#KnowYourBalls Survivor Story – Brent Dirks

It's a weird way to think about it but I know my cancer was not about me. What does that even mean? It means that cancer helps me help others.I've always been a helper. I'm the oldest son of 5 kids to a police officer and emergency room nurse. I had no chance. Public service is in my blood. I shot for the middle and became a firefighter/paramedic. I knew about the risks involved of running into burning buildings and crazy drivers on the highway while we tend to victims of car wrecks but never gave much thought to how the job could affect my health. All the old guys have bad backs so I've tried to stay healthy and active and "use good lifting form." Turns out, firefighters have a much higher risk than "the normal man" of developing testicular cancer. (Source)I'd had a pretty hard couple days working out and noticed a little twinge in my groin but didn't think too much about it and it went away. I noticed it again after a good indoor rower workout and this time it hung around a little longer.

Symptoms and Diagnosis

I'm the father of two great, super fun, busy kids. We had all kinds of activities so I didn't put my health first and put off making a doctor's appointment. My right testicle felt like it was a river stone and somewhat painful. "I've got a pretty high tolerance of pain" says every tough guy ever. So when it got bad enough, I made a doctor's appointment and went to a urologist. The tests started! Blood work, ultrasounds, and ct scans. The diagnosis came in: stage 3 testicular cancer with involvement of numerous lymph nodes, 3 spots on my liver, and possibly my lungs. (Moral of the story and the key to awareness: early detection is critical in testicular cancer. When caught early, the involved testicle can be removed before the cancer is able to spread.)Well, I wasn't expecting that. Through my faith in Jesus Christ, I knew He had me and my family in his hands and we were ready to tackle the unknown that laid ahead. All I knew was that I was going to meet a lot of new people that I never would have had the chance to without cancer. I was connected with a specialist surgeon who would take over the case from the urologist.The first step was the orchiectomy, removing that river stone I had hanging. Of course all my firefighter brothers wanted to chime in about getting an implant. "You could get one that made noise or lit up or something." My son even thought that a steel implant would be awesome because every guy wants steel nuts! We found out that a real testicular implant is much like a breast implant and I decided that in my case, it wasn't needed. So the one nut and lefty jokes started. Firefighters and my immediate family are a different breed and love to joke around about the oddest things. It's how we cope and to me, it's fun.

The Treatment Process

Now that we stopped the source of the cancer, the next step was to stop the spread. I was referred to a great oncologist and we continued the treatment plan. The standard procedure was to do 4 rounds of BEP (bleomycin, etoposide, cisplatin) chemotherapy. In each round, I would go Monday through Friday the first week and then Monday only the next 2 weeks. We would reassess my blood work and lung function with each round. Remember that part where firefighters love to joke around; my chemo nurses had no idea what they were in for when I walked in. The first day I was giving them a hard time about how to start IVs and what quality patient care looks like. I never would tell them what I did and they would always give me weird looks. Pretty soon, my wife would be rolling her eyes and tell them I am a paramedic and not to worry about my criticism. I had a blast the first couple weeks. I still felt good and was making new friends everyday at chemo.The first week of chemo started soon after my surgery so all the medications were administered by IV. My veins were quick to figure out that they didn't like how things were going and made it harder and harder for the nurses to obtain. We decided to get a port placed and I went in for the quick day surgery procedure. They keep you awake and chat with you while a plastic hub is placed under the skin of your R upper chest and a catheter is ran into your heart. No big deal. I didn't do all the research I should have and turns out your not supposed to do certain exercises with the port in. I found out later that some of the overhead lifts should be avoided with the port. I never had any real issues with it other than it clotting up a couple times. I guess they put mine in well.

Support from my Family and Friends

My firefighter and church families really stepped up! We set up a ride schedule where different people could drive me down to chemo and my wife could get the kids off to school and then come and meet us to bring me home afterwards. Firefighters can kill some time while waiting for the next emergency so the wait during chemo was no big deal. We would sit and chat and laugh. Pretty soon, all the nurse were eager to see which new cute firefighter was going to bring me in. Yup, all firefighters are good looking.Support is a huge part of the process. When you are used to being the one who helps others, it's hard to sit back and let others help you. But that's what I did and it was amazing to see how people responded. Rides were covered, meals were prepared and brought to the house, the kids were taken care of. Even bracelets and shirts were made in my support. I'm kind of a big deal. I totally felt like a pro wrestler with my own t-shirt! Things were cruising along, we were getting into a routine and I was feeling good.

Effects of Treatment

The chemo was doing it's job. My hair started falling out a little bit. Then one day in the shower, 10 days in, most of it came out. I kind of had a mad scientist look going that I wasn't too fond of so I trimmed it super short with the clippers. My bare head was pretty tender and I wore hats most days. I was pretty proud of my hair before the cancer and not a huge fan of the bald head but at least I didn't have to shave. That's right, all the hair falls out. You don't really think about that until you pull back the covers on the bed and see that all your leg hair has come out in the night and was trapped in the bottom of the bed. Gross.I want to take a second and tell you about how much of a rockstar my wife is! From the moment of the diagnosis and on, she was my rock. We were lying in bed the night after the diagnosis and she turned to me and said, as nonchalant as possible, "Well babe, you've got cancer." We both just laughed and laughed. We talked of what the future held and that we would keep a positive attitude, no matter what. She literally took care of everything. She was my crutch on the days I wasn't feeling strong or in too much pain to get off the couch on my own. She's the best wife ever!The chemo was really doing it's job. My tumor markers were slowly lowering on the blood work. So was my blood count numbers and I could tell. Standing up became a chore without getting too dizzy. Taking a shower was work. And I was tired of everyone telling me how pale I was. I didn't have much of a tan from the start but now I was almost see through. I went in for a chemo treatment in the third month and could tell the nurses were looking at me differently. They asked, "Are you feeling okay?" I wasn't feeling too bad, fatigued and a little dizzy from time to time. We started discussing a blood transfusion and a couple days later I was hooked up with 2 units of blood. A couple days later the fever and cough started. My wife was getting a little worried so we headed into the hospital. Little did I know that would start an 11 day stay in isolation. My white blood cell count was so low that the doctors worried I would get too sick in the real world. Masked up, bald and pale; I didn't feel too studly but still had faith that we were on the right track. God's plan was still on our minds. We were able to chat with and meet many new people. I was half the age of most of the people on the floor and loved messing with the nurses. Why would they put so many buttons on a hospital bed if they didn't want you to see how high it would go up in the air? An ambulance came through and I asked for help escaping but they did not oblige. After some medication to get my bones producing blood again, I was released back in the real world!I received my last chemo treatment while admitted so I didn't get to ring the bell showing everyone you've completed chemo. I loved visiting the chemo nurses and crew when I went back for follow up appointments and they let me ring it then. Those nurses had a huge impact on my cancer journey and I will be forever grateful for their care and comfort.The chemo did a good job. The cancer had stopped spreading and some of the tumors shrunk. That was not the outcome we were looking for. We were looking to be cured from cancer and the oncologist and surgeons felt they could go in with another surgery and get all the cancer out. We scheduled a lymphadenectomy and liver resection. One surgeon cut open my abdomen from the bottom of my sternum to my waistline. He went in and cut out the 3 spots off the liver. The other surgeon went in and took out 30 plus lymph nodes and other tubes and parts that were affected. They stapled me back up and sent me on my way.I always said that I would never tell the nurses I was a 10 on the pain scale but the second day after the surgery they decided I should stand up and move around a little. It took 2 nurses to get me up from the hospital bed and to sit in the chair. I knew by the look on my wife's face that I was not doing good. The nurse asked about my pain and I said "10" before she was done with the question. They reminded me that I could hit the button on my pain med pump and I quickly hit it.

Recovery and Life After TC

The rest of the recovery seemed to go by quickly and I was back to light duty work and going to physical therapy in no time. Everyone told me to take it slow but I knew my body and what it was wanting to do. I was ready to get back to fighting fires and saving lives. 4 months after my surgery I was back on shift at the fire station and happy to be back. My fire department family pulled together like never before and it was great to be back with them, sharing stories and doing life together.I've been cancer-free for a little over a year! Since the surgery, the blood work, x-rays and ct scans have all come back normal. There will always be reminders of my cancer journey. The big scar down my abdomen (second surgery), one just below my waist line (first surgery) and 2 on my upper right chest (from the port). The tingling/numbness in my right upper leg and right index finger. It took a while for my lungs to get back to normal but I'm pushing it in workouts with the guys again and holding my own. Oh yeah, and I only have 1 testicle. All these issues are a small price to pay to be cancer-free and still alive and kicking.I hope my story sheds a little light on what the testicular cancer journey is like. I hope it helps others going through it or those who have a loved one fighting cancer. Guys: check yourselves, know your balls and tell someone if you find something new or different. Don't be shy, we all have balls and want to keep them. Thanks for taking the time to read this. Love y'all.