My can caused so muc anxiety but I jus made jokes about it
Although survival rate for testicular cancer is high, the emotional impact of the disease can last for years. Amy Packer investigates
THE first time I had cancer, I didn’t want to tell anyone how I was really feeling,” admitted Bobby Bansal. “People would ask how I was and I would always deflect it with humour or make a joke out of the situation. I would say things like, ‘I’m alive and I can’t really ask for more than that’, or, ‘I can’t complain’.
“In reality, it was massively affecting my mental health and, as a result, every other aspect of my life.”
Bobby, 39, was first diagnosed with testicular cancer seven years ago, following a fortuitous accident.
“I was cycling to work when my bike had a double puncture,” he recalled. “I fell off my bike, bruising my testicles. As they were still swollen and painful a few days later, I got them checked out.”
A scan revealed that he had a 5.5cm tumour and he was immediately booked in for treatment.
After surgery and chemotherapy to treat the disease, which affects about 2400 men in the UK every year, he suffered many long-term issues.
“There were so many knock-on effects that I didn’t realise until years later,” Bobby, who works as a commercial manager, said.
“Chemotherapy affected my thyroid gland and stomach lining. I am deficient in B12 because I struggle to absorb that now.
“About a year after treatment, I realised it was affecting my memory and I was very tired all the time.”
It took three years for Bobby to pluck up the courage to seek medical advice. Tests revealed he also had a testosterone deficiency. Nearly 40 per cent of testicular cancer survivors have low testosterone levels, according to a study presented at American Society of Clinical Oncology’s annual conference.
Men with low levels of testosterone appeared more likely to have chronic health problems including high blood pressure, diabetes, erectile dysfunction, night sweats, fatigue, anxiety or depression.
Findings from a Canadian study published earlier this year also showed that, following treatment, testicular cancer patients experience a high burden of physical and mental health problems.
The results, published online in the Journal of Clinical Oncology, showed that mental health problems were significantly higher among testicular cancer survivors compared with men of a similar age in the general population. During the peri-treatment period, the rate of outpatient mental health visits was 12 per cent among men with testicular cancer, compared with four per cent among the control group. “The difference in mental health service use persisted – and appeared to increase – with longer follow-up,” said the study’s authors. They recommended that testicular cancer patients should be routinely screened for mental h distress.Testicular cancer and medications used to treat it can c both physiological changes emotional reactions that interfere normal sexual function.
A 2019 review noted that abo fifth of patients are left with se problems following testicular ca therapy.
Common emotional issues inc being preoccupied with illness hyper vigilant about minor aches pains, fears around the dis returning, distress caused by fer problems and concerns about b image or attractiveness.
“Testicular cancer is the m common cancer in young men,” Movember CEO Michelle Te “Although survival rates are high, t men are often at risk of other he problems that may be related to cancer treatments, includ complications from chemotherap
“The mental health impact o
About a year after treatment, I realised that it was affecting my memory and I was very tired all the time
disease and its treatment can also be devastating for these guys. Having confidence in how you look, having full sexual function or being able to have children (if you want) are all important for good health-related quality of life.”
Bobby, from Solihull, West Midlands, admitted that as time went on, he became preoccupied by fears that the disease would return.
“I was just terrified,” he said. “It caused me so much anxiety and I just didn’t address it. It was making a mess of me but I just made jokes about it all.
“Eventually, I knew I had to address these problems and I got help. It helped me feel a lot calmer and a lot less scared of the outcome.”
Then in 2019, just after Bobby had received the five-year all clear and was discharged from the care of his medical team, the disease struck again.
He said: “After I had dealt with the emotional demons the five-year milestone brought up, I was riding high. I’d been offered a new job, proposed to my girlfriend Kay and she’d said, ‘Yes’. Then, in November 2019, we went away on holiday for a few weeks and while I was there, I thought I should check myself because that is what I tell everyone else to do and I found another lump.
“It was only three days into our holiday. I decided that this time I was going to be honest and tell Kay. From my experience last time, I learned that I shouldn’t bottle any of it up.
“To be honest, it was a relief to be able to talk about it and while it wasn’t a breeze, it wasn’t anywhere near as stressful or painful as the first time.”
This time, Bobby was diagnosed with a more aggressive type of cancer.
Fortunately, because he managed to catch it early, he was spared chemo.
“Had I not known what to look for, it could have been potentially a lot more impactful,” he said.
This time he found support in talking to a group of men who had also been through the disease. Bobby said: “We talk about where we’ve struggled and where we can help each other.
“Even though everyone’s experience is different, it’s easier to share how you’re feeling with someone who has been through the same thing.”
Shievon Smith, uro-oncology clinical nurse specialist at St Barts hospital in central London, agrees support groups can be hugely helpful in dealing with the emotional fallout.
“Having a forum for people to share their experiences is very helpful,” she said.
She and a colleague run the St Bartholomew’s Testicular Cancer Support Group, for men who have been treated at St Barts but it also has members from Saudi Arabia and the US. Issues discussed range from cardiac health and exercise to the role of testosterone and managing the psychological impact of cancer.
Now, having been given the all-clear for the second time, Bobby, who is a keen amateur boxer, said he is in a better place, adding: “Instead of bottling things up, I talk about it now and that makes such a big difference.” He is also keen to help other men going through the disease, so has signed up to become a guide on Movember’s Nuts & Bolts digital resource. With the help of men who have survived the disease and an international panel of experts, the site has information on every aspect of diagnosis, treatment and life after cancer, communicated in a clear and straightforward way. Michelle said: “Our research has shown that although getting a diagnosis is tough, men find the period following surgery more difficult. “We wanted to ensure that no man goes without the support they need and a community to reach out to.” It also allows men who have been diagnosed with testicular cancer to connect with Movember-trained guides like Bobby, who can support them through and beyond their treatment. “I’ve been contacted already,” he said. “I’m very excited about the prospect of being able to help someone.” To find out more, visit nutsand bolts.movember.com. Contact Barts Testicular Cancer Support Group at facebook.com/StBartsTCGroup or @StBartsTCGroup on Twitter