Prelude

 I didn't know much about cancer. It didn't seem to affect those close to me. Sure I had heard words like "tumour" and "relapse", but I had never even heard the word "remission". I didn't know that it typically spreads very fast and also more commonly affects older people. 

In the fall of 2021, I was coming off a summer of being in perhaps the best shape I had ever been in. A winter and spring and summer without the distraction of races (or travelling to races) and other commitments meant that I could focus on executing a training plan and more importantly prioritizing proper rest weeks and progression. The result was that I punched through plateaus, at least with my cycling, setting PR's and KOMs. I was excited to take what I had learned in that year of the pandemic and apply it as races returned to the calendar for 2022.

September 29, I was sitting in my desk at work and I experienced some severe pain in my left testicle. It was hard to focus on work and I made a couple of trips to the washroom to sit on the toilet to examine what was happening. This was the day before a long weekend for the new Truth and Reconciliation Day on September 30, and as someone who works 40 hours a week and lives for those precious weekends, I didn't want this to ruin my long weekend at the emergency room, I had big plans. Eventually the pain went away and I was able to enjoy my weekend. 

The pain would come and go. Kind of like a stomach ache. Except the state of your digestive system is constantly changing. I don't think your testicles go through cycles. My testicle seemed bigger and had some flappy things poking out of it. But nothing I would call a "lump". TMI, but besides, my other testicle seemed to be weird for my entire life and it didn't seem to cause issues. I had a busy fall with midweek races and training for skimo season, so I didn't think to book a visit to the doctor until mid November, when my girlfriend finally twisted my arm. 

I had not been to a doctor very regularly at that point. I went to a walk-in in early 2020 because I had noticed some 200+ bpm heart rates now that I had a watch I could wear during a skimo race. And before that I had found a new family doctor in 2017 who had had me do the battery of tests, but his clinic moved to an outlying suburb. So I had to find a new family doctor.

"Oh, by the way, my testicle has been giving me some pain, seems swollen"

"We'll have you book and ultrasound"

I got the ultrasound done in the morning and not even in the afternoon, I already got a call to go see the doctor. He tells me that it doesn't look good and that a urologist will be in contact with me soon, and gives me a requisition for some more blood tests.

The urologist calls and I am to meet on Wednesday. He gives me the rundown of what is going on, how the blood tests show that it is likely cancer, what they are going to do, what the recovery time is going to be like, and that they could even do the surgery that evening...or on Saturday. It's kind of gross, a lot of information to process at once, and I am already really hungry so I decide to schedule it for Saturday with another urologist. Because they cut through the abdomen to extract the testicle affected by cancer, the recovery time can be long to avoid putting too much strain on the incision. It becomes apparent that I might miss skiing over Christmas break, and I feel silly for holding off so long in the fall only to potentially lose out on a week of skiing.

I spend the rest of my week going for some last bike rides and cross country skis and have some pizza at midnight the night before surgery. Although the urologist went EXTREMELY into depth on the side effects, I am not too nervous because I am excited to get that thing out of me.

The day arrives and I head to the hospital. I wait around the entire morning but eventually the surgery takes place in the afternoon and I am wheeled off to the operating room. I remember shifting myself onto a different bed in the operating room and then counting down as I am put asleep, then I wake up in the recovery room. I ask the nurse there if it was a boy or a girl, referring to my testicle, I don't think she got the joke. Then I am transferred back to the room from the morning.

I don't know what is wrong with the roommate in my room, but his breathing sounds labored and he doesn't want to eat his hospital food. It sound like he has diabetes and COPD and I hear him promise to his partner that maybe he will quit smoking. I can't help but be pissed off. Here I am, I have made much healthier choices in my life and I still end up in the same hospital room... Before I am allowed to leave I am supposed to demonstrate that I can pee, I guess to make sure that everything works. I drink up knowing that if I am able to pee, I will not have to spend a night listening to my roommate whine and wheeze.

Recovery from the surgery happens step by step. For the first week, I try to get outside and walk 2-3 blocks every day. Don't want to over-do it. In the 2nd week, I return to work from home and work my way up to longer walks, sometimes 2 hours at a time. In the 3rd week, I feel up for some indoor cycling and I do a bunch of 2.5 hour rides because I was bored. My heart rates seem high for small amount of power I am producing, but I see quick progress. 

Throughout this time, I went into the depths of google, looking at what the treatment will involve, options, and outcomes. Podcasts, blogs, publications from regional health services. The stats are interesting. 9000 Americans a year are diagnosed with testicular cancer. By extrapolation, that's probably 900 Canadians, and 30 from Edmonton. The 5 year survival rate for testicular cancer is 95%. 95% might be a good result on a test, but a sobering way to look at that is that 1 in 20 die...

I meet with the urologist at the end of the 3rd week for a follow up. Contrary to the warning from the first urologist, I am able to return to activity a lot quicker and it looks like I'll be able to ski during Christmas break. Yay. I am provided with a requisition for a blood tests and will be referred to the local cancer clinic, the Cross Cancer Institute (CCI). The blood test is to see if the levels of tumour markers in the blood are dropping after removing the testicle or if they are increasing, indicating that the cancer has spread.

I went to the CCI to pick up more weekly test requisitions. Upon my first trip into the CCI, it felt welcoming and close knit. I would jokingly refer to it as "Hogwarts", although instead of having magical powers, I had cancer.

So with a more official go-ahead from the doctor, I was able to start playing around more outside. I went cross country skiing, Klaebo-running up the smaller hills. I did a massive ride on Zwift. It was extremely cold over Christmas break, even with some highs of around -30C, but I didn't care, I just did warmer activities like cross country ski and run. When it did warm up, I was able to put in some big days. I was not expecting to be able to race the skimo race at Castle Mountain, but things were looking good.

The first weekly blood test looked good, with tumour markers decreasing dramatically compared to pre-surgery.

And the racing did go well. I skipped the sprint because I had not done any hard efforts since the surgery. The vertical and individual were affected by trailbreaking that kept the group together making things more tactical. I didn't feel like I was at the top of my game, but I got a couple of podiums.

The next weekly blood test showed some increase in the levels of tumour markers. I had a meeting with the oncologist. to discuss the next steps. More blood tests, another CT scan, and likely chemotherapy starting in February, finishing up in May.

Chemotherapy treatments are almost synonymous with cancer. The image of hair loss, weakness, and nausea are what you think of when you picture a "cancer patient". I wasn't sure how I would recover from losing a body part that literally produces performance enhancing drugs (testosterone), now I had to worry about how I would recover after nuking my body with chemicals. 

In order to enjoy my body while I still could, I went to Canmore to go skiing every weekend until I began chemotherapy. I was able to put in some great days on the skis. I even snuck in another race on a Saturday night at Norquay. Interestingly, blood tests showed my red blood cell count took a hit from surgery and was not quite back to pre-surgery levels at Castle, but by the Norquay race, they were back, and I would say that I felt pretty good. 

I also took a week of vacation to get the most out of more days in the lead up. Near the end of my vacation, I schemed up an "event". A grande course worthy skimo race at Rogers Pass: Peter's Mental, a play on the famous Pierra Menta. There was an amazing turnout. 

Peter's Mental!

I then nervously pedaled my bike to the CCI. I had no idea what to expect.