Background – Metastasis

My first follow-up CT scan was in February 2019. This scan showed some enlargement to a small cluster of para-aortic lymph nodes, which was concerning to my oncologist as it could indicate metastasis. I wasn’t completely convinced though, as there could be numerous reasons for lymph nodes being enlarged. I’d also recently changed some of my supplemental and dietary protocols, including stopping taking some herbal formulae which acted on the lymphatic system. Any of these could have caused some temporary change to tissue in the lymphatic system.

Also prior to the CT scan, my HCG had risen to the upper limit of the normal range (5 IU/L), which seemed to correlate with the lymph node enlargement. However, when measured a week or so after the scan, it had dropped to <1 IU/L. This left me thinking even more that what had shown in the scan was not too concerning.

At this point, to be prudent, I doubled down on how I was eating, what supplements I was taking and how I was looking after myself in terms of exercise and spiritual and emotional wellbeing. I also got in touch with an integrative physician who worked with a lot of cancer patients, and she was able to help me devise a new supplemental protocol, amongst other things. What I was looking to do was get the lymph nodes back to their usual size and shape by the time of my next CT scan three months later.

If anything, this gave me quite a psychological boost and over the three months I found that I was able to be more calm, relaxed and at peace with myself. Even though there was some concern as to what my scan had revealed, I was in a good positive frame of mind and was looking after myself really well.

My next CT scan took place in May 2019. The enlarged lymph nodes had almost doubled in size during the previous three months. There were also a couple of indeterminate spots on my lungs, which were further cause for concern. It wasn’t quite what I’d hoped for, but I was not going to let it get me down. In spite of this, my tumour markers were all normal, but it turns out that they are not necessarily stimulated by metastasised cancer cells.

The suggested treatment for this was a nine-week course of BEP chemotherapy, consisting of three three-week cycles. Chemotherapy was something I’d hoped to avoid. However, the progression of my lymph node enlargement had been quite quick, so it was important that I choose a course of treatment sometime soon, chemo or otherwise. Also, this particular type of chemotherapy had a curative success rate of around 95%, which is phenomenally good. In fact, testicular cancer is one of the very few cancers for which there has been significant improvement in the success of chemotherapy over the past few decades.

Based on the outstanding rate of success, I decided that at this point in my cancer journey I would choose chemotherapy. There are many other treatment options available to cancer patients, which are not necessarily prescribed by the NHS nor most national health systems around the world, and I had looked into many of these. However, on this occasion, I decided that the chemo was the right choice for me.

It was important to me that this felt like a decision that I was making, as it gives me a sense of ownership of my health. I can not imagine that I would have had the same positive mindset going into chemo had I felt coerced into accepting the treatment, or if I had been rushed into it without having had the time to gain an full understanding of all of my options. If there’s anything I could recommend to a patient on the brink of choosing chemo, it would be to make sure that they feel comfortable in whatever treatment decision they make.

A week later, I returned to the hospital to sign a consent form and I was booked in to begin treatment a few days after that.

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