Health Notes, December 1st 2008, by Sarah Stacey

How Julian became a father

In April 2002, tennis coach Julian Cousins found a lump in his testicle.  That’s a worrying thing for any man – as a breast lump is for a woman – but for Julian it was ‘a terrible discovery’: his other testicle had been removed in 1988 because of testicular cancer.  An ultra sound scan revealed two malignant tumours.  ‘The doctor I was referred to [at a major London hospital] told me it was “allright” - he’d book me in for surgery to remove the testicle on the following Monday, then I could take testosterone replacement therapy (TRT) and have a prosthetic testicle implanted.’  Julian pauses as he remembers the conversation, then says furiously:  ‘How can you could put “allright” and “castration’ in the same sentence?  I told him to forget it. I wasn’t prepared to lose my gender identity.  I’d rather die on my terms than live on his.’

After driving out of the car park on the wrong side of the road, Julian pulled over and telephoned Tim Oliver, then professor of oncology at Barts and the London Hospital medical school, who had treated his first episode of cancer.  With funding from the Orchid Cancer Appeal, a charity he helped to found, Professor Oliver has pioneered alternatives to removal of the testicle (orchidectomy) for men with small tumours in the remaining testicle. ‘Tim was great: I saw him the next day and because the two tumours were both small, about one cm, he advised an intensive and strong course of chemotherapy followed by micro-surgery [the equivalent of a lumpectomy in the breast], if necessary.  But my testicle would be left intact.’

The normal treatment for cancer of one testicle is surgical removal, sometimes with chemotherapy and/or radiotherapy.  This should not affect a man’s ability to have erections or his fertility.  For the two to three per cent of men like Julian,  who develop it in the remaining testicle,  castration is standard.  Taking testosterone prevents hot flushes and osteoporosis and should allow men to have an erection although they will not produce sperm (which is usually banked before surgery.)  Professor Oliver says that over the last decade ‘the cure rate with chemotherapy for all men with testicular cancer has reached over 95 per cent.  We have other patients like Julian with tumours in the remaining testis which have been cured by chemotherapy.  The risk with the less invasive treatment is that the cancer returns but, if so, you can operate at that point.’ 

Julian’s body responded well to the intensive chemotherapy, both tumours shrank and he didn’t need surgery.  He still takes the ‘bucketload’ of supplements he started with chemo, including vitamin C, selenium and a natural testosterone supplement called tribulis.  At the end of 2003, he started dating Katie, a teacher, and they married in March 2005.  Katie became pregnant naturally and baby Emelia –Julian’s ‘bundle of joy’ - was born on 27th october 2007.  ‘At the time, I didn’t really know why I couldn’t do the surgery but I knew there was a reason – I just hadn’t met her.’

Although Julian accepts he took a risk, he condemns the ‘standard operating policy’ – that is, castration for men with cancer in their second testicle – as ‘clearly outrageous: the doctor just didn’t want a dialogue.  Anyone in my situation has got to do the research and ask the questions.’  The Orchid Cancer Appeal is continuing to support research to validate this approach and offer other men in Julian’s situation the chance of avoiding castration. Julian is busy raising funds: ‘Tim was the driving force behind all this.  Without him there would be no Emelia and possibly no Julian. ‘
Orchid Cancer Appeal; 020 7601 7808, www.orchid-cancer.org.uk

For headaches, several friends highly recommend 4head QuickStrips instead of analgesic pills.  These oblong hydrogel strips, 12 by 5cm, act to chill away the pain, via a super-cooling polymer plus a natural compound called levomenthol (minty-smelling), which causes blood vessels to constrict.  The effect lasts for up to six hours.  £4.88 for 8 (don’t forget you have 5% discount, making it just £4.66), from Victoria Health; just click here.

When chaps ask for a failsafe present for women of every age, I always suggest scented bath oils.  One of my longtime favourite brands is Aromatherapy Associates and among their new Christmas specials is Party Oils, a gift box with three different blends – Revive Evening, Revive Morning and Support Equilibrium -  to waft you over the party season and cheer you in January.  £8.81, for three single baths/showers.  Just click here to order from Victoria Health.  Or splash out on the Miniature Bath & Shower Oil Collection, £23.49 for nine 3ml oils.  From Victoria Health, just click here.  And don’t forget you are entitled to a 5% discount on each order.

Website of the week: www.nimh.org.uk

The National Institute of Medical Herbalists’ website gives lots of information including qualified local practitioners and a first aid kit.  For the drinking season, herbalist Paula Grainger suggests milk thistle (Silybum marianum), ‘which is terrific for preventing hangovers; use before and after indulging’.