So this week I got the news that two good friends of mine have cancer. One has colon cancer and will be undergoing a colECTOMY (ecto = Greek for “to cut out”) during the Christmas season.
The other is twenty-some years younger than me. He was diagnosed with testicular cancer and had a radical orchiectomy after which…well, we don’t know because they are in the specific diagnosis part of his New Normal. He said he’d let me know because I pray well for biological specifics – I can see the parts of the body that are affected – cancer, breaks, dislocations, flu. I am a great prayer for healing of body parts as well as for restoring the heart and mind.
At any rate, some time ago, my wife asked “Why do so many people have breast cancer?” I marshaled statistics in this post: http://breastcancerreaper.blogspot.com/2011/06/why-do-so-many-women-have-breast-cancer.html
The research led me to the statistics for other kinds of cancer – lung cancer, Liz’s mom died from this; blood cancer (leukemia), the son of close family friends; brain cancer, an old friend of mine died from this at 30; skin cancer, my sister, brother and sister-in-law have this; there are others with other cancers that I don’t care to enumerate at this time.
Testicular cancer has increased by 60% in the past 25 years. Why? Right now no one knows the answer, it just…has.
A student of mine, after we talked about why my wife’s hair all fell out during chemo. I talked about how the chemicals target fast-growing cancer cells – and kill the fast-growing hair cells “accidentally”. She then went on a rave about how we should make drugs that ONLY target cancer cells…and that got me to thinking.
Are all cancer cells created equal? Or are they egalitarian? Is testicular cancer the same as breast cancer? Brain cancer? Lung cancer? Skin cancer?
Questions – and today…no answers. Just more questions that I’m going to try to answer in the future…
After the initial diagnosis and orchiectomy…
The friend who had a radical orchiectomy faces a second operation next week. The procedure is a real mouthful so to speak because it doesn’t have a “common name”. He will be undergoing a retroperitoneal lymph node dissection or an RPLND – which really doesn’t do anything to make it easier to remember, because the letters might make up the word “ResPLeNDent”, but that’s not helpful and I doubt very much that it’s particularly descriptive of how my old friend will feel AFTER the procedure.
Not even Wikipedia has a simple explanation, so as I am wont to do, let’s see about translating the doctors:
Retro (= behind) Peritoneal (= a sack that lines the area below the lungs and above the bladder that holds the kidneys, liver, parts of the large and small colon, most of the pancreas and the stomach) is surgery that tries to get at and remove abdominal Lymph Nodes. The nodes are outside of the sack that holds all the abdominal organs and lie against the INSIDE part of the spine. Lymph nodes are usually found at “bending points” like knees, ankles, arms, elbows, etc. Humans bend at the waist as well and a node in the abdomen pumps lymph through the body just as the others do. But it is close to the testicles and the nodes are the first to be attacked by cancer cells if they metastasize from there. Testicular cancer spreads in a well-known pattern, and these nodes are a primary landing site during spread of the disease.
During the surgery, doctors need to remove the nodes in order to treat testicular cancer, as well as help establish its exact stage and type, or Dissection. This has been done in the past by surgery so invasive that it required cutting a man open from the bottom of the sternum (middle of the rib cage) to below the belly button! There are dangers in this as well that I prefer not to go into.
But several doctors do the same surgery laparoscopically and while some surgeons consider it “less effective” others suggest that it is less painful, runs fewer risks and joins the ranks of laparoscopic surgeries for repairing knees, shoulders, hernias and prostrates (and at the end of the particularly trying year of 2020, removal and repair of a herniated spinal disk in someone close to me...) It’s more expensive and detractors point out that not “all hospitals” have the capability of doing this, but it is far less incapacitating than the invasive older surgery.
Once the nodes are removed, an oncologist can examine the tissue to determine the extent of spread of the cancer. If no malignant tissue is found, the cancer may be more accurately considered as a stage I cancer, limited to the testicle and the orchiectomy may either be considered the “final solution” or they can follow it with chemotherapy or possibly radiation therapy. The low mortality and relapse rate with this procedure, as compared with the alternative, which is the main reason my old friend has considered this as an alternative to the invasive surgery.
If you have testicular cancer – and any of us with testicles are susceptible. Warning signs are NOT LIMITED TO but may include: a lump or mass in either testicle, any enlargement or swelling of a testicle, a collection of fluid in the scrotum, a dull ache in the lower abdomen, back, or in the groin, a feeling of heaviness in the scrotum, discomfort or pain in a testicle or in the scrotum, enlargement or tenderness of the breasts (yes, you read that correctly...) If you’re worried, go to your doctor! If you’re wondering, try the link below.
Resource: https://www.webmd.com/cancer/features/testicular-cancer-self-exams-at-home#1
Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg
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