Tyler’s story: Strength found in taking action

As I headed for the door the ultrasound technician spoke softly and said "you will hear from your doctor by tomorrow." That is when I knew something was wrong.

A few months prior I had been on road with my brother in the Canadian Rockies. After hours of quietly sitting in a car I started to notice a dull aching sensation in my groin. At the time I didn't think anything of it as I had been stationary for so long in the car and I had thought maybe I had been sitting in an odd position causing this discomfort. Fast forward to a week later when I returned home to Toronto when I recognized that the ache was still persistent. By this time I had decided to do a self-exam and I noticed a small lump. Since I had very little knowledge or experience of what might be a testicular irregularity, I decided to wait some time to see if it would go away on its own... only it didn't. I finally rang my family doctor and spoke to him about this bump over the phone. He encouraged me to make an appointment with him for an examination. I was nervous as I had lived with the genuine fear of visiting the doctor for any sort of examination of my genitalia. Simply put, I was scared. I pushed on with the scheduled appointment as I knew my body and I knew something was not right. After a quick ten second examination with my doctor he wrote a requisition for an ultrasound.

It was a Friday in April when I received a call from my family doctor. The day after my ultrasound... Only, I missed the call. I had been busy enjoying the day with my best friend celebrating her twenty-seventh birthday. By the time I returned the phone call my family doctor was unavailable. My GP finally emailed me later that day to say he had set up a phone call with me first thing Monday morning. That meant I had to endure the entire weekend waiting and wondering. My fear was evident. When Monday rolled around I had all but read everything there was on Google about testicular lumps and I was in full restless mode. My doctor called as scheduled and not long into the call he uttered the sentence "I don't usually share this sort of news over the phone, but the results came back from the ultrasound and it is testicular cancer." I sat quietly on the phone while my GP affirmed that this is one of the most curable forms of cancer and that he was urgently referring me to see a urologist-oncologist. Through the entire experience my GP made me feel comfortable & reassured. I felt like everything was being taken care of.

Some time had passed since the dreaded phone call and I had soon found myself sitting in a windowless room with my brother, awaiting the doctor to come in. I was so lucky to have my brother by my side as I entered into the unknown. I was twenty-six and I never imagined I would be sitting in the office of an oncologist. I was a cancer patient and I was still processing this new discovery. When the doctor entered the room he talked me through the next steps and all the statistical information. He was confident and self-assured, I felt comfortable. My case was unique in that I was born with the rare condition of being born with an undescended testicle, meaning I only had the right testis my entire life and I was facing a surgery (orchiectomy) which would remove it.

I was terrified of this prospect. What did this mean for my self-esteem? Would I be able to have sex again? Would it look funny? The list of questions running through my head went on and on... Fortunately, I was assured by my doctor that two testicular prosthesis could be implanted during my surgery, so that when I woke up and I was healed nothing would look irregular. I breathed a huge sigh of relief in that moment, but that moment didn't last long.

The first twenty-six years of my life had taught me that I could live a healthy and normal life with only one testicle. But what I didn't know was how I could live with none. Your gonads perform many functions, but two of the most important ones are sperm and testosterone production. I was encouraged to do sperm banking before the surgery, as once the operation was performed I would be rendered infertile. Living as an openly gay man I had never really expected to have biological children. I had long since conceded to the idea that I would most likely adopt should I ever decide to have kids one day. However, I decided to proceed with banking sperm as I knew I was in a heightened emotional state and did not want to make any finite decisions at the time. To this day I have no regrets.

May 26, 2022 was surgery day. I had my brother stay the night with me prior as I was so nervous. This was my first surgery as an adult and I knew my body would change from this day forward. We rolled up to the hospital for 6am. COVID was still a prominent health concern and the hospital had strict protocols. My brother who had planned to join me right up until the surgery was denied entry because he was not a patient or on the "approved guest list." I was left to find my own way to pre-op. I could have cried in the moment as I felt so alone and vulnerable. Once checked in I was visited by a barrage of nurses and doctors preparing me for the surgery. I waited anxiously in full hospital attire clutching my phone, texting my friends and family until the last moment to soothe my discomfort. The OR nurse finally greeted me and we made what felt like the longest walk of my life to the operating room.

The surgery was a success. The doctor confirmed that the tumour was the least aggressive form (seminoma tumour) and that the next step was to be a CT-scan and further blood tests. The doctor had decided to perform the surgery prior to having me get a CT-scan as my tumour markers from my prior blood test came back normal. This meant there was less of an urgency due to the lower likelihood of the cancer having spread by this point. Fortunately, after the scan I received the great news that I was clear of any tumours and it was confirmed that for the time being, the cancer had not spread. I was officially diagnosed with stage 1 testicular cancer and had narrowly avoided the prospect of further treatments of radiation and or chemotherapy. It was at this moment I realized the importance of early detection and how important it was to see a doctor as soon as you spot any irregularity.

Fast forward to almost a year later and I can confidently say that this experience was one of the best things to ever happen to me. I know this sounds strange. However, I gained confidence in knowing I could go through hard things and come out stronger on the other side. I have also started TRT (testosterone replacement therapy) daily to artificially replace my body's inability to produce testosterone. Through this change I noticed that my mental health had drastically improved by three months post-op. In fact my doctor told me that when they tested my levels after the surgery that I had some of the lowest levels of testosterone he had ever seen. It left me wondering if my levels had been low all my life living with one testis as I had openly struggled with depression my entire adult life.

I share this because we are talking about men's health and it is all encompassing. It includes not only the physical but also the mental. Through my experience I learned I can be vulnerable -- even as a man -- and that I must advocate for myself and my wellbeing. My life changed because of cancer but it changed for the better and my hope is that more men get to say the same thing because they took action when they realized something wasn't normal with their body too.