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 was hoping for a good outcome from my scans... but deep down I was expecting the worst
Monday, Nov. 7, 2016 brought forth the day of the post-op appointment after my orchiectomy for testicular cancer. It was a day that would prove to continue the trend of the worst of the possible two options becoming my reality.
"Your X-ray was clear, your blood work showed no markers for cancer, and your scar looks to be healing really well. The numbness in your groin is normal; it will take a while for that to fully recover."
Why wasn't he mentioning the CT scan? With the exception of the X-ray, I already knew everything he had just told me.
He took a deep breath and continued. "You CT scan showed enlarged lymph nodes. The cancer has spread."
Triple wow. It was the third time a bombshell had dropped since this had all began. At this point, I kept expecting the worst. At first ,I knew a lump was concerning, and it was. I knew it was cancer before the biopsy came back. Of course it had spread; why would I get lucky at this point in the game?
"One of your lymph nodes was 2.1 centimeters, which isn't the biggest they can be, but certainly big enough to be concerning."
"How big are they usually?" I asked.
"Just a few millimeters. Usually they don't show up on CT at all."
After teaching the metric system for three years, I knew that a few millimeters to 2.1 centimeters was a big deal. Who says school isn't applicable to real life?
Dr. Dumont continued his diagnosis. "With testicular cancer, there are two types: Seminoma and nonseminoma. Your particular cancer falls under the latter category."
Although nonseminoma sounded like it was a good thing, something told me that I was wrong. Dr. Dumont confirmed this.
"Nonseminoma (which is also called embryonal carcinoma) is more aggressive and spreads much more quickly. At this point, you are in stage 2b cancer."
Realistically, stage 2b didn't mean anything to me. All I had heard was that the cancer had spread. I wanted to know what was next.
"There are two options here. My recommendation is chemotherapy. The other option is major invasive surgery. They would remove your lymph nodes and biopsy those. You would have a scar from your chest to your groin."
Now, that scar seems pretty cool. I would feel like The Rock in “Walking Tall.” However, I would also like to avoid being cut open. After further discussion, we found out that even after the surgery, I would most likely still need chemo. Dr. Dumont indicated that the surgery wasn't a wise option.
Mallory reacted with emotion and tears, as was expected. Me? I was more or less numb. I know what needs to be done will be done. Grandpa's mantra echoed in my head, "Just tell me what to do and I'll do it." My first instinct was to get my action steps nailed down now; process it later. It had been a whirlwind of a month, but the chaos had become my normalcy.
"So chemo," I started, "What kind? Would it just be oral pills or would it be-"
"You would need to go to an oncologist and receive it there. It's recommended to complete three to four rounds."
I needed to see an oncologist ASAP, but they were having lunch when the urology office called. That amused me; the people who would be taking part of my virility and life from me were off having a delightful lunch. Lovely.
We also immediately started looking into banking some of my sperm. I quickly found out how expensive it was, but I had to think beyond the cost. We decided to bank some of my sperm the following morning, just in case.
"In most cases, this cancer is completely curable and that is a really good thing," Dr. Dumont shared.
I was well aware of this fact. Dying from this was not something I was worried about, although it was something I had imagined as an improbable outcome. People had been reassuring me (or maybe themselves?) of this fact for the entire time. Knowing you are going to be cured doesn't soften the blow when the immediate situation seems so dire.
I knew I had to update people. Brian, my principal, for one, as this would mean more time off from work, especially because once the chemo was completed, I would need to be monitored every few months for the foreseeable future. My friends and family were waiting with bated breath for results. Those who texted me received a terse reply from me, "It wasn't good. We'll talk more later." Perhaps this wasn't the best way to handle it, but I didn't want to ignore them entirely.
As had become the pattern, I had anticipated the worst and it came true. The physical pain from the surgery was improving each day, but the emotional pain was being exponentially compounded each time. I did my best to keep it in, but it was starting to show through. Keeping it in had always been my go-to. I know it's not healthy, but it's how I've managed.
"This isn't a hereditary cancer nor are there environmental factors," Dr. Dumont said as he ended my appointment. "It's just a bad luck cancer."