Sat, Nov 21, 2009
 George B. Sánchez empties his pockets as he prepares for a CT scan at University Medical Imaging. As a follow-up to his cancer treatment, he is required to get a CT scan every four months. Jeffry Scott / Arizona Daily Star
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BENSON HOSPITAL RESPIRATORY THERAPIST Sales and Marketing Ever-Ready Glass Glass Sales Health Care RLM Services, Inc. Orthopedic Assistant-CMA AccentCOVER STORY
One man's cancer journeyA survivor is silent no more
Arizona Daily Star
Tucson, Arizona | Published: 07.06.2008
It was my first summer in Tucson, July 2007.
I was sitting in a circle with some guys, gnawing on barbecue in the early evening, the conversation wide-ranging.
My friend Will looked up, said he'd heard I was sick and wondered how I was.
"I'm doing all right," I said, looking him in the eyes. "Thanks for asking."
One of his buddies chimed in about picking up a cold in Mexico that took about 10 days to shake. But something inside of me didn't feel right, as if I was hiding from the truth.
So I coughed and said: "I don't have a cold. I have cancer."
It was in that moment that I decided never to shy away from talking about my cancer.
Ever since I discovered the tumor in my right testicle in April 2007, I've noticed how men don't speak, or don't know how to speak, about testicular cancer.
But not talking about cancer doesn't make it go away. Not wanting to get tested, or not wanting to know the results, doesn't change anything.
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A clarity arrived with my cancer. The infinity of time and life that cradles youth slipped away. I discovered my boundaries. The fragility of the body I had once pushed with reckless abandon became obvious. This is my story of cancer: just mine. Every one is different. Every body is different. I don't speak for anyone but myself.
I am lucky. Testicular cancer is the most common form of cancer for males between their teenage years and mid-30s. But in the pantheon of cancers, it's highly curable. In my 29 years, the mortality rates have reversed: The chance of surviving testicular cancer, just 10 percent in the past, is now 95 percent.
When my disease was diagnosed, I started on a very specific path. There were options, each with its own risk, but every decision had a very precise aim: surviving the growth inside my body.
Talkin' cancer
People always ask, "How did you know?" or "How did you find it?"
Well, I touched myself.
To be specific, I touched my right testicle. How do I explain? To be honest, I must have been getting ready to masturbate. I don't know. Picture me shrugging my shoulders.
When I tell my male friends, I can see the gears cranking behind their eyeballs.
"What did it feel like?"
"I found a hardened spot, like a sharp edge, on my right testicle."
This usually prompts them to check themselves — and inform me later that they did so.
The drummer in my old band actually checked himself while we were on the phone. My brother got so concerned that I think he checked himself too often.
My sister asked me what it was like to get stitches in my scrotum. I asked her where she got that idea from. My sister, like most of my friends and family, thought my testicle was removed through my sack.
You can hear the surprise — and relief — when I explain that the surgeon didn't cut through my scrotum, but removed my testicle through a small incision in my lower abdomen, at the root.
A ton of other questions pop out.
"Can you have sex?" Yes. Oh, yes. A friend from high school, Adrian, went through the same thing — testicular cancer — when he was 18. It was our senior year. He said he was back in the saddle within two weeks. So I vowed to beat his record.
During chemotherapy, the nurses warned me that if I had sex, I had to be careful, because the toxins were in my semen. My oncologist told me that, because of this, survivors generally shouldn't try to conceive for six months after chemotherapy.
My best friend jokingly snarled later: "You have radio- active sperm." I suppose I do, er, did.
At the same time, the questions are telling.
More than a few adults — fathers — had trouble asking if I was going to bank my sperm. One asked me if I was "going to save some of my man juice."
Men asked if I considered getting a prosthetic testicle.
While back home in Los Angeles for Christmas, my family ate at an Italian restaurant we've patronized for more than 15 years. My mom told everyone I was a survivor. Our waiter, whom we've known for 15 years, too, asked what I survived.
When I said testicular cancer, he was confused. I said it was in my right testicle.
"What's that?" he asked.
"My balls," I responded.
"I'll be right back with your garlic bread," he said as he stepped away from the table.
Options
When I met my urologist, Dr. Jennifer Peters, she explained that my testicle had to be removed. A biopsy would follow to see if it was cancerous.
With some forms of testicular cancer, removal of the testicle is all that's necessary. But because of what I had — my tumor was actually composed of two types of cancers: embryonal carcinoma and teratoma — this wouldn't be the case.
Life was no longer this seemingly endless highway, but a series of small roads. I wouldn't wake up cured. There wasn't a magic pill, or treatment, to make it all go away in an afternoon.
Instead of looking at this as a single, massive journey, I recognized it as small steps: test to test, appointment to appointment, day by day, one day at a time.
After my testicle was removed, I had three choices:
A) Undergo a second, invasive surgery to remove the lymph nodes in my lower abdomen, where the cancer was likely to spread.
In plain language, this surgery entailed cutting me open from my belly button to my pelvis, moving my organs on one side and, one by one, removing about 200 grape-size lymph nodes. The surgery would last at least four hours.
Complications could include infection, blood loss and a 5 percent chance that my ejaculatory muscle could be damaged, causing my penis to inject, rather than eject, semen.
B) Begin chemotherapy.
C) Monitor what are called cancer markers through weekly blood tests.
My urologist recommended I have my lymph nodes removed.
I sought second, third, fourth and fifth opinions.
Not long afterward, I met Dr. Fredrick Ahmann, my oncologist.
Dr. Ahmann dresses for work like my dad used to: slacks and a short-sleeve collared shirt with a tie. In some strange way, his '70s detective style was comforting.
He also puts up with my many, many questions.
The surgery would be intense, he said. Following the removal of my lymph nodes, doctors would perform biopsies of the little glands. If they turned out to be cancerous, after recovering from surgery I would still have to undergo chemotherapy.
That being the case, Dr. Ahmann said, chemotherapy would be no cakewalk.
Uncomfortable with the idea of having a Frankenstein-like torso, I opted for weekly blood tests to monitor the cancer markers. After a confusing two months in which the markers went up and down, the cancer levels rose and it became clear that I needed to undergo chemotherapy.
Months later, Dr. Ahmann would tell me if any of the treatment doses were doubled, it could kill me.
Family
There are certain things no parents should have to endure. Watching their child endure cancer treatment is one.
Family and friends expressed helplessness as they watched me undergo chemotherapy.
It took my father, Bernard, a while to get used to watching me, his young, otherwise healthy son, get connected to a machine, injected with chemicals and see my eyes go from nervous and tense to drugged and dopey.
During the first week of chemotherapy, as I sat in the recliner at the clinic and intravenously received my treatment, I turned to my father and saw anxiety in his eyes, concerned by not knowing and not being able to protect, his fear and confusion apparent.
"What's up?" I asked.
He grunted something. We grunt.
Then a few minutes later he got up and said he was going to find my mom. He didn't come back until it was time to go.
I couldn't blame him.
No father I know likes to show fear. Not to their wives or children, not to their friends or community. That's not how they were raised.
My dad grew up in a two-room shack in Echo Park, north of downtown Los Angeles. Four generations of Sánchezes had been raised in New Mexico. My father was the first not born on the dusty rancho.
Two days before I began chemotherapy, for the first time in both our lives he'd cried in my arms. It was a shock to both of us, and my mother, who was the only other soul present.
My father and I were arguing. I was about to head out for my last night on the town.
My dad is a scientist. He has a degree in chemistry and criminology and at one point headed the Los Angeles Police Department's Hazardous Materials Division. More than most, he knows what scientific research says about the effects of drugs and alcohol on the body.
He told me alcohol can spread cancer. I laughed at first and told him he should have told me that a few months earlier.
He begged me not to go out. He asked me to promise that I wouldn't drink anything. He kept telling me I would only do my body more harm.
Then he burst into tears, sobbing like a child, vulnerable like I'd never seen.
I didn't know what to do. So I did what he did when I, his first-born son, was a child. I put my arms around him and held him close. I felt his tears soak my T-shirt and told him it would be all right.
"Doing really well"
It has been more than six months since I completed chemotherapy. But thoughts of cancer and chemotherapy don't seem to fade.
On Memorial Day I was swimming at the Downtown YMCA. I stood up to take a breath and looked out onto the empty pool. The surface was calm and still. Suddenly, the image of shunts and tubes connected to my wrist appeared in my head. Just as quickly as it appeared, the image was gone.
While the scar from my surgery is somewhat hidden under the hair that has returned, when I shower I notice my pubic hair is still thin. It reminds me of being hairless during chemotherapy. I just want the hair to grow back like it was.
A few weeks ago, I went to a barbecue for my friend Paul's 30th birthday party. Five years ago, he was diagnosed with thyroid cancer. Though he still smokes and eats more chili cheeseburgers than he probably should, Paul's otherwise in fine health.
When I arrived, his father greeted me, asked how I was.
"I'm doing really well. All my tests are clean and I've got my hair back," I said. That's my typical post-chemo response.
"I'm really glad to hear that," he said.
Questions continue from friends and family: How are you? Are you done? Are you cured?
A disease was diagnosed and, for the most part, there was a treatment and cure. But for the rest of my life, there will be regular blood tests and CT scans.
I find encouragement in fellow survivors, like Paul. Not the ones with best-selling books, like Lance Armstrong, another survivor of testicular cancer, but those in my daily life.
In every walk of my life, there are survivors. Sources are survivors. Co-workers are survivors. Yoga classmates are survivors. College and high school classmates are survivors.
We're everywhere, I've discovered. So we might as well be honest and talk about it.
● Contact reporter George B. Sánchez at chicanotengouno@gmail.com.
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