More tests

I explained to my GP that I'm experiencing low energy, lack of motivation and difficulty sleeping. He asked me about my eating habits, how often I exercise and my sex life. I'm eating much much more than usual, putting on the Kgs, I'm now only training once a week, putting on the Kgs, and I don't have a problem performing sexually. He concluded that its very unlikely to be my testosterone levels, but I convinced him to test me anyway. In addition he wants to test me for anaemia and diabetes.

This is boring. I 'recently' moved to a new area, so I must change over to my new local GP. I had to fill in a bunch of forms, take in ID and proof of address, and make a 10min check up appointment for next week. Only then I can I can make an appointment for my tests.

9 months and looking good, but...

It's been 9 months since I was diagnosed with Testicular Cancer and 8 months since my last post. I've had 2 lots of tests and x-rays since my operation 3 months apart. Each time an all clear and looking good. There have been some pain, but it seems to be getting better. The Doc explained it's probably nerve damage. The pain isn't as frequent, but I still feel a dull ache on my right side near the incision.

As soon as I was feeling Ok from the chemo I went into first gear. I had quite a lot of work to catch up on. I decided to continue with the film festival, which kept me very busy right up to the end of April 2011. I travelled to Australia for the festival with a short break in Korea. I also worked on a number of website projects plus my day job. Basically, I'm just working and working.

I'm avoiding the fact that I am depressed. I really don't know what to do about it. I've dealt with depression in the past and I know what to do to lift myself out of it. This time... it seems to stick.

I did some reading and found this information:
http://home.comcast.net/~Testicular/cancerdepression.html
http://community.macmillan.org.uk/groups/testicular-cancer/forum/t/11627.aspx

The first website is written by a cancer survivor and his advice dealing with depression. Many of these points I already put into practice, but one did strike a chord, 'Talk about cancer.' In the beginning I didn't want anyone to know. I eventually had to tell my family and friends, but only because I had too. I'm more at ease with it now, but I think I'll try talk about it more.

The second site explains it could be a case of low testosterone levels. My girlfriend spoke to a friend who said this is very likely. So, I'm seeing my GP tomorrow. I'll let you know how it goes.

William Li: Can we eat to starve cancer?

William Li presents a new way to think about cancer treatment: angiogenesis, targeting the blood vessels that feed a tumor. The crucial first (and best) step: Eating cancer-fighting foods that beat cancer at its own game.

And the winner is Chemo!

I decided to do the chemo. After a lot of reading, feedback from forums (tc-cancer.com) and talking it through with friends, I feel it was the right decision.

Last Wednesday I had my kidney function test. Then I had the procedure on Friday. I arrived at Charing Cross Hospital with my wonderful girlfriend. She has been the major support throughout the entire experience. Without her I would be a mess. We met with my doc briefly, then we waited about 4 hours before a nurse took us in. I sat in a chair. As soon as I saw the tray of needles and tubes I started to sweat. It's not the pain. Often I don't even feel it. It's the idea of a long thin piece of metal that stirs this phobia. I know, it's irrational. The nurse said, "Don't worry, I'll give you a the smallest needle the one we give to little girls," in a Filipino accent.  She jabbed me and hooked me up to an intravenous drip. Have a look under Delivery on Wiki: http://en.wikipedia.org/wiki/Chemotherapy

This is also a good source of info on chemotherapy: http://www.cancer.gov/cancertopics/coping/chemotherapy-and-you

I was given a single dose of Carboplatin. Have a look at this leaflet, a good overview on what it is and side effects: http://www.wales.nhs.uk/sites3/docmetadata.cfm?orgid=357&id=92730

It took an hour and I was allowed to go home. I felt a little strange, but I was able to eat that afternoon. The next morning I felt terrible. It was like a hangover. The idea of food made me feel ill. I had a headache. My muscles and joints ached. I spent the day in bed. Sunday wasn't much different. Monday feeling tired, but much better. I'm at work.

My worst nightmare

I love food. In particular, I love meat. I enjoy Thai, Vietnamese, Chinese and Italian food. But I'm told I should review my eating habits. I did some reading on diet for people with cancer or going through cancer treatment. There is a lot of info out there and many different ideas.  I’ve decided to pick and choose based on my lifestyle and advice from friends who have gone through a cancer experience.

Here are a couple of sites I found useful:

http://www.cancer.gov/cancertopics/coping/eatinghints

http://www.healthcastle.com/cancerdiet.shtml

My diet choice

Zero meat. Why? Read this: http://www.cancertutor.com/faq/faq_meat.html

Majority raw fruit and vegetables. Here are just a few of the cancer cell killing nutrients (direct or indirect) in vegetables and fruits:

• Raw Carrots (alpha carotene, beta carotene, Vitamin E, etc.)
•  Raw Broccoli (sulforaphanes/isothiocyanates)
• Raw cabbage (isothiocyanates)
• Green Asparagus (saponins)
• Beetroot/red beets (proanthocyanidins (PAC's or OPC's))
• Turmeric (a spice) (curcurmin)
• Raw pineapple (bromelain and pexoxidase)
• Whole purple grapes with seeds and skins (more than a dozen, see Grape Cure article)
• Apricot seeds (laetrile)
• Strawberries, red raspberries, black raspberries (laetrile and ellagic acid)
• Blueberries (ellagic acid, anthrocyanins, OPC)

I found this list from “Raw Food Treatment”.  Sounds interesting: http://www.cancertutor.com/Cancer/RawFood.html

Modest amounts of milk products. I love my yoghurt.

Very small amounts of fat, sugar, alcohol, and salt.

My previous diet, which I love, is actually bad for me. It is a dramatic change, but a change I must make.

The chances of relapse

I have Stage I Seminoma with two risk factors - tumor greater than 4cm (mine being 5) and invasion of the rete testis.

Rete testis is an anastomosing network of delicate tubules located in the hilum of the testicle (mediastinum testis) that carries sperm from the seminiferous tubules to the vasa efferentia. Read more: http://en.wikipedia.org/wiki/Rete_testis

This information was kindly given to me from Fed at tc-cancer.com

The most thorough analysis of [seminoma relapse risk factors] has been carried out by Warde and coworkers [...]. Their analysis indicated that a primary tumor size greater than 4 cm, invasion of the rete testis, lymphovascular invastion and/or the presence of anaplastic (as opposed to classic) seminoma increase the likelihood of a relapse, particularly if multiple factors were present. Of these, tumor size and rete testis invasion are the most important prognostic factors that would deem a patient as "high risk" for relapse. In patients without any of these factors the relapse rate was 12% compared with 32% if two or more risk factors were present.

Source: Expert Rev. Anticancer Ther. 8(7), (2008)

My doc also gave me a paper to read. It wasn't the easiest thing to follow. It is titled Prognostic Factors for Relapse in Stage 1 Seminoma Managed by Surveillance: A Pooled Analysis. According to this report I have a 31.5% chance of relapse within the first 5 years. It is very detailed with relapse-free rate graphs based on risk factors over a 15+ year period. If anyone wants a PDF copy of this paper please email me.

And then the plot twist

Yesterday, my girlfriend and I met with the oncologist to give him my decision, but before I could do that he explained further about the report. The tumor removed was 5cm in diameter. Patients with a tumor greater than 4 cm were twice as likely to relapse. So, the 20% chance of relapse last week is now 40%. This is new information and 40% is a huge difference.

What to do now?! To quote a guy from a forum, "It's TC hell." This is a good forum thread of experiences regarding surveillance and chemotherapy http://www.tc-cancer.com/forum/showthread.php?t=11553 or the main forum on the subject http://www.tc-cancer.com/forum/forumdisplay.php?f=6

Referring back to the TCRC website, they have a good list of Surveillance Pros and Cons to help cancer patients make a decision. http://tcrc.acor.org/surveil.html

That's where I'm at. I haven't made a decision. I'm still researching and talking to people. I'll continue to post my findings here.