Chemotherapy

On the day of my chemotherapy I woke up and felt… nothing really. Maybe a little nervous? No, not really. Anxious? No, there was none of that. Weirdly, the best I could muster was some good old fashioned dogged determination. I needed to get this done. I was going to get this done. It won’t be that bad.

Mark and I went and met my friends Gary and Kaz for lunch. Kaz had come up to London especially for a dance festival that Mark and I were supposed to be attending the next day. Obviously we’d had to sell the tickets, another thing that pissed me off about this whole cancer lark. It really was eating away at my summer.

We had lunch in a pub. I ordered a steak and a pint of bitter. My companions furrowed their collective brow at this, but I wanted one and couldn’t think of a good reason not to. I’d not been told not to drink beforehand. So I did. Unfortunately the beer was off and the steak was chewy. That’ll teach me.

There was an unusual atmosphere. Gary and Kaz were concerned and lovely but, I sensed, not really sure what to say or how to behave. It was a weird situation – going for a pub lunch then popping over to the hospital for some chemo. But we all did it because we couldn’t think of a reason not to. There was no need to isolate myself. I didn’t want or need time on my own before having it. These things – ‘going to have chemotherapy’ - always sound more monumental and dramatic than they actually are. In fact it’s a fairly straightforward procedure, as I was to discover.

I didn’t have to wait in the chemo waiting room for long. They ushered me into a room that was exactly the same as the waiting room – armchairs, etc - except it was larger and the people sat in here were attached to drips.

The nurse sat Mark and me down in some armchairs. She went about inserting a canular into my arm, something I’d had some experience with before when I did a medical trial in Australia. But not something you can ever get used to I feel. It is the most uncomfortable and ‘wrong’ feeling to have something sitting in your vein and coming out of your skin like that.

The drip was hooked up to a machine that dictated the flow of the drug into my bloodstream and timed it. The nurse explained that it should take about an hour and a half. I asked if I will experience any symptoms during the process and she told me probably not but (I hear it again) everyone is different.

The drug they gave me was called carboplatin, a colourless fluid that looked harmless enough sat in its clean clear bag. It's usually given to patients with lung or ovarian cancer and I wasn't clear on why they'd decided to give it to me, apart from that it would do the job in one dose.

I looked it up later and found this: “Carboplatin kills cancer cells by binding to DNA and interfering with the cell's repair mechanism, which eventually leads to cell death.” Basically they pumped me with poison.

So I sat back and relaxed while I was pumped with poison. I looked around at the people there. Those attached to the drips were all over a certain age. There was no one young. I supposed children with cancer have their own oncology department. And people my age… well they don’t get cancer do they. Just the unlucky few.

I sounded sorry for myself then. I wasn’t, and am not. I was and am actually just grateful that the whole thing wasn’t a whole lot worse. In fact, rather than overwhelming and upsetting, the experience of getting chemotherapy was underwhelming and even a little funny.

For a start the machine kept fucking up. Every now and then we’d hear a beep telling us that the drip had finished. The first time it happened was a few minutes in. “Well,” I said. “That wasn’t so bad.” Mark went and got a nurse.

About half an hour in, a batty-looking woman who looked like an extra from Rent-A-Ghost came bursting into the room shouting, “Mabel! Mabel! Are you here Mabel?!” She was obviously near-blind, despite walking around unaided. But there was an obvious candidate for ‘Mabel’ – a batty-looking woman who looked like an extra from Rent-A-Ghost sat in the corner on a drip. They soon found each other with the help of the nurses.

I was engrossed in my book, but Mark heard them talking. They were trying to assess our relationship. “Well, that’s a very good friend to come in and sit with him like that,” said one. “They might be brothers,” said the other. “True, but it’s still good of him.”

Then Mark spilt tea everywhere. Everywhere that is, except from on me. We had tea and biscuits sat on a tray on a trolley and Mark smashed his arm down on it, sending the tea flying. To this day I don’t know how he managed it. Thankfully I didn’t have to move. Not that it mattered; the drip and incessantly beeping machine (it couldn’t wait to get rid of me) were on wheels. I could have popped down to the shop if need be.

And finally the beeping machine was no longer lying to me. It really had finished. I was pumped full of a litre or so of poison. And I felt fine. Disappointingly normal. We went home, still normal. Watched TV, still normal.

Then at two in the morning, still wide awake I realised the first of my symptoms – insomnia. The anti-sickness drugs they’d given me were supposed to be taken first thing in the morning so they wouldn’t affect your sleep. But my chemo was done in the afternoon, so here I was wide a bloody wake.

Saturday was my first full day after chemo. I woke up feeling nauseous and forced down my anti-sickness. I texted my friend Steve to tell him I wouldn’t make his birthday lunch. I’d said I might come along if I felt alright. But I didn’t feel alright. And I didn’t feel in the right state of mind to socialise with people I didn’t know. And I was the other side of London. It just wasn’t a good idea.

But then as the day rolled on I felt normal again. Mark wanted to go out and buy a TV stand he’d seen in a second hand furniture shop down the road. Did I want go with him? We weren’t sure what was best. We debated it. I felt alright. We decided I may as well go with him.

And I was alright. When we got to the shop the dude who ran it wasn’t there; he’d put a sign up saying back in 10 minutes. I felt the first wave of tiredness. I sat down on one of the second-hand chairs and felt better. I wasn’t hungry – I’d eaten okay at lunch. Just felt a little woozy. It soon passed.

We took the TV stand back on the bus. People stared and frowned like they had never seen a TV stand before. To be fair they’d probably never seen a TV stand on a bus before. But come on. The bus driver didn’t look sure about letting us on. But the stand was on before he could argue. We took it home.

I went to bed earlyish. Tiredness hit me like a truck. I woke up some 13 hours later, feeling awful. The best I can describe it is somewhere between a hangover and a drug comedown – a wooziness that is all-encompassing but that is not alleviated by lying down, sitting on the sofa, or walking around. Sunday, the first day of full-on symptoms, was in a way the easiest, as I slept through most of it. I ate a little, took my anti-sickness drugs, and went back to bed. That day was pretty straightforward.

Monday I was more awake. But this was a pain. I still felt the wooziness, the uncomfortable, want-to-climb-out-of-your-skin feeling. But I could do nothing to ease it. Nothing that I would treat a hangover with – coffee, food, Berocca, lying down, watching TV – made any difference. I couldn’t concentrate on TV, reading, talking to Mark. As soon as I tried to do something it didn’t take the feeling away so I wanted to do something else. It was horrible.

Over the next few days however, I gradually felt more human. The weekend approached. Mark had an idea. Why don’t we go to Cornwall for the weekend? Over Wednesday and Thursday we discussed it. We could hire a car, drive down, stay in the hotel in Padstow Mark’s dad had booked for us, chill out for a few days, come back.

There were two issues – one, was I feeling okay? Yes, I was feeling alright. Good enough to spend two nights in a luxury hotel, anyway. Secondly, what are the risks in regards to my immune system?

I was now entering the second week of my post-chemo window, the week where, according to the oncologist, my immune system would now be at an all time low. We weighed up the options – stay in London and not leave the flat I’d not left for the past five days for fear of catching something from the hordes of people living in an over-populated and dirty city. Or. Drive in a contained car to a secluded and quiet part of the country where there is plenty of fresh air and far less people around.

Mark got on the phone.

It was a brilliant weekend. The hotel was beautiful and not intimidatingly luxurious; homely rather than decadent. It looked out over Padstow harbour, of which we had a view from the decking out the front of our room. We relaxed, went for a drive up the coast, relaxed some more, had a wander round the quiet streets of Padstow, relaxed some more. I breathed deeply of the fresh sea air.

On the Sunday night Mum and Dad came to Padstow and we had a meal at Rick Stein’s restaurant. It was the perfect place for Mark to meet the folks for the first time. I didn’t think about what I’d been through throughout the whole meal. In fact I barely thought about it for the whole weekend. It was nearly over and soon I could consign it to my past.

We drove back to London and I spent the rest of the week roaming around the flat like a caged tiger. It seemed to drag at the time but before I knew it, it was time to return to work.

I was nervous going back. I wasn’t sure still what people knew, what they would say. I was greeted with gentle concern from those that asked about it. My immediate colleagues sought assurance that I was ready to be back. Initially I felt fine. But as the week wore on I noticed that I fatigued easily. It was subtle but it was there. So I took it easy. I was pleased to have something to do, to focus on, that wasn’t situated in the four walls of my flat.

Also, I was pleased to be through it. The worse was over. I was almost healed up properly from the operation and I was through the drowsy, druggy hell of the chemo. Now it was time to get my life back on track.

Infection

So I was ready for chemo. My holiday was cancelled, my sperm banked, and the operation distant enough for me to be healed. Or so I thought on the latter.

The night before I’m due to go to the chemotherapy ward for a run-through of what to expect, I’m getting ready for bed when I notice a small wet patch on my boxer shorts. I go through the possibilities: have I done a little wee wee by accident? Nope, too old for that. Or not old enough. Have I got a little excited at something or other? The sight of a pie maybe? No, it’s not quite in the right place.

I took off my boxers and had a look at my scar. There at the bottom of it was a small area that was a little gungy. The rest of the scar had healed perfectly, but right at the bottom was a small patch of sticky clear liquid. It was hardly worth talking about. Just a tiny bit of seepage. But I instantly knew it was going to be a big problem.

I saw the chemo nurse the next day. She was Mediterranean-looking, thick accent, short and pudgy. She wittered away like a bird, constantly repeating herself. She was nervy, worried she was going to forget something. But I don’t think she was new. She seemed to know what she was doing, just that if she didn’t keep going over it, it was going to escape from the clutches of her memory never to return. She drove me mad.

She went over everything Dr Laurence had told me already, enhanced with much of the stuff I’d read in the leaflet he’d given me. She’d even go over stuff that was only relevant if I was having more than one dose of chemo, ending it with “But that’s not the case for you so that’s okay.”

Just when I was about to scream at her that I knew all this stuff already what the hell was the point of this you mad bitch, she would give me a nugget of information that was useful. Like I should use a baby toothbrush when cleaning my teeth as my gums were likely to bleed from vigorous brushing. “So I can’t use my electric toothbrush then?” I joked. She laughed but looked horrified. “No!” she squealed. “Just a baby toothbrush.”

Eventually I managed to get a word in edgeways and asked her about the puss oozing from my scar. She put on her serious face but failed to cover up the fact that she had no idea what to say to me about it. She didn’t even ask to look at it. She just said I should speak to my oncologist.

I phoned the nurse practitioner, Nurse Kathryn, and left a voice mail, trying to make it sound as innocuous as possible. I had thought about not saying anything. The last thing I wanted was to delay the chemo; I needed to get it over and done with as quickly as possible so I could get back to normality. But that need also fed my decision to ’fess up and ask them about it. If I had chemo and it made what was looking like an infection worse, then my return to full health could be delayed even further. It wasn’t worth the risk.

It was an infection. I saw Dr Laurence the next day – the day I was due to have chemo. He looked at it, took some swabs, and put me on antibiotics for a week. I was going to have to wait a whole week. He confirmed my fears – if I had chemo then there was a risk that my dilapidated immune system would allow the infection to fester and grow worse.

A week. A whole fucking week. I was angry. Angry and frustrated. To add insult to injury it looked like the day I would now have chemo was the day we were supposed to be going away. It wasn’t the holiday itself as such - we could go down to Cornwall any time, although it would have been nicer at that time of year. What made me angry was the demanding, unreasonable, inflexible nature of this illness. You dance to its tune, not the other way. There’s no give at all. I’m not used to being properly sick I guess. But if I want to beat it then I have to play by its rules. I can’t take it on and still live my life exactly the way I want it. I’ve had to put certain aspects of my life, bits that make it fulfilling, enjoyable and, if I’m honest, manageable, on hold a bit while I take care of it. And I hate it for that. I really hate it.

Yesterday I went back to the hospital for them to check my infection. It looked like the antibiotics had made little difference to me. It doesn’t seep as much I guess, but it’s still infected. Dr Laurence was more positive however. He felt it had improved enough for us to go ahead with the chemo, but he wanted to get a second opinion just to be sure and called in a urological surgeon to have a look.

It wasn’t the guy who operated on me, thank god. This guy was unexpected – a big burly man, very muscular, his hair cut in an army style. With his thick Eastern European accent he could have been a bad guy from a Bond movie. It was hard to imagine him doing something as delicate as surgery, but I trusted in Dr Laurence that this was the man to give a second opinion.

I lay back on the bed again, trousers dropped and boxers down enough to reveal the scar. I wasn’t getting my dick out again for anyone, that was for sure. He asked me some questions about the surgery and how long I’d had the infection then bent over to take a look. He pressed his meaty fingers onto the scar and pushed into it. It was very uncomfortable. He pushed some more. And more. He kept pushing until I thought my pelvis was going to snap. I cried out in agony and pushed his arms away.

“What the fuck are you doing?” was my immediate response. He responded apologetically, saying he was trying to squeeze any remaining pus out. He bent over to have another go. I sat up and pulled my shorts up. “No fucking way, you’re done mate.” He looked a bit mortified. He started jabbering away, saying he was just trying to see how much of the infection was left. I said I didn’t care what he was doing, but he should at least give a bit of warning.

He kept apologising and trying to get me to let him look at me again. I wasn’t having any of it. I’d been so upset by my last run in with a registrar that somewhere in the back of my head was a voice going, ‘Never let that happen again.’ I wasn’t a piece of meat he could manhandle however he liked and I let him know it.

He got me to try and push some pus out of my scar but nothing really came out. Either I wasn’t doing it hard enough or there wasn’t much there. I did my trousers up but he wouldn’t go away. He kept apologising, at which I would just stare stonily at him. Then he started asking me questions about children and sperm banking. Unbelievable.

“Do you have any kids?” “No.”
“Do you want kids?” “I’ve already sperm-banked,” I cut in, not wanting to get into the conversation with him. I wanted him to go.
“Did you give a few samples?” “No.” I stared at him. He put his hand on my shoulder. “You’ll have plenty of kids.” Wanker.

He apologised again and I nodded. This seemed enough of an acceptance for him to finally leave. Dr Laurence had tried to mediate a bit during this exchange, to no avail: he’d been determined to apologise and I’d been determined to let him know he was out of order. He sat me down and said some soothing words. I told him about the first registrar and he conceded that there was a certain type of personality drawn to that job, and that they saw so many patients that in a way they lost sight of them as people.

But down to business. He reckoned the infection had cleared up enough now that by the time my immune system started to be affected by the chemo, it would be long gone. It was time to book me in. He had no spots free today – imagine that, all those people needing chemo – so tomorrow it is. Just one dose then I’m done. Sounds easy right? How hard can it be?

Banking

Did I need to bank any sperm? Probably not. From the professionals’ surprisingly non-judgemental point of view they offered me the opportunity as a precautionary measure. They knew I had no children and they knew I was gay and when they asked me if I wanted to have children I said probably not, but they still offered me the chance. They told me that although my fertility level would be lowered somewhat by the chemotherapy most patients saw it return to normal afterwards and went on to have children normally, and I would probably be the same given I was only getting one dose. But they still offered me the chance. And I thank them for that.

From my point of view, given my sexuality and where I was at in my life right now, I thought it unlikely that I would want children of my own in the near or distant future. Add into this the thought that if I did want children I would think it better to adopt, then it’s increasingly unlikely. But why take away the choice? I decided that, though I probably wouldn’t have any use for my sperm in the future I envisioned for myself, I still wanted it there if I changed my mind.

Plus I wanted to experience what sperm banking was like.

Turns out it’s quite amusing.

So I left work in my lunch hour and headed to the hospital, this time to yet another new department – the Assisted Conception Unit. It was a little awkward at the reception as there were people stood behind me but I eased the situation by using medical euphemisms: “Hi, I’ve come to give a sample.” Much more appropriate than: “Hi, I’ve come to wank into a pot for you.”

A nurse showed me to the room. She explained the procedure: I’m to lock the door twice so the red light is switched on and people know not to disturb you; I’m to produce the sample into the pot, screw the lid on tight, place in the plastic bag, and place into the plastic container to be sent up a shoot (as it were) to the laboratory. She then showed me how to work the shoot (as it were).

She left me to it and I shut the door behind me. I fiddled with the lock for awhile, unsure whether it was locking twice or not. I realised I was nervous and told myself to stop pissing about and get on with it. The room was small with a leather recliner and foot stool in one corner, a sink and mirror in the other and a desk with a TV and DVD player.

I decided to peruse the ‘materials’ they’d kindly left to stimulate you. I was sorely disappointed: all the magazines and DVDs they had were aimed squarely at the heterosexual market. There wasn’t even the odd cock to look at – it was exclusively girl on girl action. I had to rely on the old ‘wank bank’ instead.

(For those not au fait with the term ‘wank bank’, it merely means a collection of sexual fantasies or previous excellent sexual experiences that are stored in the head for the use of stimulation as and when they are required.)

The harsh glare of the hospital light added to the clinical nature of what I was about to do. But they’d thought of that. Between the desk and the sink was a lamp with which you could create ‘mood lighting’. I did just that.

When I was done (I’ve got to tell you I aimed well, not a drop was wasted) I screwed on the cap and had a look at what I’d produced. I was pleased with it. It looked pretty, you know, spermy. I wrote my number on it, put it in the bag and container and went outside to stick it up the shoot (as it were). I braced myself as I opened the door, expecting to have to look someone in the eye who would know exactly what I’d been up to. There was no one there.

I was told I had to wait to see a doctor before I could go so I settled in the waiting room. It was all young couples. I got the odd questioning look. I was kind of wondering why I was here as well.

I waited forever. I filled out some forms they gave me. It was pretty heavy stuff. I had to give consent for embryos created with my sperm to be stored, fair enough, but I also had to decide whether I would allow my sperm or embryos to be used for training (I did) and what would happen to my sperm or embryos in the event of my death or mental incapacity (sperm got rid of, but embryos could be used by my partner, I decided). I wasn’t sure that any of it was the right decision. The enormity of it overwhelmed me a little. It was the kind of ethics I never thought I would have to contend with, yet here it was getting right in my face.

I flicked through a massive book of photos of London to distract myself. I got through the whole thing. I was getting antsy as I’d not told them what I was doing at work, I’d just mentioned blood tests as I couldn’t be bothered to explain this one, and I didn’t want any questions when I got back. I went to reception.

Everyone had seemed to have gone to lunch. I eventually got someone’s attention and reminded them of my existence. I was cajoled by the receptionist, who assured me she would get someone to see me. It took another 10 minutes but she eventually came good on her promise.

A lady doctor saw me. She was pretty and gently direct. We discussed the forms and she told me I didn’t have to worry about the questions of embryos and using my sperm for training. It was more just to get my permission for storage. We talked a little about what would happen if I needed to make a withdrawal (as it were) on what I’d banked. She told me about IVF. It all seemed totally irrelevant to me. What was I doing there? All she knew was I was single with no children, so she was giving me all the information she felt I needed. I made out like it was more important to me than it was.

She told me I may have to bank some more. This wasn’t so appealing. The novelty was totally gone now. But if the sample I’d given them didn’t have enough sperm in it for the IVF process then they would need more, i.e. if it wasn’t good quality they needed more quantity.

Despite my long wait and the chat with the doctor, the lab hadn’t yet analysed my sample. So I made a tentative appointment to return. A couple of hours later the lady doctor called me at work. I retreated to a quiet room where no one could hear me discussing the quality of my sperm. Turns out it was pretty good stuff. The doctor told me it was up to me if I wanted to come back and give more, just to be on the safe side. I said I’d go with her advice: did I need to go back or would there be enough sperm there for the IVF process? She told me it was good enough.

I may be firing on one cylinder, but I’m still firing well.

Decision

Nine days after my operation I went into hospital to get the results of my biopsy. My oncologist was Dr Laurence Krieger, henceforth known as Dr Laurence. He’s a nice guy, well-dressed – not elaborately exactly but certainly with an eye for detail. He’s quite earnest, softly-spoken, with a wry smile that says: “Isn’t the world a funny place? Oh well, let’s get on with things as best we can.”

With him was Kathryn Elwis, my nurse practitioner – the person assigned to me to be my point of contact with the hospital should I have any questions or issues to raise outside of my appointment times. She’s a tall Scottish woman with a friendly face and practically-cut short hair. She struck me as unflappable, someone who could face down any stroppy or temperamental customer just by continuing to be incredibly nice.

I liked them both.

Dr Laurence checked my wound and told me it looked fine, healing nicely. Then he sat me down and started doling out the news. First he asked me if I’d done much reading. I hadn’t. I’d decided not to delve too deep into the information available, especially into the panic-mongering that I thought I might find on the internet. I didn’t want to wallow in this experience. I wanted to be pragmatic and get it over with as quickly as possible. To me this meant just listening to the doctors and nurses and taking on board their advice and information, nothing more.

My tumour was a seminoma – the classic testicular cancer tumour that they enthusiastically told me is easily curable. It was roughly four centimetres in diameter. While the x-ray and scan had revealed that I was clear of cancer in the rest of my body, and there were no what they call tumour markers in my bloodstream, there was evidence of ‘lymphatic vessel invasion’.

This means they found that cancer cells had moved around in the vessels of the testicle. It followed therefore that cancer cells could have moved on to other parts of my body. The emphasis was on ‘could’. It was unlikely given all the other evidence, but it was still a possibility. Therefore they wanted to give me one dose of chemotherapy, to be on the safe side.

They were adamant it was my decision whether I had chemo or not, but made it quite clear that it was sensible to do so. I was given odds of 40/50% of it coming back if I didn’t have chemo, 5% if I did. They were hard odds to ignore. I made the decision to have it then and there, but played along with their game that I had time to think about it. What was there to think about, really?

They gave me something else to think about: sperm banking. Chemotherapy works by breaking down the fast-producing cells in your body, as that is how cancer grows. But this also includes things like white blood cells (which form your immune system), hair, and sperm. As such there is a risk of infertility from having chemotherapy. Given that I was only having one dose this was unlikely, but the risk was still there and they advised sperm banking if I thought I would ever consider having children in the future.

I’m given a week to think about it, though I don’t need to do much thinking. My own opinion and that of everyone I speak to is that the sensible option would be to have it. As Maz put it: “Of course you should have it. What’s to think about?”

When I went back, this time with Mark, Dr Laurence - flustered and tired-looking this time as he juggled three doctors’ work due to illness - once again went over the side effects of chemotherapy so I was aware of the possibilities of what I was letting myself in for. He didn’t paint a pretty picture.

I’ve already mentioned the possible effects on the various bits of my body that are made up of fast-producing cells, although Dr Laurence was happy to admit that I was very unlikely to lose any hair given that I was only having one dose of chemo.

The main side effect would be nausea, but this would be treated with anti-nausea pills given before the treatment and for some period after. The effects on my gut may also cause diarrhoea or constipation or, most importantly to me, loss of appetite. If I can’t eat to make myself feel better then I was in for a rough ride.

I was warned I could bruise easily and that my gums may bleed, particularly after I clean my teeth. I may get mouth sores, dry skin, or flaky nails. I was told there would be an increased risk of blood clots, both from having had cancer and then chemotherapy as well.

I may find myself overly tired, lethargic, even breathless. This is due to anaemia caused by the red blood cell count being diminished: less red blood cells means less haemoglobin which means less ability to carry oxygen around the body. This may also cause dizziness or aching muscles or joints.

A more unexpected one was the possibility of getting the pins and needles feeling or numbness in my fingers and toes. They call it peripheral neuropathy. Other symptoms included headaches, changes in how well my kidney works, effects on my hearing; it didn’t sound like much fun at all.

The other main effect though was to my immune system. As my white blood cell count would be dramatically diminished by the chemotherapy I would be at increased risk of infection. If I was to get sick in the recovery period after having chemotherapy it would be a matter of heading into hospital to recover, not just heading to bed.

But it was inevitable. Despite this onslaught of gently discussed possible side effects I never really wavered in my decision to have the chemotherapy. It was just a matter of when.

Mark and I had organised some time away to Cornwall. It was an important holiday. Mark would finally meet my parents for the first time. I would spend some quality time with them and my godchildren for the first time in some three years, having been away for so long. Mark and I would travel around Cornwall as tourists as well, me getting to see my homeland through his fresh eyes. But the week we were heading down was the week Dr Laurence wanted me to have the chemotherapy.

There was a certain period after the operation that needed to be left so that I could heal properly, before exposing my body to chemotherapy. But there was only a certain period after the operation where they knew chemotherapy would have some effect on any remaining cancer. If we delayed the treatment until after our holiday, Dr Lawrence said regretfully, there was no scientific evidence to say it would have the desired result.

It was yet another inconvenience. That’s how I saw it: an irritating thing that was causing much inconvenience and bloody well ruining my summer. I’d already had to give up weeks of kickboxing training so as not to risk a hernia after the operation, now I was going to have to give up my holiday.

Again Dr Laurence gave me time to go off and think about it, but again I felt I didn’t really have much choice. It was either treat this sensibly and go with the doctor’s advice, or carry on living my life how I want to regardless of the risks to my health.

This week I went in for more blood tests. This time I found myself in the Nuclear Medicine Department. Dr Laurence wanted me to have what he called ‘EDTA creatinine clearance’. My understanding of it is that it’s an injection of a small amount of radioactivity in your arm, followed by a series of blood tests every hour for a few hours. With the results they can assess how well my kidneys will respond to the chemotherapy. I may have that wrong, but that’s the general idea. I did well anyway so I’m good to go for chemo in that respect.

I tracked down Dr Laurence and gave him the go ahead to arrange a session of chemotherapy. I need to get this sorted, get it out of the way. Only then can I go back to doing the things I want to do and living my life properly.

Recovery

The day after I left the hospital I was ready to tell more people. I sent a, in hindsight, silly text to a bunch of my closest friends: ‘Hi. I was admitted to hospital yesterday. I’m okay but can you give me a call at some point?’ Too vague. Too much potential to worry. But how do you broach that sort of news without going into it in something as flippant as a text? The flurry of concerned answer phone messages I got as I took equally concerned calls made me realise I probably could have phrased it a little better.

The different reactions of each close friend made me realise why I have each one of them in my life: Maz’s stern concern, Gary’s gentle consoling, Emma’s laidback look on the bright side, Julia’s dry humour – each one reassured me in a different way.

It took me a good two weeks to feel recovered from the operation. I spent a full week at home. People visited, each purveying their curiously different reactions to my predicament. Maz was all fussing and frowning, dropping work for the afternoon to come and sit with me. She wouldn’t let me do anything, which was sweet and frustrating at the same time. It was probably good not to be getting up and down, but at the same time I didn’t feel like an invalid. I didn’t feel sick or injured enough to be waited on. I still felt normal.

Four days after the op I was due to go to the nurse at my GP’s so she could check on my stitches. I got a taxi there with a driver whose initial concern at my easing myself into the car didn’t stretch to his driving carefully. Instead he shouted at people, drove around waiting cars, and seemed intent on getting me to the doctor’s as quickly as possible, which was fun going over the sleeping policemen.

My scar was fine. But the nurse’s supply of bandages was less healthy. She seemed reluctant to give me any, pleading poverty. I managed to squeeze one out of her. My pharmacist boyfriend would have to get me the rest. Welcome to down side of the NHS.

I got the bus back to Clapham Common and walked the rest, which was silly. I got home and passed out for a bit. I managed to get up and go and meet Em for lunch. Very little walking this time but it was still tiring. The next night I headed over to Gary and Maz’s, having been going a bit stir-crazy looking at the same walls and windows for so long.

It was a busy weekend really. Jen and her partner Paul took Mark and I for a drive out to some National Trust property. It was a pleasant distraction. I was due to attend my friend Sean’s birthday gathering at a pub that afternoon. He’d texted me the night before telling me he’d cut my balls off if I didn’t come. I texted back saying that was funnier than he realised.

An awkward moment at the pub followed with Sean asking me questions in front of one of his friends. It took him too long to realise my saying little meant it was a conversation for another time, but eventually he realised.

A week in and I’d forgotten how shocking the news is to unexpecting ears. As I went back to work I was greeted with a mixture of expressions when I talked about it. The sympathetic ones I could take, but the stunned and uncomfortable ones were hard to bear. It fell to me to make them feel better, which seems unfair. But when people asked I couldn’t be bothered to talk around it, and lying wasn’t really an option. So I fessed up, and watched curiously to see what reaction I got.

Going back to work wasn’t easy, but it was easier than doing nothing at home. I hobbled onto the Tube at a much slower pace than the crowds around me. It was nice to be one of the slow ones for a change, I felt a whole lot less stressed. I hobbled around at work as well, easing myself in and out of my chair. But slowly I began to walk more freely, and slowly I began to take less pain killers. I’d stopped the dihydrocodeine pretty quickly – they made me constipated. But the others I’d carried on, easing off at one point only to go back to my full regime as I started to feel the pain.

My first few days back at work were fairly uncomfortable. I couldn’t find the right position to sit on the office chair. Eventually I found slouching was good, broken up with periods sitting up straight. My boss asked me how I felt at one point. I explained my slouching and sitting up straight routine to her. She just emailed back with a picture of a blow-up ring. I like working there.

But my brush with cancer is far from over. The operation was just the beginning. The doctors of Guy’s have a little bit more treatment up their white sleeves for me.

Aftermath

I woke up surrounded by big bosom-y black women. There may have been six, there may have been just two, but they exuded enough love and care to make me feel surrounded and fussed over and looked after. Or maybe I was still high.

“Where am I?” I slurred. They told me I was in the recovery room. Then it hit me: a gut-wrenching tidal wave of emotions. The events of the past 12 hours overwhelmed me and I started sobbing. Tears drained down my cheeks and my chest heaved with every sob. The nurses did some more bustling: “What’s wrong dear? Are you in pain?” “No,” I managed to say, “it’s just been a really long day.”

I don’t remember much after this. Apparently I called Mark once I was back on the ward. I slurred at him as I once again railed against the bastard registrar. Then I sunk into more sleep.

The next day there was pain and pills. They had gone in via the old scar from my previous operations and it was now longer. It was held together by stitches that would dissolve – which was a relief. I remembered having to have my stitches taken out and it wasn’t pleasant. The registrar came to see me at one point, to check out his handiwork and let me know how the operation went. I said little, watching him with suspicion and waiting for his insensitivity to jumpstart my counter-attack. But he was fine, a lot less boisterous this time, and he spent only a little time with me.

The pills were a cocktail of pain killers, and not as exciting as you may imagine: two paracetamol, one ibuprofen and (the only exotic one) one dihydrocodeine. Generally I was left alone by the nurses to sleep and speak to the next batch of people I thought I should tell.

My friend Jen texted me first thing to ask what time she should arrive for dinner at mine that night. I called straight back, there would be no dinner tonight. She was great as always and asked if I wanted to tell our friends Su and Yuki or get her to do it. I was glad she could do it for me. Already it was a hard conversation to have. But my family handled it all so well. I really experienced the benefit of having two parents who worked in the medical profession. They were concerned, consoling, but practical at the same. Then there were my sisters, with their sentimental pep talks; Libby in particular had a reassuringly no-nonsense but caring approach that comes from her own training as a nurse.

But the hospital wasn’t done with me yet. I couldn’t spend all day chatting on the phone and reading my book (Day of the Triffids, if you must know). They wanted me to have a CT scan, to check my innards for any signs of cancer there. They asked me if I could walk down. I’d hobbled to the toilet okay so said I reckoned so. They reckoned not and got me a wheelchair and a porter. Which sounds quite nice but is actually quite weird when you’re used to being so independently mobile.
The scan staff made me drink a vile-tasting liquid which they’d tried to sweeten with lemon cordial. It didn’t really work. The liquid was supposed to dye your insides so they showed up when scanned. They told me it may make me feel nauseous. It did. After waiting around for an hour for the dye to pass through my body, they invited me in for my scan. I’d given up drinking the dye as it was becoming hard to keep down, but they told me I’d drunk enough.

The mixture of pain from walking and the dye in my stomach made me feel queasy and I began to retch. A nurse got me a bowl but the only thing that came out was spittle. I waited until my stomach had calmed down then slowly manoeuvred myself onto the scanner. I had to lie down with my feet through a large donut-shaped contraption. Another nurse then hooked me up to a drip, more dye apparently, and told me that when the scan started I may feel warmth inside my body, as well as some nausea and a tingling sensation. That sounded like a mixture of the pleasant with the unpleasant to me, so wasn’t sure whether to be nervous or not.

The nurses retreated to a safe distance and the scan started. An American female voice boomed from the donut as it moved up and down and around me, telling me when to breath and when not to. Then the tingling started. It was mainly in my belly, though went up to my chest and I got, yes, little waves of nausea, but I didn’t feel like I would vomit. The sensation of warmth was quite pleasant but none of it felt natural so I wouldn’t say it was an enjoyable sensation; just an interesting one to have experienced.

And that was it. The American female voice fell quiet. The nurses reappeared from their hiding place and helped me off the machine. Soon I was being trundled back to my ward to answer more phone calls.

I’d been told I would be discharged that day but there didn’t seem to be much rush to do it. Libby had decided to come down from Bath with Joseph, my four-month-old nephew, and her unofficial mother-in-law in tow. She arrived early in the afternoon and was immediately bouncing around the place, quite obviously as comfortable on a hospital ward as she would be in her living room. Joseph quickly garnered the unabashed attention of the nurses; understandably given they spend their day surrounded by sick old men. Their faces lit up with joy at the sight of him. He had a similar effect on me.

Mark came to pick me up as well and by mid-afternoon I found myself in a bar by London Bridge supping on a latte while Libby changed Joseph’s nappy next to me. I got the Tube to Clapham with no problem. Mark was jumpier than I, getting nervous any time someone went near me. We got a taxi home for the final leg, as a 10 minute walk, I thought, was just pushing my luck and physical tolerance. Before long Jen was on the doorstep with a bottle of organic white wine - “It’s organic; it’s definitely good for you” – and I could almost wonder whether it had actually happened. Until I moved. Then I knew it had.

Diagnosis

I went into work as normal. I had no idea of what the day held for me. None at all. The morning went smoothly – the freelancer was a chilled out chick who had worked there before and kinda knew the ropes. I warned her I’d be off for a couple hours around lunchtime and not to worry, I’d be back before she knew it. She was watching YouTube at the time; she didn’t seem too fussed.

With my mind at rest that everything at work that could be done had been done, I set off for my scan. I wasn’t even worried. Not at first, anyway. The wait dragged me down a bit. I started to get worried about getting back to work. Eventually they called out a batch of names, mine included. A group of us, all men, went to sit in a corridor. For another really long period of time. I decided to give up on worrying about work. Instead my mind was leaning towards thinking about what the problem could be. Still I only got so far with considering cancer. I still didn’t know what to do with the thought once I’d had it: “So what if it’s cancer?” “Um…”

The doctor was a lady. Does this bother me, I thought? No, I decided, and shimmied my trousers down. A tube of cold gel, the thought that this was a bit weird, and a magic machine that can see through things later and the lady doctor and I are looking at my bollocks on a TV screen. It’s all a bit awkward because I’m sat forward looking back at the screen to my side, with my pants down, and her hand on my groin. She tells me I have a tumour. This makes things more awkward, mostly because I don’t really understand what she’s saying. Is she saying cancer? She’s not said cancer. But is she being polite? Easing me into the idea? No, she’s a doctor, she’d just say. But does she mean cancer? What does she mean, a tumour?

My first question: “What caused it?” That’s the one question they can’t answer. Another lady doctor came in to have a look, a second opinion if you will. Yes, definitely a tumour. But what does that mean, I kept thinking. The first lady doctor started talking about Lance Armstrong. So it is cancer then, I thought. But still I didn’t say it out loud. It never occurred to me to actually ask.

Then the big news: I was going to need an operation. “When?” I asked. “Today,” was the reply. “But I have to get back to work,” I said. “I’m afraid you’re not going back to work today,” was the reply.

Instead I was sent to another hospital, one with a urology department that could have a look at my tumour and decide what it was; instead I was going to be admitted to that hospital for an operation to have the tumour, whatever kind it was, taken out; instead I was going to have to call my scary boss and tell him I wasn’t coming back in that day.

Waiting for the shuttle bus to take me to the other hospital, I call people. My friend Steve who I work with is stunned. He says he’s happy to cover for me. My boyfriend is not so stunned – he’s been the only one to have any warning that this was coming. My sister is stunned. My Dad is reasonable and stoically tells me to get it out, quick smart. My scary boss is immediately supportive and tells me not to worry about work, just go and get myself sorted. Incredible. That’s enough for now. There are only so many times you can have that conversation in one go.

But still it wasn’t cancer. It was a ‘tumour’, and would remain so until I was told otherwise. The nice, though very green, Japanese doctor at the urology clinic told me otherwise. It was testicular cancer. I texted Mark afterwards: “I literally have testicular cancer. Brilliant.” I’m glad I wasn’t the one receiving that text.

I was sat there once again with my trousers round my ankles, my dick in my hand and a stranger rubbing cold gel into my balls with a magic machine that can see through things. “Do you want to have a look?” asked the Japanese doctor. Of course. He told me most people don’t want to, which struck me as strange. Why wouldn’t you? We compared bollocks – each of mine, I mean, not mine with his. One looked like a textbook drawing of a testicle. The other one looked like, well, Canada. He pointed out the tiny bit of testicle that remained amongst the tumour – kind of where Hudson Bay is – and told me it wasn’t worth saving. What a ridiculous thought – that someone could be so insecure in their manhood that they would want that tiny bit of testicle saved in order to claim in some way that they still had two testicles. Silly.

There was an awkward moment where I’m cleaning the gel off my balls. I could have spent hours doing it, it’s clingy stuff. We sat down. He looked at me expectantly. I got that a lot over the next few days, that expectant look. That searching for a reaction. What was I supposed to do? Cry? Get angry? Go into denial? All of the above? I didn’t feel like any of that was necessary or justified.

Things happened very quickly after this. I was admitted and found myself in one of those backless gowns, though mine was more of a wraparound affair. There was a nice moment with the ward nurse where I stupidly asked if it was okay to wear my pants underneath. “Are they nice cotton ones?” she frowned. I nodded, dumbly, wondering what her standard of ‘nice’ was. “Okay then,” she said.

It was this moment that made me feel like I was being looked after, that my figurative Mum was in attendance to this situation. It was going to be dealt with in a no-nonsense but caring fashion. I was going to be all right.

I met a plethora of hospital staff that afternoon – nurses, urologists, oncologists, anaesthetists. Even my very own pharmacist in the form of my boyfriend Mark, who left work early and popped in on his way to go and get me some stuff from home. I also met the x-ray staff while I had an x-ray to see if the cancer had spread to my chest. But there’s only one visitor that really sticks in my memory – the evil, dastardly registrar.

Surgeons have a reputation for being full of themselves. It’s well-known they’re supposed to be ego-maniacs because of this magic power to cut and fix that they have. But I always find it so inherently depressing when a person lives up to their cliché.

The man who was about to operate on me came in and immediately put me off kilter with his incredulity that I didn’t get this checked out for so long. “I was out of the country for a long time,” I said, lamely. “But even with your Dad having had cancer?” he exclaimed, looking at me with a ‘what a moron’ look on his face. “I didn’t think it was cancer,” I replied, feeling even lamer.

He started talking about children, do I have any? No. Do I want any? I don’t know. Do I have a girlfriend? I have a boyfriend. “So you’re…” he whispered it, “homosexual?” I laughed. I can’t help myself, what a prick. Why whisper that after bleating to the whole fucking ward about my testicular cancer? Yes, I said, and, obviously a little perturbed, he started banging on about sperm-banking. I wasn’t really listening. Was this necessary right now? I was about to have a testicle lopped off for fuck sake. One thing at a time, please.

He asked me to drop my pants. As had become de riguer for this process now, I held my dick out of the way. It had almost become a comfort thing while I exposed myself to all and sundry. But he knocked my hand away. “Just let it lie there,” he said. I was still of the opinion that he was the doctor and me the patient and did as I was told, despite him being an overwhelming prick. He poked and prodded uncomfortably at my tumour-ridden testicle. I let it ride. Then HE PICKED UP MY DICK OPENED THE URETHRA AND LOOKED DOWN IT. I knocked his hand away. “What are you doing?” I exclaimed. He said nothing. I was literally just a piece of meat to him. I was disgusted. To add to the humiliation I was then drawn on – a big black arrow on my right thigh pointing to the correct testicle to be removed. I was saying nothing now and the surgeon made his exit. “We’ll just get it out then,” he said as he went. Damn right you fucker, do your fucking job.

After he was gone the Japanese doctor came in with a student doctor. He asked politely if the student could have a look at my tumour. Any other time I would have been fine but I was brimming with anger and humiliation. I couldn’t take any more poking and prodding and exposing myself to strangers. I tearfully declined and the doctors retreated quickly.

My mood darkened rapidly after this experience. The gravity of the whole situation started to hit and I realised three awful but unavoidable things. Firstly, I had cancer. Secondly, I was going to have a hugely invasive operation to remove that cancer. Thirdly, this will leave me with just one testicle.

This was all starkly contrasted with the fact that I just didn’t feel sick. I felt just as healthy and normal as I had that morning when I woke up. There was nothing obviously wrong with me, so how could there be something so wrong with me? I was surrounded by old men - old, obviously sick men. What was I doing there??

By the time I was being wheeled down to the operating theatre - a mere seven hours after I’d left work – my mood was as black as night. I wouldn’t – couldn’t – speak to anyone. I stubbornly refused to lie down on the bed – I wasn’t sick or tired, why would I lie down? So I just sat there as they took me into the depths of the hospital.

The two anaesthetists were charming but they did nothing to lighten my mood. They needed my verbal permission to go ahead with the operation. “Are you happy to go ahead with this operation?” one of them asked. “Not really,” I replied. “Are you as happy as you’ll ever be to go ahead with this operation?” he countered. “Yes,” I sighed.

One of them injected me with “something to chill me out”. “Is that working?” he asked. “It’s definitely doing its job, yes,” I said, a little happier. They wheeled me into the theatre. It was remarkably old fashioned, like something from the 70s. I started banging on about how we were in an episode of Life On Mars. I was getting quite chatty now. One of the anaesthetists came towards me with an oxygen mask. “Now this is just a bit of oxygen for you,” he said. He was lying. I was gone before I knew it.

Suspicion

Finally I went to the GP. Not as soon as I was back in the UK, as you might imagine. It took me awhile. Was I in denial? I couldn’t tell you. From my perspective I just didn’t think about it. Of course it occurred to me whenever I reached down absent-mindedly, but I was easily distracted from thoughts about it. Other things were more important: getting work, reconnecting with my friends and family, some of whom I’d not seen for the three years I was elsewhere, finding somewhere to live.

But it wasn’t going away. By the time I made the doctor’s appointment it seemed to be slightly bigger than my other testicle. The bouts of grumpiness were still very occasional – it was only a handful of times I complained to Mark about it aching a bit. But it was hard. I couldn’t get away from the fact it was now almost entirely hard and lacked the spongy feeling of the other one.

Yet still I didn’t entertain (or didn’t allow myself to entertain) thoughts of cancer. I was reasonably sure it would turn out to be something else. At one point I did say to myself, well what if it’s cancer? But I didn’t know where to go with that thought. What do you do with it? It was best just to wait and find out.

The GP confirmed my way of thinking. He’s a batty old man, scatty as. One of those, “Now, where’s my glasses?” Around your neck. “Oh, yes, jolly good. Now, where’s my pen?” He had a look at me and decided it was probably scar tissue developing because I’d knocked it, maybe doing kickboxing. A recent development from the old operations I’d had. With hindsight, it doesn’t sound very plausible; I had those operations some 20 years ago. Why would nothing have occurred from them until now?

He started filling out a form for me to take to St Thomas’s Hospital and make an appointment for an ultrasound scan. Then he said something that shook me. “I’m going to put suspicion of cancer,” he said, and paused. A really long pause. Far too long. “But I don’t think that’s the case. I’m just putting that to get it hurried along a bit. If I leave that out they might not look at it for awhile.” I nodded. I was still hearing the words ‘suspicion of cancer’.

He jolted me out of my thoughts by slamming his pen down. “I can’t do this,” he said. “They’ll think I’m inept if I say that and it’s obviously not cancer. Sorry.” I shrugged, not really sure what was going on. He went off to get another form.

Speaking to Mark later we wondered if he’d been caught being inept before and was a bit paranoid about it. Either way he needn’t have worried. They looked at me pretty quick on seeing what the problem was.

After work I went to St Thomas’s to book the appointment. I got to the Ultrasound Department late and it had just shut. For the first time I felt the urgency of getting this sorted. It was Friday and they weren’t open at the weekend. I could see the receptionist but couldn’t get his attention. I stood there like a lemon, wondering what on earth to do. Then luck struck. A nurse left the clinic and I was able to sneak in. The receptionist looked at me with some annoyance but I immediately launched in with the apologies and didn’t let him get a word in before I handed him the doctor’s note. He immediately softened upon reading it and set about arranging an appointment.

But there was a problem. The earliest appointment was Monday, the next one after that was a week after. The problem with Monday was, my boss was on holiday and my colleague was on a lieu day. I was going to be holding the fort on my own with an inexperienced freelancer my only help.

I decided to risk it. I could just pop out for a couple hours and be back to work the rest of the day. Better that than wait a week for this to get looked at. The appointment was booked. I went home feeling a little better.

Bollocks

It all started what turned out to be a silly amount of time ago in a land far, far away. I was in my bedroom in Melbourne, lying on my bed. Absent-mindedly I reached down to my balls, had a feel. It’s what we do. Men, I mean. It’s what men do.

But I gradually became aware of what I was doing. Suddenly it gained importance. Suddenly it required my full attention. Something was different. The left one felt different. Or was I imagining it? I paid closer attention. It felt the right shape, and there was the tube coming off it. Yes, that seems okay. I’m imagining it.

It had always been the ‘weird’ one. I was born prematurely and with an undescended testicle. I had two operations before I was 10 to rectify this state of affairs and so I was always aware that this one wasn’t quite the same as the other one. Really, it was only a bit smaller and later discreet (and not so discreet) investigation of other men revealed this to be the usual.

But it continued to change. It changed so gradually that it was, for a long time, hard to tell if I wasn’t imagining it. The clues began to fall into place, however, increasingly hard to ignore. There was an occasional ache in that ball, something I initially put down to not having ejaculated for a few days. I wasn’t comfortable with my boyfriend touching my balls, something I put down to my general ‘sensitivity’ at being touched. But it soon became that particular ball. We started calling it the grumpy one.

Soon it was the same size as the other one, but nothing like the same shape. And it was getting hard. Occasionally the word cancer would fleetingly float through my brain and just as quickly drift off. It seemed like a ridiculous concept in relation to me. At that point I didn’t know how common testicular cancer was amongst men born with an undescended testicle. My father’s experience with testicular cancer some two, three years ago didn’t come into the equation either. He was an old man compared to me. I wasn’t due anything like this for a long time. Or so I thought.

I wasn’t really in a position to do anything about it either, really. When I first noticed it I was in Australia, and while they give reciprocal health care to British citizens I didn’t take the changes in my testicle seriously enough at that time. By the time it was starting to clamour for my attention and getting a bit ‘grumpy’ I was in Thailand, a country where medical attention for foreigners is costly and, worse, unpredictable in quality.

A female friend of mine had the unfortunate experience of having to have an abortion in a Thai hospital. They did it under local anaesthetic and she could feel the doctor going in and the … pain … was unbearable. With this in mind the idea of getting my bits checked out in that country held little appeal. But it quickly became clear that I wasn’t going to be in Thailand for any length of time and so it went on the list of things to do when I got home.