"How long have you had the pain?" asked my GP, groping me with intent.
She wouldn't be the last over the next few months to send a rubber-gloved hand into my trousers.
"Er, just a few weeks," I lied. By now I couldn't be sure, but it felt a lot longer. It had started with a dull ache, left side. An ache that began gently and sporadically but had been getting more intense. Angry even.
Still, the only logical course I could decide on was almost total denial. I'd had similar episodes before, three times, all of which had been false alarms. Ergo, I told myself with a tinge of anxiety, this too would pass. I also knew that cancer is rare, a 0.2% chance or thereabouts, just 2,000 cases in the UK each year, and in anyone's head, rare means someone else.
But then the aches morphed into occasional shooting jolts now also in my leg and abdomen. Jolts that made my eyes widen. And then there was the small matter of wearing trousers. One pair of jeans was already off limits. Another made me walk like Jay-Z. At this rate I'd soon be going to work in a dressing gown. It was time to take my head out of the sand.
"Pain is normally a good sign," my GP told me, "But it feels a bit hard so I'll book you in for an ultrasound, just to be on the safe side."
I'd first heard about testicular cancer when I was about fifteen. A boy in our year told us that his cousin, then in his late twenties, had to have one of his balls cut off and still nearly died. I remember being stunned at the concept of being unlucky enough to not only get cancer, but one that required the humiliation of partial castration.
Relaxed conversation isn't easy when you're naked from the waist down and a radiologist is smothering your testicles with jelly, but we managed it pretty well. He took me through the process, first on the right.
"You see? Perfectly normal". I nodded in approval. But when he started work on the left side, the easy banter stopped. And judging by the dark mass that had appeared on the monitor, you didn't need 10 years of medical training to work out that this one wasn't right. I stared up at the ceiling tiles bracing for the impact of the inevitable hit.
"There's no easy way of saying this I'm afraid. You've got a testicular tumour and you're going to need to have it out as soon as possible."
By the time I'd pulled on my trousers, the news was beginning to register. 'Have it out' meant surgery - I would soon be a man down. 'As soon as possible' meant time was definitely a factor. I was handed a mug as the doctor began making phone calls. This was one scenario where a cup of hot tea and a sit down was not going to be sufficient.
The cancer spectrum stretched ahead - hospitals, pain, scans, blood tests, bandanas, more pain, time off work, smiling in the face of adversity, charity treks, death.
That night–20 November 2008–is a solid contender for worst of my life. And I've seen Witches of Eastwick: The Musical.
What cancer first makes you aware of is a presence. An out-of-control band of malevolent cells was burying its way inside me.
In the morning, I was booked in for a CT scan to determine if this growth had forced its way into my abdomen or lungs. A recent lower back problem convinces me I'm riddled. What yesterday was an unnamed trouser pain is now a violent enemy that throbs through a sleepless night.
Things you hear referenced a lot when you have testicular cancer, number one: "Just look at Lance Armstrong." (I should say, this was before the Oprah confession). It's what the nurse at the scan told me as I emerged from the CT tube. But right then his against the odds battle with cancer that had spread to his brain was the last story I wanted to identify with.
I wanted the good odds, get it done, no-need-to-set-up-my-own-foundation kind of tale.
Number two: 'if you're going to get one, this is the one to get'. In the Seventies, get a testicular tumour and things didn't look too good, but a combination of getting it earlier and more effective post-op treatment has made it one of the most treatable cancers of the lot, with a survival rate of over 95 percent.
But while the good stats were reassuring, they didn't completely cover up the whiff of death, however faint.
When this is over, I vowed, not a minute would be wasted. Perhaps I'd try life as a mountain guide in Peru. Or help build an orphanage in Nepal. Or maybe just ring my Mum more often.
The scan is basically clear, they tell me, but not completely.
There's a smudge on a lymph node that they're looking into. I didn't want a smudge but I'm not riddled. And not being riddled feels good enough.
When a surgeon cuts off one of your testicles, it comes out where your groin meets your waist, just below your beltline. The reason is to minimize the places where the cancer cells might be left behind.
If that was one surprise, being asked if I wanted a prothesis was another–a fake ball they pop in the scrotum at the same time they pull the other one out. Aside from the risk of infection and complications the idea of an alien sphere bobbing about seemed an odd choice, especially as I rarely wore Speedos.
"For Christ's sake make sure they get the right one," was my Dad's advice as I leave for the hospital.
Not what you want to hear perhaps, but it provoked me to scrawl a DIY arrow on my thigh in biro just in case.
Sure enough the surgeon comes in with his own marker pen before the op. Goodbye old friend. It's a strange loss that I wouldn't face up to until I got home the following day. Queasy, in pain, an irrational dependency forming with my track pants. And an unconscious grief that had me sobbing in to my pillow for two consecutive nights.
I rethink the idea that I left it late when a former TC patient in the waiting room confides that his tumour had grown to the size of an orange. He could hardly walk before a friend had to physically force him to a doctor. My oncologist adds that he had once seen one the size of a melon. I'm starting to look proactive.
After surgery, the biopsy results. It's a seminoma, he tells me–apparently the best kind–and it hasn't fully escaped the testicle. It has, however, reached a point where a blast of chemo would significantly reduce the chances of it coming back–from a 20% chance to 2%.
A one shot, high-dose blast of liquid platinum that has only recently replaced 2 weeks of radiotherapy as the preferred treatment, that also carries the chance it will leave me infertile. I spend the week before treatment heading to the sperm bank.
Hopefully, the idea of my future children being conceived in the disabled toilet at the Royal Surrey hospital won't need to be addressed. There's nothing like a chemo ward to put things in perspective. Looking around, I realise that I've got it good.
There are people here who are in so often they have favourite seats, who know the receptionists by name. I'll be out in a few hours. As I watch the bag of carboplatin, a skull and crossbone warning sign on its back, pumping through a vein in my hand, it's almost with a sick excitement that this 8-week saga is nearing the end. Just a week of post-chemo, Trainspotting-style, babies-on-a-ceiling-turmoil to get through against a backdrop of more episodes of Quincy than is mentally healthy and it's back to work to spread the news of my brave fight.
While the intensity of the experience inevitably fades, the awareness lingers on. Those sweeping promises and altruistic ambitions shift to more selfish, everyday alterations.
Giving up smoking. Cutting down on crap food. Not putting mobile phones in my pocket. Throwing out the laptop. Questioning perisistent aches and pains. Maybe even going to the doctor.
This article was originally published in the September 2009 issue of Esquire but is being published online for the first time for #WorldCancerDay
How to Perform a Self-Examination
Testicular cancer is the most common form of cancer in men under 45, so checking regularly should be a top priority. Alison Morgan from the Everyman Campaign talks us through it:
1. The best time to check is after a shower or bath.
2. Roll each testicle between your fingers and thumb to check for any lumps, swellings or changes in firmness.
3. Common signs to look out for:
• A lump in either testicle,
• A sudden collection of fluid in the scrotum,
• Any enlargement of the testicle,
• A feeling of heaviness in the scrotum,
• A dull ache in the abdomen or groin,
• Growth or tenderness of the upper chest.
4. If you find any of these or something else unusual, go to your GP. Most lumps are not cancerous, but the earlier you find out the better.
Find out more about testicular and other men's cancers here.