Cancer
It started with a tumor.
I was skiing with my family in British Columbia. One morning, I awoke and discovered that my left testicle had doubled in size. At first, I was embarrassed and said nothing for about a day. The next morning, I decided that the problem was beyond my capacity to resolve. I informed my parents of my condition and that afternoon my father took me to a small regional hospital in Revelstoke, BC. The first lesson is never hide or delay addressing a problem.
I received expert medical care but it was amusing when my (mostly) female doctors and nurses asked if I could have neglected to notice the swollen testicle for some time. If you have testicles and one of them swells to the size of a hard-boiled egg overnight, it is not the sort of thing that goes unnoticed.
The doctors looked me over, ordered an ultrasound for the next day and, based on the results, pronounced that I had a ‘heterogenous mass in the left testicle’, doctor speak for ‘you have a tumor’. You cannot feel a tumor growing and it is impossible to ascertain for how long it has been there. What alerted me to its presence was the rapid swelling. The doctors hypothesized that trauma from skiing (perhaps a fall) caused bleeding. The blood vessels in tumors are much more disorganized compared to the rest of the body. Therefore, the second lesson of this story is that skiing can save your life (if it does not kill you first).
Pause: I walked into a hospital in the middle of nowhere in BC, 3000 km from home in Toronto, and all they asked me for was my OHIP number. Canada is an amazing place.
When I returned to Toronto, I had surgery at Sunnybrook hospital to have the tumorous testicle removed. The surgical oncologist, Dr. Nam, calmly reassured me that the “whole shpeel” would soon be over. I am still waiting for it to grow back. A few days later, the results of the pathology came back and confirmed that I had stage IIA testicular cancer. This meant that the cancer was not solely confined to the testicle. Caucasian males between 18 and 35 are at risk for testicular cancer but the probability of contracting this kind is only 0.04% (although it is the most prevalent type of cancer for males my age).
Next, I saw Dr. Bedard at Princess Margaret Hospital who prescribed me three rounds of BEP chemotherapy. BEP: bleomycin — etoposide — cisplatin. They are all poisons, in one form or another, that impede DNA or RNA replication. Cisplatin is heavy metal (not a rock band). I received bleomycin every Tuesday for nine weeks, and etoposide and cisplatin on the first five days of every round. Each round lasted 21 days. I received my last dose of ‘bleo’ this past Tuesday.
Even after becoming familiarized with chemotherapy, I am still amazed that this is the state of the art of medical science. On one hand, indiscriminate poisoning is so crude and unpleasant. On the other hand, it works with a high degree of accuracy. I am fortunate to have had cancer now and not thirty years ago.
The nursing staff in chemo daycare is phenomenal. They work hard as a team to make the experience as easy as possible. I am very grateful for their kindness and professionalism. I do not know much about the state of the world but I do know that without immigration, no one would receive chemotherapy. Over three quarters of the nursing staff is a visible minority.
Chemo daycare is an eye-opening experience. Health is the great leveler of society. There are old and young people of every color and socioeconomic background. These arbitrary distinctions mean nothing in the grand scheme of things, and it is very humbling that no one is entitled to be healthy. The public health system may need fixing, but I cannot imagine being denied access to unaffordable healthcare, and I do not think anyone else should be either.
Chemotherapy is not fun. Basically, everything fast-replicating is targeted. My hair fell out and I developed mouth sores, skin rashes, bone aches, heartburn and chronic upset stomach. The chemo drugs cause nausea, and the prescription anti-nauseates cause dizziness and fatigue.
This unpleasant ordeal brought back hard-learned lessons from the army (and Winston Churchill), namely that “when going through hell, keep going.” When faced with adversity, the only rational response is to take the best course of action available and not worry about the uncontrollable factors. That is much easier said then done.
In my case, the best course of action was to follow the expert advice of the doctors and nurses to the letter and try to continue my life as best as possible. I will graduate from engineering at the end of this semester. Self-pity has no value, quite the opposite; it has a demoralizing and paralyzing effect. Hard work is an effective and satisfying distraction.
It is also important to remember that it can always be worse and to be grateful for what you get. Our brains put greater emphasis on negative events (I strongly recommend Thinking Fast and Slow by Daniel Kahneman) and it is therefore easy to neglect all the things which miraculously work, like chemotherapy and public health. I recall looking around chemo daycare and noting the frailty and discomfort of the elderly patients, though many of them also displayed an intrepid determination to keep fighting.
Getting cancer is never a good thing but I got a curable kind of cancer, I caught it early and I fought it when I was young and strong. Cancer has been a life challenge and not the end of the road. I am lucky.
I have been the recipient of many acts of kindness and volunteerism over the last nine weeks. Countless people have expressed concern, offered to shuttle me places, and delivered books and packages of food. Thank you all and I am sorry if I offended anyone by turning down your offers, but I received all the support I needed from my parents and brothers.
For now, I can cautiously breathe a sigh of relief. I look forward to putting this all behind me and getting on with my life. I did not expect to fight cancer before I was 24, but you never know what will happen next.
Seize the day and live without regrets.
