Two Cancers One Ball

On February 28th, 2022, after spending hours in a panic upon receiving some out-of-reference range tumor markers in MyChart, my urologist sat me down in his office, my dad sitting a few feet from us, and soberly confirmed that I did in fact have testicular cancer.

What followed in that conversation, I can only remember snapshots of—survival chances being “quite high,” “at least one surgery, probably two,” “possible chemotherapy,” and how “it might be a long road ahead, but we’re going to fix you.”

In those first couple days, I clung to the hope of best-case scenarios, of the shortest possible path to being cured—of avoiding any treatment plans or procedures that could have consequences of “forever” (to a young person who had never before received a cancer diagnosis, one foolishly conflates their short lifespan with “forever”). Oh young, innocent, naive Jon. I had no idea then just how much I would go on to lose forever.

On the third day, it was time to do my first CT scan. This was, of course, to stage the disease and to see if there had already been any metastasis (“spread,” for the uninitiated). The results came back that evening. Always the cold and callous MyChart notification, its distinctly inhuman sound puncturing the tightly held breath in your soul.

I don’t know what hit harder, the raw shock or the utter despair at reading about how there were various large tumors in my abdomen, as well as a blizzard (“too numerous to count” the radiologist vividly stated) of cancerous nodules in my lungs. I still remember sitting stone-still in my living room, my father’s hoarse and teary voice softly breaking into a million pieces as he said aloud to me, with my mom looking at us both, “You’re going to have to do chemo,” in a way that betrayed the fact that he’d been hoping against all odds that it wouldn’t ever come to this.

So consumed by the terror of my uncertain fate and the inevitable suffering and loss that now lay ahead, we had hardly even noticed the small suspicious mass on the head of my pancreas—the radiologist report noting that I should follow up about this with a Gastroenterologist.

After my first surgery to remove my left testicle (and with it, my primary tumor), I was in and out of the hospital several times with complications. My cancer was growing rapidly and it became clear that if I did not begin chemotherapy soon, my prognosis was questionable. I was started on my chemotherapy regimen while still in the hospital. It looked and felt like the nurses were preparing to walk into a radioactive room and then launch the nuclear codes at Russia or something, for all the PPE and protocols that were involved. In the course of several additional CT scans and MRIs, it had surfaced that the tumor in my pancreas was even larger than the first scan had indicated and that it seemed probably unrelated to my testicular cancer. But the doctors weren’t too concerned about it yet.

“I wouldn’t lose any more sleep than you already have,” one attending physician said to me. “The chances of you having two different cancers at the same time are infinitesimal.”

But that’s the thing about having cancer in the first place, I suppose. Infinitesimal becomes your middle name.

After finishing treatment for metastatic testicular cancer, I was proudly inducted into the “one nut club”—the cohort of men whose cancer compelled them to part ways with one of their balls. I was okay with this. What I was not OK with was being put in a club of my own, a much rarer one: a young adult who presented with and needed treatment for two distinct and concurrent malignancies.

The treatment for my second cancer was absolutely brutal and tragic and is largely responsible for why I am still grieving two years later and struggling with long-term side effects. But that is a story for a different article.

So this is me, one testicle short of the default factory settings, and two cancers that were successfully wiped from my hard drive. At least, that’s the hope. Only time will tell. But that’s just the outside. On the inside, I have a new concept of “forever.” It doesn’t include me. None of us is forever. But the good that we can do for others—the kind that leaves an impact, the kind that makes them too want to pay it forward one day—this feels like my purpose now. This feels like my new forever.

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