25 Points: Testicular Cancer

1. Germ cells are immortal.

2. Germ cells contain half the number of chromosomes needed to make an organism, and so are specially made for sexual reproduction, but they can divide and differentiate into any kind of biological tissue. They can even create complex organs made of multiple tissues.

3. A teratoma is a germ-cell tumor—a bunch of inappropriate tissue in some inconvenient spot on the body, replicating wantonly. The best teratomas (the ones with gory, romantic stuff like hair or teeth or—gasp—eyes!) are collectible, formaldehydable medical oddities.

4. Though they form prenatally, teratomas commonly become large enough to notice only much later. Some are detectable by prenatal ultrasound. Some develop so rapidly in the womb that they endanger the fetus.

5. Teratomas are benign in themselves but, for reasons not yet understood, occasionally undergo cancerous transformations.

6. Words that rhyme w/ teratoma: adenoma, carcinoma, granuloma, hematoma, melanoma, myeloma, Oklahoma, papilloma, tokonoma.

7. My teratoma swole my entire right ball w/ almost nothing but cartilage. When I first noticed it, it was the size of a peach pit. By the time I had a doctor look at it, it had grown to the size of a jumbo egg and it was hard as a rock. I didn’t know what a teratoma was when I dropped my pants so the urgent care doctor could get a good look.

“Jesus Christ!” she said. “It’s hard as a rock!”

The urgent care doctor wanted to know how long had it been like this. It had been like this a year and half. Well then, why was it suddenly such an emergency I had to come in here on a Saturday?

8. It could be a few things, she said. It could be cancer, which was unlikely; or it could be like four other things which I don’t remember—and which don’t matter now anyway ‘cuz it was cancer. (She never said the word teratoma, which is in hindsight like duh the only thing it could have been, right?) Whatever it was, I had to get an ultrasound immediately, and then go see a urologist.

9. If you pay in full at the time of your visit, it costs $100 to have your balls touched and screamed at by a real doctor.

10. The ultrasound technologist held a tube of ultrasound gel upside down over my human junk.

“When did you first notice a lump?”

“Like, a year ago.”

“And it’s some kind of emergency today?”

“Um, yeah. Uh, my wife…”


11. The ultrasound technologist zoom’d his little machine around my cold, gelled up balls, and hit enter on his computer a few times.

“Okay, that’s it. Clean yr self up with these.”

He handed me the two coarsest, least absorbent wash cloths in the history of America. 

12. When the urologist asked how long the testicle had been like this, I said nine months.

“Come on, man.”

13. The ultrasound showed that the tumor was not fluid-filled. “There iss a one-in-ten chans that thiss iss not cancer, but my feeling iss that thiss iss cancer,” the urologist said. “First thing we do iss get a CT scan and remove the testicle. Thers a fifty-fifty chans you go infertile. Then we see if it’s cancer.”

14. The CT scan technologist had a radioactive-sign tattoo

“You’re going to feel warm all over, and you’re going to feel like you’re peeing. But I promise you: you are not peeing.”

15. It’s easy for pre-op to turn a regular, functioning adult into a helpless creep. The open-assed gown does plenty, but the yellow tube socks and the IV pole seal it.

16. While I was waking up from the anesthesia, the urologist went to the waiting room to inform my mother and wife that the surgery went well and that my testicle was hard as a rock.

17. Having only one testicle is called monorchism. (Wikipedia specifies “one testicle within the scrotum,” so, yeah, I guess if you have two testicles but one of them you carry in your wallet you’re still monorchid.) Famous monorchids include Bruce Lee, Mao Zedong, and (maybe) Adolf Hitler.

18. The first pathologist looked at my testicle and said it was benign. The second pathologist agreed with the first pathologist. But then the third pathologist found the tiniest bit of cancer. Bingo!

19. For a second there, the only thing Lance Armstrong and I had in common was not being recognized as having ever won a Tour de France.

20. Testicular cancer is one of the most curable types, but it requires a particularly difficult—and unalterable—chemotherapy regimen that may or may not give you a critically low white-blood-cell count, which may or may not put you in the hospital.

21. My mother happens to be an oncology nurse, so she administered all my chemotherapy.

22. Nausea from the chemotherapy has given me a universal aversion. I associate standing up, sitting, lying down, eating, drinking, and going hungry with nausea. I don’t enjoy colors and sounds the way I did before the treatment. You know how sometimes it doesn’t matter how interesting something on the Internet is, you’re just sick of looking at a screen? I feel like that about looking at anything.

23. During my bad weeks I take three or four or five different nausea medications. Two or three of them make me sleepy. The steroid one makes it virtually impossible to sleep. The day that I take the steroid lasts a thousand years and I think of what a precise, narrow set of conditions a human being needs to thrive.

24. John Giorno had testicular cancer. He underwent surgery to remove a bunch of lymph nodes. He called the extreme pain of the first 36 hours after surgery his “best tantric meditation.” Then he said, “Anyway, they can have any other part of my body they want, and they can have the whole thing.”

25.That’s not quite how I feel about it, but it’s my ideal of how to feel about it.

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  1. Brian Nicholson

      Bob deliberately did not mention this for the sake of artistic pursuit, but this is all costly, he’s a dude without insurance, and money can be donated here:

      Much love

  2. O. Ravag
  3. deadgod

      Does music help with the nausea (and boredom)? I mean music that you didn’t like before the chemotherapy, music about which you were neutral (or worse) and so of which you have no positive anticipations: Mozart, Ellington, Swans, hillbilly fiddling. Just guessing, but patterns that weren’t pleasurable before can’t be ruined, so maybe you’d be entertained or calmed or whatever by them now.

  4. mimi

      cancer is a bitch, man, fuck cancer

      but there are plenty of people out there fighting the good fight, & helping others along the way; great strides are being made all the time, and a doctor friend of mine once told me “chemo works”

      so, here’s hoping for the best, R.M. O’Brien

      also, compelling 25 points – keep writing!

  5. A D Jameson

      Thanks for writing this, R.M., and best wishes for a speedy recovery!

  6. A D Jameson

      Swans, definitely.

  7. RM O'Brien

      First, I shd say that I am now a couple weeks out of chemo, and the Universal Aversion has been steadily subsiding. But, yeah, I eventually stopped listening to any music I enjoyed and passed the time watching cooking shows and stuff like Live w/ Kelly and Michael, which wasn’t pleasant, really. But less depressing than growing an aversion to things I loved.

  8. Richard Grayson

      Thank you so much, Bob, for writing this. I hope you will be feeling much better very soon. I am sorry for all your pain and trouble and expense.

      I was much, much luckier. Discovering a giant lump in one testicle the first time I did a self-exam years and years ago, I went right to a doctor the next day and after tests, mine turned out to be a harmless, fluid-filled spermatocele which causes no problem but looks like a third testicle.

      I’ve copied what’s below from a website and hope it is OK to post because since my experience, I tell young guys to do a testicular self-examination (TSE)
      to check their own testicles to make sure there aren’t any unusual lumps or bumps — which can be the first sign of testicular cancer.

      Testicular cancer is the most common cancer in males between the ages of 15 and 35. It’s important to try to do a TSE every month so you can become familiar with the normal size and shape of your testicles, making it easier to tell
      if something feels different or abnormal in the future.

      Here’s what to do:

      It’s best to do a TSE during or right after a hot shower or bath. The scrotum (skin that covers the testicles) is most relaxed then, which makes it easier to examine the testicles.

      Examine one testicle at a time. Use both hands to gently roll each testicle (with slight pressure) between your fingers. Place your thumbs over the top of your testicle, with the index and middle fingers of each hand behind the testicle, and then roll it between your fingers.

      You should be able to feel the epididymis (the sperm-carrying tube), which feels soft, rope-like, and slightly tender to pressure, and is located at the top of the back part of each testicle. This is a normal lump.

      Remember that one testicle (usually the right one) is slightly larger than the other for most guys — this is also normal.

      When examining each testicle, feel for any lumps or bumps along the front or sides. Lumps may be as small as a piece of rice or a pea.

      If you notice any swelling, lumps, or changes in the size or color of a testicle, or if you have any pain or achy areas in your groin, let your doctor know right away.

      Lumps or swelling may not be cancer — as mine was not — but they should be checked by your doctor as soon as possible.

  9. fufu192