Cancer: I Got it and Prevailed the First One

The memory of my most favored uncle, Ede, surfaced, again, as I turned to be 49.  Ede was 49 years old when he passed away from Cancer.  He died quickly. It took about six months from the discovery of Cancer in his abdomen and his passing away from brain metastases.  I was only 17 years old then.  It was my first experience of a death of a much-loved person; obviously, it affected me immensely.  “Oh, well”, I thought to myself, “I am past his age, and doing well. Cheer up, and go on with your life…. so much to do!”

You all, regardless of your gender, know men: they do have a vital organ.  One that is extremely important to the survival of the species and it is not the brain…  We frequently check it up, making sure that all is good and comfortable.  I must admit that I am no different.

One morning, late June, 2004, something was different down there.  During one of those instinctive checks, I felt that instead of two there were three (testicles, I mean…).   Something wasn’t right.  Initially, I wasn’t too worried, yet did make an appointment with my family physician.  After a quick physical check, she sent me to an ultrasound test at the very same day.  Then I started to be concerned.

I got it done, returning to her with the results.  The tumor, more likely than not, was Cancer.  She couldn’t tell if it is benign or malignant; it was beyond her pay grad.  She forwarded the results with a referral to the Urology department at Haifa Carmel Hospital.  I had so many things to take care of, so I headed to my office which was nearby.  Connie, my wife, and I worked for the same company, and had our offices in the very same building.  I briefed her about the latest developments and we agreed to continue discussing it at home, after work.

One cannot disengage the mind; it has a spirit of its own.  Here I am, at 49, and might follow my uncle’s fate.  The positive thoughts I had a few weeks earlier took a turn for the worst.  Despite all my efforts not to, I was scared.  Not knowing the nature of the tumor, the hope that is benign was overcome by the fear that cancer had already metastasized in my body.  Flashbacks of my uncle Ede’s last weeks scared and depressed me.  This was bad.  

I realized that I needed to change my attitude if I want to conquer this beast.  I needed to find a balance between taking care of the situation and continuing life as if there is nothing there.  We would study the situation, find out what the alternatives were, and make the best decisions for us.  And above all – I decided that I was going to survive this disturbance.

Back at home, Connie and I started consulting with Dr. Google.  Very resourceful and Knowledgeable, this guy!  Now we knew that it is probably Seminoma, AKA testicular cancer.  We read about the possible treatments, prognosis, stats, you name it.  We also started looking for physicians that specialized in treating this beast, both in Israel and abroad.  That research, along with the meeting with the Urologist, brought us to the conclusion that first, and as quickly as possible, the affected testis must be removed.  Having decided to “Close the children factory” several years earlier, made the process less complicated.  Thank you, G-D, for designing us with some redundancies!

The date for the operation was set, two weeks apart from the beginning of the ordeal.  This was the time to share the news to a broader circle.  I invited my team for a lunch at a nice restaurant that we enjoyed occasionally.  It was small and quiet, much different from the noisy and crowded cafeteria on the premises.  I broke the news, all of it, to my team.  Calmly and quietly, in a matter-of-fact fashion, openly and candidly.  I told them that I will not be present in the office for a few weeks.  However, I will be available for them on the phone, and life will go on as before: nothing changes.  

Connie continued reading about the various approaches to perform the procedure.  More importantly, she found out who should be the best to operate on me.  We made the required arrangements to have the Head of the Urology department commit to do the surgery. 

During our meeting with the professor, Connie (already possessing a considerable amount of knowledge, thanks to Dr. Google) was questioning the professor about the particulars of the procedure that he intended to perform.  He did have the patience to answer all her inquiries in details.  Then he asked her with a smile: “It seems that you know exactly what to do, what do you need me for?”  Connie answered: “I just want to make sure that my husband gets the best possible treatment, with minimal risks”.  After the meeting we all felt good about each other, and that everything would be all right.

The next day, I was taken into the operating theater, where the professor waited for me.  The procedure was smooth and eventless; a few hours later I was back in my room.  And the following day I came back home, thank God.  I had to stay at home, in bed (or close to it…) for two weeks.  People came to visit: friends, family, team members and acquaintances from work.  It was a true rest, both physical and mental, a rest that I needed for so long.

Believe me, two weeks are a very long time to ponder about things.  The initial decision I made was still valid, much stronger than before.  It is just another episode that we are going to overcome.  There is no other option.

The pathology results came in.  Yes, the tumor was malignant; it is Seminoma, stage 1A (whatever it means…Not as dangerous as stage 4.).  Not too bad, could be much worse.  Other thoughts also emerged.  What is important in life, and what is less?  How could my lifestyle affect my health, and what should I change?  How should I relate to circumstances and external events, how to relax, how to distance myself from disturbances?  

Yet, I didn’t want to give up the passion that drove me at work.  And in life in general.  A new balance needed to be found, a different perspective.  I started making up my mind about all these issues.  Health is first, equanimity is a must to sustain health.  Caring about family and friends is important, because it makes me feel good about myself.  Passion at work is the same.  But not to a level that could jeopardize health and equanimity.

Meanwhile, Connie and I studied the prognosis, the various treatment options, the statistics.  We read numerous papers and researches.  We consulted with experts, getting second opinions on almost everything.  THE world-renown expert on testicular cancer was Prof. Williams, that treated the famous Lance Armstrong, the Tour de France champion.  He also recovered from the very same cancer prior to that race.  I visited Prof. Williams in Indianapolis.  

All the experts that we talked to, Including Prof. Williams, said that the decision, eventually, would be mine.  Basically, there were two options: active or defensive.  The first included taking aggressive radiotherapy and possibly chemotherapy treatments that will provide the peace of mind that recurrence probability is low.  The defensive approach meant to do surveillance only.  The chances of recurrence were higher; however, we will stay on top of things with frequents scans and blood work.  In case of recurrence, it will be detected very early, and could be relatively easily treated than.  It was interesting to learn that there was no essential statistical difference io overall mortality between the two approaches.

True to the conclusions of my philosophical journey, I decided to take the “no treatment” path.  I felt confident that changing my perspectives and attitude to life I would increase my chances of staying clean.  In the unlikely chance that I will have a relapse, I will handle it just as I did now.  The advantage is that I am now more aware, knowledgeable and better equipped to deal with it then.

Finally, after seeing 4 oncologists, I found one that I had good with. She was calm, supportive, patient, and talked with me at my level.  We went forward with the surveillance plan.  The first three years were very demanding, each set of tests happened every three months.  Following the tests there was about a week of uncertainty until we got the “all clear” signal.  But only for the following three months, until the next series.  Later, the frequency reduced until it was only an annual check-up during the final three years (of ten).

In retrospect, the lessons I learned and implemented changed my life.  The attitude, perspective and the relaxed approach gave the ability to enjoy the little things life presented.  I had, and still have, the ability to not overreact to the mishaps that always happen.  My growth was almost a steep step function since that episode.  As I matured, I gained wisdom and confidence.  I became better aware to my own body, better watching and listening to what it tells me.  In the process, I reconnected also to my own spiritual self, better understanding the real purpose of life.  Because of that experience I was aware to the minute indications of a new appearance of cancer in my liver.

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