time about how complicated and worrying this process would be. Deep breath, one foot in front of the other! Fortunately (and somewhat mind-blowingly), the miracles of modern medicine meant we had the option of using sperm from the awkward freezing experience all those years before. As well as my gratitude for the marvels of science; I am forever grateful for the organisational skills of my mum. At the time of providing my original sample there was a lot of paperwork to fill in. My head was not in it and the gravity of the situation hadn’t fully sunk in. Handily my Mum was there to pester me and could see the bigger picture which ultimately helped me future-proof my fertility. So 15 years later, following the stressful administrative and logistical nightmare of getting my sperm moved from Manchester to Leeds; all that was required now was to wait and wait and wait. BLOODY COVID!

More paperwork and what seemed like an age of waiting; the emotional rollercoaster of wishing and hoping was upon us. I felt responsible, guilty for putting my wife through this long drawn out, clinical process. I cannot truly understand what she must have gone through self-injecting, second guessing and worrying, whilst being prodded and poked. It was cold. I felt helpless. It was really tough. Unbelievably though, it worked! One embryo stuck around, and we now have a six month old who’s healthy and happy and filling our life with joy every day; an outcome which has made this hellish journey so worth it. All babies are miracles really; but having gone through the wringer of a very convoluted journey which culminated in our daughter, I can’t help but marvel at how amazing modern science and medicine is!

I may have lost two small pieces of my ‘manhood’ but I have gained so much in return. I am aware of how lucky I have been, and I am forever grateful to the care and support received from the NHS, friends and family. As well as a new addition to our family, I’ve gained the knowledge that I can get through pretty much anything if I just keep putting one foot in front of the other.

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