Interview 30

Age at interview: 39

Age at diagnosis: 35

Brief Outline: Testicular cancer diagnosed in 1998 (seminoma and teratoma in both testicles), followed by left orchidectomy and right partial orchidectomy, chemotherapy (2 cycles, each 3 days in hospital), and radiotherapy to right testicle to prevent any recurrence. In 2001, recurrence of seminoma in right testicle, followed by right orchidectomy, and hormone treatment.

Background: Software Development Manager; married, 2 children.

Describes the first operation and the shock he felt when he had to have the rest of the second. testicle removed.

Because I had the double orchidectomy, when I woke up I was in quite a bit of pain, just because you can't even favour one side or the other. And that was another thing that surprised me is that nobody said is that the incisions are actually taken on your lower stomach  where you'd think if you've got testicular cancer you know you'd go through the scrotum. I, I just assumed that it would be through that, so that surprised me afterwards.

So basically you gave him permission to remove both testicles?

To do whatever, whatever he thought was necessary and the upshot was that my left testicle was completely removed and my right testicle was partly removed. The reason for saving part of the organ is to allow the body to continue to generate some hormones otherwise, then you might as well take, take the pair of them off. So he, he was very pleased with his, his work and I then got referred to a cancer specialist at a different hospital.

And I think it was about a, about a month from when I first felt ill to when I had surgery for the second time. Which was quite strange. I, I think it, my blood tests were normal, my blood tests were, they had taken a number when I first went to hospital, all the way through and it wasn't until, I think the week before my operation that my cancer markers went up again. And then the week after my operation they went down. So it was quite strange. But that was a, a bit of a shock.
 

Describes a rare situation, where radiotherapy was directed at his remaining testicle to try to...

So the next aspect of my treatment was I think in '98, October, November  where I had radiotherapy. The idea was to be sure that there was no pre-cancerous cells left in there and the idea was to get the dose just right such that the hormone generation was maintained. And the can, pre-cancer cells were killed because if you're gonna kill off your hormone generation there is no point in saving the organ. So I think it was ten consecutive week days where I had to go up and have a, a short bout of radiotherapy the, the queues and waiting I did it in the afternoons so I used to go into work in the morning and then go off for my radiotherapy in the afternoon. So sometimes I could actually wait about five minutes, sometimes best part of an hour so I did chance me arm and try and get in earlier occasionally. And you did all that  for I don't know probably about thirty seconds worth of treatment!

Just directed at the right testicle?

Yeah what they do, all they do is they go in there, again you undress, lay on the bench and then there's a small dose of radiotherapy to the right testicle which was just to, belt and braces, to make sure that there was nothing left.
 

Explains that he is taking tablets of testosterone because he has had both testicles removed.

Now the biggest thing I had was I tend to sweat a lot my cancer man asked me whether or not I'd had any hormone replacement because with, now having both testicles removed then the body has no means of generating them, so you're gonna need some. Now there's apparently no rush immediately after surgery because the hormones that are generated, last within your body for a fair amount of time. But I'm sweating a lot. My cancer specialist asked me whether or not my other people had done anything in, in that area, so I said 'No.' So I've been prescribed tablets of testosterone, which I take three times a day, with meals, and I'm scheduled to see a specialist, I'm waiting for a referral to give me a date where I'll sit down and discuss what the options are.
 

Describes different forms of HRT and explains why the tablets have been beneficial.

My information to date, which I believe is quite right, because I've spoken to my GP about it, and I seem to know more than he does! Is tablets, you can take three times a day; you have to have them with food. Tablets aren't ideal; the stomach acids tend to eat them quicker than the body absorbs them. Apparently there is a new one, which is to be, you have with a milky drink, which aids the absorption.

There are injections where, I believe its two to three weeks apart you have the injections. I don't think I'll go for that one because I think I'm having my blood tests, I actually want to get those as far apart to actually go back to two weekly ones now. And the third option is a small implant under the skin which I believe lasts for two to three months, which just slowly dissolves and goes through the body, provides the hormone replacement. Hormones in the tablet form, my GP laughs, he says it doesn't matter if you forget one because it's not critical! The worst that you can have if you're not taking a tablet is you sweat a bit is not a problem. But I mean basically it keeps your sex life going, both the, I guess the capability and the desire and it seems to work. I function normally, I have no necessity to worry about buying a bigger house because we will not have any more children, but its all the fun and none of the pain I guess. I don't know which way I'll go on hormones. I'm a bit of a coward so to do implants is, is probably not my bag. Although for some people, it lasts three months, its maybe what they want.

Oh, patches are the other one that you can have. But I have been told again by one of my doctors that I see is that patches aren't necessarily good for a bloke, yeah. Because all blokes are hot and hairy and sweaty so, all the patches tend to fall off!

Right yes.

But I'm quite happy on tablets, it's something that you have to do.