Thanks to a friend's advice, Paul Plinske was diagnosed with testicular cancer soon enough for a good prognosisBy TERRY RINDFLEISCH
Of the La Crosse Tribune staff
Paul Plinske noticed a lump on his left testicle toward the end of last summer. He said the lump was about half the size of a pea and had become more sensitive to the touch as he trained to run the Chicago Marathon. Plinske told a friend about it, and his friend advised him to have the lump checked out.
``I thought, I guess it wouldn't hurt to get it checked out,'' he said. ``I didn't think there was a sense of urgency.''
Plinske had not seen a physician in four years, and he did not have a regular doctor in La Crosse. He called the general information telephone line at Gundersen Lutheran Medical Center and made an appointment to see a doctor.
On Oct. 9, Plinske saw a doctor, who suspected testicular cancer. Plinske put off surgery for four days so he could run in the Chicago Marathon.
Plinske, UW-L's 33-year-old associate athletic director, is an example that early detection can cure testicular cancer.
``Paul came in pretty early,'' said Dr. Kurt Oettel, a Gundersen Lutheran cancer specialist. ``Paul is educated and an athlete. He recognized it and sought help right away.
``The take-home message here is testicular cancer is not a death sentence, it's a treatable disease, and the earlier we detect, the easier it is to treat. Men treated early realistically are looking at a normal life span.''
Testicular cancer is the most common type of cancer among men ages 20 to 35, but represents only 1 percent of all cancers in men.
Oettel said there are 7,000 to 8,000 testicular cancer cases a year in the United States compared with 170,000 lung cancer cases.
``The numbers are low for this cancer to have advocacy,'' Oettel said. ``It also affects young males who believe they are invincible, don't see a physician regularly and often don't have health insurance.
``It's hard to target a group not in the health-care system,'' he said. ``There are not many good risk factors for this cancer, and men don't do self-exams. You also can't biopsy a testicle. You have to remove it.''
Generally, young men will notice pain in the testicle area or a growth.
``This growth has gotten in the way, and it starts to hurt,'' Oettel said. ``At first, the young man will have his head in the sand or ignore it, but then he becomes scared and sees a physician.''
Oettel said the cause of testicular cancer is unknown, and he doesn't know why young men are the highest risk group.
``I can count the number of 50 year olds with testicular cancer on one hand,'' he said. ``All of us together here at Gundersen Lutheran see no more than 10 to 15 cases of testicular cancer a year, but I saw three new cases in the last year.''
American bicyclist Lance Armstrong, who won the Tour de France after being treated for testicular cancer, and Olympic ice skating gold-medalist Scott Hamilton have been advocates for the cancer.
Oettel said Armstrong almost waited too long to be treated because the cancer had spread to his chest and brain.
``Testicular cancer is a very curable cancer even with very advanced cancer,'' he said. ``It's never too late to seek treatment, but it's easier to treat and more successful if the cancer is caught early.''
Plinske is this year's honorary chairman of Midwest Security/American Cancer Society's 22nd annual Family Run/Walk on April 27 in Onalaska, Wis. He will run in the fund-raising event as part of the UW-L team.
``I have no problem being open and helping others be pro-active,'' he said. ``In my position, I hope athletes educate themselves and learn through the example I live. I want to serve as an example of hope for everybody.''
Plinske said he urges young men to conduct self-exams of their testicles once a week, or at least once a month.
``I didn't know the long-term ramifications of testicular cancer,'' Plinske said. ``Fertility is a huge concern. But young men don't pay much attention to testicular cancer. It's like men never asking for directions when they're lost. I forgot that Lance Armstrong had it.''
After crossing the finish line at the Chicago Marathon, Plinske said he couldn't help but think the road ahead of him was more difficult than a marathon.
``I felt I was another Lance Armstrong, it's going to be my battle,'' he said.
He had surgery the following Tuesday and discovered he had testicular cancer. ``My feeling was I was going to go into remission and go on with my life,'' Plinske said.
A CT scan revealed he had swollen lymph nodes below his left kidney. Plinske had learned that testicular cancer could spread through the lymph nodes, lungs and ultimately the brain in a matter of days.
Drs. Thomas Londergan and Marvin Van Avery wanted to perform a retroperitoneal lymph node dissection, or RPLND. The procedure involved lifting Plinske's intestines, placing them on his chest and removing the lymph nodes that appeared cancerous.
As it turned out, Londergan and Van Avery operated on Plinske just in time. Out of the seven lymph nodes they removed, one was cancerous.
``Testicular cancer is a disease that can grow rather fast. We're always conscious of that, and we try not to delay treatment,'' Londergan said. ``Sometimes a period of a week or two can make a big difference in the spread of testicular cancer. We like to try and move as quickly as possible.
Plinske said he knew his best odds at beating cancer were two rounds of chemotherapy. He started treatment Dec. 30 and had his last treatment on Jan. 24.
Oettel said Plinske's prognosis for a cure was excellent after surgery, but chemotherapy reduced the chance of cancer returning by less than 5 percent.
``He's back to work, and he has his whole career ahead of him,'' Oettel said.
A CT scan March 3 showed the cancer was gone.
``I feel great,'' Plinske said. ``Every day I've been regaining my energy, workload and capacity. I've been running a lot lately.''
On a recent Sunday, he went for a two-hour run.
If it had not been for a friend, Plinske said, he probably would have waited a month before seeing a doctor because he was focusing on a marathon.
``I have a whole different perspective on health,'' Plinske said. ``It's been a physical, spiritual and emotional rebirth.''
Despite the hard road traveled, he said he has grown by leaps and bounds and feels blessed. When he was diagnosed with cancer, Plinske said, shock turned to tears, then to more tears, then to hope and then to possibilities.
``The possibilities were realized through my faith in God, unending hope in being restored to health, support and prayers of those in my personal and professional life,'' Plinske said.
``Through faith, hope and love, I've found that overcoming cancer is possible,'' he said.