My name is Andrew; I am an Extra-Gonadal Germ Cell tumor (Testicular Cancer) survivor. I was a married 28-year-old father of two when I was diagnosed with cancer. It was June 2003 when I first went to see my primary care physician complaining about some lower abdominal pain. Most people probably would have blown this off, in fact the pain had started to go away prior to my appointment, but I decided to honor my appointment anyways. During the office visit, my doctor decided to perform a digital rectal exam of the appendix. While checking the appendix she happened to check my prostate as well.

I should have known that something was wrong when she brought in another doctor for a second opinion. They told me that my prostate was 2-3x its normal size, but that it didn't feel like prostate cancer. They set me up with an appointment to see an urologist. Four weeks later, I finally got to see an urologist. During this office visit, the urologist felt the prostate and thought it might be a cyst. He scheduled an ultrasound of my prostate to be sure. The ultrasound indicated that it was not a cyst. A second appointment was scheduled to perform a needle biopsy. This is when the tour of my tissue slides began. They ended up going from Tulsa, OK to Baltimore, MD to the Mayo Clinic to LSU to Indiana University (Dr. Einhorn) before anyone could type it. This process took about 6 weeks, during this time I was left in a state of anxiety. During this time they drew blood for my AFP and HCG levels. I went straight home and researched these tests with my wife, Amy. We started to figure out that we were dealing with testicular cancer. I think it was around this time that I finally uttered the words "I have cancer"; the scariest thing was that it felt real.

The blood tests came back, my HCG was normal but my AFP was elevated to the 70s (well above the normal threshold of 15). This confirmed that it was a germ cell tumor. No one wanted to believe that my tumor was primary to the prostate. So, I underwent CT scans of my chest and abdomen and an ultrasound of my testicles. Nothing was found (except for the prostate mass); it was confirmed to be a 2.5 cm hypodense lesion of the posterior prostate. I was then referred to a local oncologist, Dr. Alan Langerak.

September 2003, my first visit with the oncologist, what a nerve-racking experience. This was my first exposure to people under-going chemotherapy. I left the appointment feeling much better about my situation, he had a clear plan and I was going to start chemotherapy soon. I was terrified that the tumor was spreading. More blood was drawn for another AFP test, a CT scan was scheduled for the brain, chest and pelvis, and a PET scan was scheduled. I was leaving the PET scan facility when I got a call at the front desk. This seemed weird, no one but my wife and the oncologist knew where I was, and it was my oncologist. The CT scan of my brain indicated that there is a "small area of low attenuation in the inferior right basal ganglion". The nurse informed me that I needed to have a MRI performed on my brain ASAP. I was really freaking out at this point, my mind was racing, for all I knew I had a brain tumor. One of the hardest calls I have ever made was to tell my wife that they thought they had found something in my brain scan and that I had to undergo a MRI. The next day I received one of the best calls of my life, the MRI results showed that they were cysts and not tumors, nothing to worry about. This was on a Friday, the following Monday I would have a follow up appointment with my oncologist and begin my chemotherapy on the same day.

After my first two rounds of BEP, I underwent a follow up CT Scan and AFP test. While my AFP level continued to drop, it was still higher than normal and this concerned my oncologist. This combined with the fact that the tumor was unchanged in it's size led them to pull me off the chemo and perform a follow up needle biopsy. This time the tissue was sent directly to Indiana University and they confirmed that it was a Non-Seminoma Yolk Sac EGC. After consultation with Dr. Einhorn, we started the final two rounds of BEP. Those were the roughest weeks of my treatment. After the third round they had to stop giving me the Bleo because my pulmonary functions were impaired significantly. According to the breathing tests, my lung function was approximately one-third what it was prior to chemotherapy. My final round consisted of only EP. I completed my chemo in the second week of December 2003. 12/12/2004 was my last day of treatment.

I was severely weakened by the chemotherapy. On 12/23 I went in for a follow up and my CBC counts were very low. I was admitted to the hospital that day and received 4 units of red blood cells and 8 units of platelets. My anemia was so bad that I could barely walk across a room without my heart racing and my head pounding. The units of blood helped considerably. The next week I traveled to Indianapolis to see Dr. Einhorn for his clinical opinion. He is a great man, and a great doctor. He advised me that I would have to undergo a radical prostatectomy to remove the tumor (It still had not changed in size after 4 rounds of chemo). Because the AFP level had not dropped dramatically as expected and the tumor size had not changed, Dr. Einhorn felt strongly that there was a high likelihood that the tumor would still have live cancer cells.

January 26th 2004, I had the surgery. All my margins were clear and my lymph node dissection showed no signs of cancer. The surgeon was able to perform the nerve sparing surgery to leave me functioning. The tumor was still alive and growing, it was apparently changing into a teratoma among other types of cancer. According to the pathology from Indiana University following the removal of my prostate, the tumor was still representative of a germ cell tumor. It was showing several features that are sometimes identified in post-chemotherapy resections. The tumor had formed a foci of primitive neuroectodermal tumor as well as a low-grade sarcomatous component showing rhabdomysoarcomatous features. Indiana University believed that foci did qualify for residual yolk sac tumor having both microcystic and glandular arrangements. There were also solid foci, but it was unclear without additional studies whether these corresponded to yolk sac tumor or primitive neuroectodermal tumor. The recovery from the surgery was no fun, but I could relish the fact that I wasn't undergoing chemo.

Now I'm back at work, training for the Lance Armstrong Foundation's "Ride for the Roses", and expecting my third child in June. I could not have made it through this struggle without the love and support from my wife, my family, and friends. A support system is critical for a cancer patient. I want my story to be published on the website so that people can see that EGC can be beaten and that there is hope.

If anyone is dealing with EGC and would like to e-mail me I can be reached at ajmolenda@sbcglobal.net.

My Story - Part 2: Relapse
2004 Ride for The Roses

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