Justin Birckbichler is a fourth grade teacher, testicular cancer survivor and the founder of aBallsySenseofTumor.com. From being diagnosed in November 2016 at the age of 25, to finishing chemo in January 2017, to being cleared in remission in March, he has been passionate about sharing his story to spread awareness and promote open conversation about men's health. Connect with him on Instagram @aballsysenseoftumor, on Twitter @absotTC, on Facebook or via email firstname.lastname@example.org.
I rolled out of surgery with one fewer testicle, but also as more of a man for openly admitting it.
Friday, Oct. 28, 2016 was the day of my surgery, and just over a week since my initial visit to the doctor. If there is one thing that I have learned, it's that cancer is not always a slow-moving process. In my head, the process for discovering, diagnosing and treating cancer takes months, if not years. Even factoring the initial discovery in mid-September, it had been less than six weeks since this all started.
Mallory (my fiancée) took off work to take me to the hospital. We arrived around 6:00 a.m. to arrive for prep work. I had to change into a gown, and then they started prepping me. The prior evening, as part of my pre-op appointment, a nurse had drawn blood, and they had to put in an IV line in the morning. I do not like needles. I do not like them here or there; I do not like them anywhere. I especially don't like them when they don't work right the first time and they have to put in a second.
The surgeon came in to discuss the surgery with Mallory and me, which was called a "radical inguinal orchiectomy." In layman's terms, they would be entirely removing my left testicle. He had told me this when I had initially met with him, but it was still something that I was not fully ready to hear. Why couldn't they just remove or biopsy the affected area? Due to the anatomy of the scrotum, this was not possible. It would potentially cause even more harm to my body. In nearly 95 percent of cases, a testicular tumor is found to be malignant. Trying to biopsy it inside me could spread cancer cells more quickly and could leave behind precancerous cells that hadn't yet been detected.
In addition to internally preparing for the trauma of surgery, I had to grapple internally with the fact that I would be losing 50 percent of my testicles. Much of my college vernacular revolved around the word "balls." If you were taking charge of life, you were grabbing life by the balls. You chickened out? You have no balls. Literally now, I would have less balls than most people.
Biologically, there would be no impact. You only need one testicle to produce testosterone and sperm, and it just takes one sperm to father a child. My surgeon did share that there would be a psychological impact. Something that is a direct physical manifestation of my manhood would be removed from me. I hesitated in telling people, because I didn't want them to think I was less of a man. When I shared that fear with those who knew, they assured me I was more of a man for doing this surgery. I smiled, but deep down, I knew I was literally less of a man.
Some people may look at me differently now, knowing this information, but I wouldn't be doing my story and the journey of others justice if I omitted this fact. It is a very common treatment for suspicion of testicular cancer; one that nearly all cases where a solid mass is present. Part of my goals with being a health advocate is to destigmatize men's health issues, and this is something that I felt I needed to keep hidden at first due to my own personal (and on a larger scale, societal) views. Sharing my story may help others to share theirs and get the ball rolling on these important conversations.
Besides, as my father put it, "It sucks to lose one of your balls, but keeping it and letting the cancer kill you would be truly nuts."
Despite my resolve and decision to use humor, losing an integral part of me still hadn't completely sunk in, even after the surgeon's thorough explanation, but I knew, as with everything that had happened to me so far, there was only time to act, not react. After he left, the anesthesiologist visited. I remember entering the surgery room, and then nothing.
About two hours later, I woke up. There was a nice nurse attending to me. Sadly, there are no funny stories about me coming out of anesthesia. The nurse talked with me a little bit, brought me water and juice, and walked Mallory back. I was told that the surgery went well, and the testicle had been sent off for biopsy. I got dressed, used the restroom, and was discharged.
My incision is on my groin and is about as long as my index finger. The physical pain started almost immediately. We had to stop to get me some food so that I could have my first round of pain killers as soon as we got home.
While the surgery seemed like the biggest obstacle at first, the real pain was soon to begin.