TC Treatment

With apologies to John Deacon for the title of this entry. Had another check-up last Wednesday. Everything fine and dandy.

Got the usual physical check of the lymph nodes in the neck & abdomen. Also had a chest X-Ray taken to make sure my lungs are clear. My oncology consultant has decided to stop checking for tumour markers in my blood every 2 months. It’s been 20 months since my IO. My markers were normal pre and post IO. Have been normal on every test since as well. I’m happy enough to stop getting spiked for a blood sample every 8 weeks. Next visit will be in 6 months at which time I’ll get an ultrasound exam of the remaining nut!

So assuming the X-Ray is clean (and it should be) it’s full steam ahead. The TC escapade is retreating further into the past 🙂

Had another post treatment check-up today. This was the 4th since the radiotherapy finished. Got the usual check-up as reported previously. Oncologist checked for lymph node swelling in neck, abdomen and groin. Nothing untoward to report 🙂

Also got the results of my CT scan confirmed. Nothing out of the ordinary found. Blood was taken the check for beta-HCG and AFP protein markers. I was told that my check-up frequency would now go onto a 6-month schedule with chest x-rays on that time-scale as well.

So much rejoicing again.

I had a follow-up CT Scan last week.

Got a call from my Oncology consultants Secretary today to say that the scan was clear. Much rejoicing 🙂

So thanks to science and modern medicine it looks like my adventure with TC is not going to stop me annoying the crap out of people any time soon!

Had another check-up today after the radiotherapy last year. Nothing untoward to report 🙂 The oncologist checked for lymph node swelling in my neck, abdomen and (surprisingly) ankles!! Nothing found. Blood was taken to check for beta-HCG protein markers. The check box for AFP markers was not ticked this time. This is to be expected as seminoma tumours don’t release AFP. In fact only about 10 to 20% of seminomas release beta-HCG markers. Mine were never raised.

The check-ups have occurred approximately every two months since the radiotherapy. I was told today that I would be going onto a four month check-up schedule. A CT scan was also ordered for sometime in the next few weeks. This was ordered not in response to any symptoms but rather just because it’s been a year since my last one. I expect it to be negative!!

So happy days 🙂 Is it okay to use the C word?

[C word = cured]

As I wrote in a previous entry when I was away in New York and Toronto I walked lots and lots over the week and discovered it is really good exercise. I lost weight and felt really fit. When i got back I made a point of going for a long walk at least once a week. Really enjoyed them. Over the last few weeks I’ve failed to keep this up. Have noticed a difference. I don’t have as much energy and have felt tired more often. I definitely feel better when I exercise. There’s a surprise 🙂
Was reading a neuroscience book this afternoon and felt really drowsy. I know what you’re thinking! A neuroscience book would put anyone to sleep 😉 Actually the stuff in the book is really, really interesting and was not the cause of the sleepiness. If I had stayed there reading I would have been impersonating a nodding dog in no time. So I forced myself to go for a walk. Good call!! Did 5 miles listening to solo Roger Taylor tracks on my iPod.
Feel really refreshed and alert after getting back. So will have to force myself to do more exercise in the future. it does make you feel better. it also makes it easier to learn new stuff as well. Like neuroscience for example 🙂

This week I had my 2nd check-up after the “zapping” last year. It is only about 2 months since the last check-up so I was surprised to get the appointment letter just before Christmas. Apparently the check-ups will be every 2 months for the rest of this year.

I got the same examination as I did last time. The doctor checked for lymph node swelling in my neck and abdomen. Nothing found. Blood was also taken to check for AFP and beta-HCG markers. I was told I would get a CT scan at the 18 months after surgery timescale. This will be about December of this year. I’m happy with this. I had pure seminoma with no indication of spread. No need to go though a CT scan and get another dose of x-rays at the present time if not needed!

So happy days 🙂 as far as I’m concerned.

Had my first 3 month post radio therapy check-up yesterday. The doctor examined my abdomen and neck checking for lymph node swelling. Nothing strange to report. Blood was also taken to check for AFP and beta-HCG markers. No x-ray or CT was ordered. I had lots of x-rays taken during the RT and they were all clear. I expect the blood tests to be normal as well.
So that’s that done until February 2004 🙂
I actually feel really well. I was in New York and Toronto last week on holiday and walked about a million miles! Had loads of really good food and still lost weight 🙂 I’m down to my cricket bowling weight again! Walking is really, really good exercise. Much better than that gym nonsense 😉

My zapping (or radio therapy as the medical staff insist on calling it) finished on 5th August. It’s been a month since I finished my treatment for TC so here is an update on how it went.
Over the three weeks of the treatment it was similar to the description given in the previous entry. There was mild nausea a few hours after the sessions. some days this was worse than others and it got slightly worse towards the end of the treatments. An unexpected side-effect was that the incision site of the orchiectomy got slightly sore and swollen again. At least this showed that the x-rays were having an effect 🙂
I started back to work a few days after the last treatment and started mild exercise in the gym a few weeks later. I played cricket about three weeks after the treatment ended. After this I was sore all week so I think it was a bit early for this. The cricket season in over now until April 2004. My goal is to get fully fit for it so lots of gym time over the winter is needed I think.
I will have an appointment with an oncologist in October for a checkup. Will probably get x-rays or a CT scan to ensure there are no other tumors. All the evidence is that there wont be. Previous CT scans and tumor markers were negative. So hopefully my brush with TC is behind me with the exception of the periodic follow-up checks.

Three days into my radiotherapy treatment (or zapping). Actually this is day 4 but I get Saturday and Sunday off for good behaviour 🙂 Very strange feeling.
The best way I can describe it is that I feel like I’ve been punched in the stomach. Or it’s like the muscle strain felling I get when I start cricket training at the beginning of the summer. Of course with the training pain it’s my whole body that’s sore (even bits I didn’t know I had!).
I felt really nauseous a few hours after the sessions on day 2 and day 3. Same this morning but its not too bad at the moment. Nearly chucked this morning after gargling with mouthwash. The action of leaning forward to spit it out nearly triggered further action!. I have tablets to take for the nausea. One a day. Plus I’m drinking lots of water. I feel like I do when I have a viral infection that my body is fighting off. I don’t think I have an infection but rather it’s just the feeling on my body repairing the damage done by the X-Rays. Just as I was starting to feel okay again after the surgery. Still better than some of the other alternatives though.
The worst part is pain in my pelvic region related to the scar tissue from the surgery. I think this is a result of the manipulation to fit the lead shielding to protect the remaining testicle from the radiation 🙁 Liberal does of Panadol Extra for that issue.
12 more sessions to go over the next 17 days. Chin up as they say!

I had my first appointment with my oncologist this morning to discuss follow-up treatment after my orchiectomy on May 12th. During the appointment I had a very long detailed discussion about what I should do next.
It was confirmed that I had a Stage 1 seminoma that had some vascular invasion.
The option of surveillance was discussed at length as an alternative to getting radiotherapy immediately. The decision was that I should get the radiotherapy now as –
1) Young men are notorious for not following surveillance regimens. Whilst at this minute I would obviously say 100% that I would follow any regimen, who knows what I’ll be doing in a few years time.
2) The doses that are given are very low as seminoma is very susceptible so the risks of causing other cancers are low.
So I have an appointment on Monday to plan the treatment in detail. They will inject me with contrast solution to outline the kidneys etc. then. The treatment itself with last 3 weeks and will be every weekday. As a result of some past history of surgery in my case (that I won’t go into) they are going to irradiate both the retroperitoneal lymph nodes in my back and the left inguinal nodes in the lower pelvic region of my abdomen. As a result I will be banking sperm before the treatment. I can’t get the image of Leslie Nielsen in The Naked Gun 33 & 1/3 out of my mind 🙂 Were he is under cover in the fertility clinic and has to give 3 samples so as not to blow his cover 🙂
The remaining testicle is covered with a lead protection cup during the treatment and sperm production should not be effected. Even so the recommendation is not to father any kids for a while (a year?) after the treatment. Even though it’s covered there is always scatter of radiation during the treatment. The banking of sperm is a precaution just in case something goes wrong and sperm production does not recover. I have no plans for any kids in the near future anyway 🙂
I’ve just got the following from another member of the TC support list about the effects of radiotherapy:
> Btw, when you have RT, you will need to avoid whatever sun you get in
> Belfast, for a year. No problem, I know. :).
>
> Nausea and diahorrea are common side effects of RT and you can expect
> body hair to fall out towards the end of the routine..
>
> Afterwards, you can expect it to be a year before your stamina fully
> recovers.
>
> Itr just means you have to life the Liffey water with two hands !
>
> Good luck with it.
Hmmm. Hopefully it wont be quite that bad 🙁 If nothing else it’s give me an excuse for a sedentary lifestyle with lots of studying.

I got a telephone call from my urologist this afternoon with the pathology report on the testicle removed during my orchiectomy. I will get a copy of the actual report later but basically the doctor said it was –

Seminoma only
No spread to the sperm tubes or other areas
Did have vascular invasion

So it could have been worse. This is in addition to my negative CT scan and negative blood markers.

I’m being referred to another doctor to discuss options for further treatment. The protocol in Northern Ireland seems to be give everyone preventative radiotherapy. I’ll discuss the option of surveillance with him.

So all things considered, happy days.

I got out of the hospital today after surgery, for what looked like testicular cancer, and as a result have a (very sore) scar on my abdomen and 1 less testicle 🙁

On the upside my CT scan result was negative for lymph node enlargement and there were no tumour markers in my blood. The surgeon told me that I need to get the path lab report to be sure but he cut the removed testicle open in the theatre and it looked like a seminoma to him. Seminoma is a cancer of the germ cells in the testicle. It is very treatable. See the Testicular Cancer Resource Centre or the http://www.cancerresearchuk.org/about-cancer/testicular-cancer page for more details.

So, assuming it is a seminoma, he will be referring me to an another doctor for further treatment options. I’ll probably get some radio treatment to the lower back lymph nodes as a precaution just in case any of the cancerous cells have spread to the lymph nodes but haven’t had time to manifest yet.

I’ll also arrange some sort of surveillance schedule for the next few years. All in all a better outcome than some other possibilities.

I had to get a CT scan of my chest, abdomen and pelvis. A CT scan is an x-ray technique that takes pictures of your body in slices. CT is an acronym for Computed Tomography. It is also called a CAT (Computed Axial Tomography ) scan. The reason it is done is so that doctors can see if there are any anomalies (like tumours etc.) in your internal organs or body cavity.

What happens during the scan?

I was told not to eat or drink anything for the 4 hours prior to my appointment time. As my appointment was for 09:30 this meant no breakfast! I arrived at the x-ray department about 09:20 and was given a jug of liquid to drink. There was about a litre of this liquid which was flavoured with black-currant juice. This drink is an x-ray contrast solution that makes your stomach and small intestine stand out better in the CT scan pictures. I hate black-currant 🙂 Also I was told not to drink this quickly but rather to spend about 5 minutes sipping each cup full. Yuck!! It took about 30 minutes to drink it all. This reminds me of an important point. You have to wait about an hour for this liquid to make it’s way into the small intestine. As everyone knows the magazines in waiting rooms are crap. So take a book with you if you are going to get this done. I took “The Universe Next Door” by Marcus Chown. Excellent stuff. I’ve been told by others who have gone through this that the drink can really open the sluice gates and staying near a toilet is recommended. That hasn’t happened to me yet. I’m writing this about 12 hours after the scan.

At 10:35 I was called for the scan. I had to strip to my boxers and socks and put on one of those weird hospital gowns. The CT scanner itself is like a big doughnut with a bed through the middle. I had to lie on the table of the CT scanner table with my head in a hard pillow that has a cut out section for the head. One of the medical staff tried to put a line into my left arm. She was unable to get a good vein for the needle. She did try. Boy that was sore 🙁 She went for plan B and put it into my right arm instead. The line in is used to inject “dye” into the blood system during the scan. This is to make the blood vessels, and the tissues they flow through, stand out during the scan.

During the scan itself I had to place my arms above my head and tight against my ears. The scanner operators spent about 2 or 3 minutes taking practice pictures to orientate the scanner to my body. During this time the table moved to take me through the scanner. The operators talk to you during the scan, and there is the typical pre-recorded voice with a north American accent that gives instructions like “breathe in and hold your breath”. The doughnut part of the scanner does not move, but you can see the bits that spin inside it through a plastic window. On one of the trips through the scanner I felt a sensation of heat in my chest. It was very pronounced, like having deep heat rub inside your lungs. This was caused by the dye that was pumped in via the line in. A very weird sensation indeed. This lasted about 30 seconds and I moved through the scanner during this time. That was it. The scan was over. The actual scan bit lasts about 5 minutes. During that time about 500 pictures are taken as slices through your body.

All in all an experience of 2 “halves”. A first half with a lot of waiting about drinking that yucky drink then a second half burst of activity as the scan is done. I had read a lot about the CT scan procedure before going so I sort of knew what to expect. I hadn’t read anywhere about the warm sensation caused by the injection of the dye. That was disconcerting but about 5 seconds into the sensation I realised this was what it was and I was not getting cooked by the x-ray machine or having a heart attack 🙂

So if you ever have to go for a CT scan don’t sweat it. It is a painless, reasonably fast procedure. About an hour after the scan, when I was at home, I fell asleep for about 3 hours in my chair. Not sure if this was a result of any of the stuff pumped into me, or the drink or just a reaction to the anxiety associated with getting the scan.

Now I have to wait for the results of the scan and see if it has highlighted anything weird. Fingers crossed it didn’t 🙂