Recently, Nathan Adrian, an Olympic swimmer, posted on social media that he had testicular cancer. I immediately reached out to him and he responded just as quickly! He agreed to do an interview with ABSOT to share his own testicular cancer story and his newfound mission for men’s health awareness.

ABSOT: Tell us about yourself before your shocking diagnosis of testicular cancer.

Nathan Adrian: I am 30 years old. I have been to three Olympics (2008 in Beijing, 2012 in London, and 2016 in Rio) for various swimming events, winning eight medals in all. I finished up eligibility in 2011 and turned “pro” shortly after that. Life for me was eat, train, sleep, repeat for a majority of that time until after the 2016 games.

I don’t think I am doing a good enough job, however, to describe how much I did and still do love swimming. It almost seems like you are listening to a broken record to train all year long just for a single chance at the end of the year to go for a best time. However, it was the puzzle aspect of it all that fascinates me. How do we optimize training so we can find a way to go .01 faster at the end of the year?

Anyways, life leading up to diagnosis was going great. I was engaged in 2017 and married in 2018 so as you could imagine my life changed quite a bit, but all things for the better. We had gotten married a couple months before and moved into a new house in Oakland. We were ready to leave the craziness of San Francisco behind and I wanted to be closer to Berkeley where I train every day.

What symptoms or signs of testicular cancer led you to go to the doctor?

I actually didn’t notice anything was wrong until I accidentally hit myself and it hurt a lot more than it should have. At that point, I figured that for whatever reason my testicle was just swollen maybe from hitting it or whatever else it could have been but I needed to keep an eye on it.

So a few days go by and the pain goes away but the swelling does not. I figured, “Hey something is getting better, I guess. I am on the right track.” Yet, the swelling/hardness never goes away. After another week or so, I decide it is time to go in to the doctor to figure this out.

How fast did things move once you got the ball rolling?

Once I was at the doctor it went pretty fast. Not quite as fast as some people that I have read about, but certainly not the slowest. I was put on antibiotics in case it was an infection but my doc wanted me to get an ultrasound and an appointment with the urologist ASAP just in case. If the ultrasound went well and the antibiotics cut down on the swelling then we could cancel the urologist appointment and go on our way.

As we all know now, the ultrasound showed a mass and the urologist appointment confirmed that it needed to get taken out but my urologist was semi retired so he didn’t do surgery anymore. He got me into another urologist he recommended and the surgery was the next week.

I think the sequence went as follows:

  • Monday — PCP appointment
  • Tuesday — Ultrasound
  • Thursday — First urologist appointment
  • Monday — Second urologist appointment
  • Thursday — Orchiectomy

After the orchiectomy, I also did a laparoscopic RPLND [retroperitoneal lymph node dissection surgery — a surgery to removed affected lymph nodes] as well just to try and cut down our chance of recurrence as much as we can surgically. The procedure took 3.5 hours instead of the 1-1.5 hours the orchiectomy took, but I have to say the recovery from the L-RPLND was easier than the orchiectomy since the incisions were only about 1-1.5 cm across, rather than the 3-inch incision from the orchiectomy. There were four of them, but I would take four 1-centimeter incisions over a 3-inch one any day based off of this experience.

How was recovery from the surgeries?

Recovery went as well as it could go. I did do the low fat diet thing which was probably the worst part of recovery from either surgery. I really thought sticking to the diet wouldn’t be a problem at all but just eating carbs and protein leave you so unsatiated! After a couple days I started feeling super cloudy in my head and needed to get MCT Oil [medium-chain triglyceride, an oil that has a variety of uses] just to get to the point where I could think straight again.

The restrictions on lifting were annoying but obviously they serve a really important purpose. I also have a great physical therapist at Cal that I have worked with for years so I had access to the weight room and all the recovery modalities available to a Division 1 football team so that helped keep my mind where it needed to be.

Just so we are clear, “working out” over the past couple months would mean anything from taking a quarter-mile walk with my mom through my neighborhood (and feeling exhausted afterwards) a couple days after surgery to lifting/swimming for three hours after all restrictions were lifted. No matter what the actual workout was, the fact that I was doing what I could to get back to normal life was what was important.

I think some of the most important lessons I learned from this is that there are going to be good moments and bad moments. When I had a bad moment I knew how to fix it and that was by getting back into my regular routine and working out. Figuring a way to progress towards my next goal. It made me feel better physically and emotionally.

What is the outlook and treatment plan going forward?

I am now on the active surveillance protocol. One of the hardest things about ‘real life’ vs the training we all receive in school as children/young adults is that a lot of times there are decisions that must be made that don’t have always have a clear right or wrong answer. In this case, the choice between active surveillance or adjuvant chemo was one of those decisions.

Fortunately, I remembered my old days as a public health major struggling in one of my population statistics classes. Given my staging and pathology, the “right choice” regarding treatment options is to opt for active surveillance. If you had 10,000 people that were exactly where I was at regarding testicular cancer, the vast majority of them would be over treating themselves if they were to do adjuvant chemo.

Knowing this I decided to opt for what I feel is my “right decision” to try and avoid chemo if at all possible. Please keep in mind this is all knowing that ultimately my disease free survival rate. My next scans/bloodwork are in April.

As someone who has been there, I know that facing testicular cancer can be very overwhelming. How have you been coping with all of these sudden changes?

I feel like my wife and I did a great job. To walk in to a doctor’s appointment together and hear the words “you have cancer” is some very real adversity that a lot of people are going to have to deal with in their lives. I am proud of the way we got through it and are continuing to go through it together.

As I had mentioned before there were good days and bad days for both of us and fortunately not too many of them overlapped. We could be each other’s strength when the other wasn’t feeling too hot.

I would be remiss not to mention that my mom flew down to help with recovery and attend doctor appointments with me so she was an incredible source of support and help through the whole thing!

Shifting gears here a bit, how important was taking care of your health before this testicular cancer diagnosis (aside from the obvious being a world-class athlete)?

Taking care of my health was/is my job! Being a pro athlete means that you need your body to function optimally at all times. I was having three green smoothies a day, making sure I was eating enough protein before, during, and after practices. I would eat a different type of protein at night that was a little slower digesting since I wasn’t going to eat for 8+ hours. I blew the daily recommended fruits and veggies out of the water! So I guess I never really separated the two because in the world of swimming, performance and health are so interconnected that you can’t have one without the other.

Why did you choose to go public with your testicular cancer experience?

I decided to go public with my story after every single doctor told me it was a good thing that I decided to get checked out as quickly as I did. All of them had stories about people waiting six months — or even longer — until the symptoms were too serious to ignore.

I was also a public health major at Cal, so it really spoke to me that if we could get guys to go get checked out sooner we could have a higher cure rate at stage I on a population level and less people would have to go through chemo and deal with the side effects.

That’s very admirable and what really spoke to me when I started reaching out to you. What do you plan to do to keep this momentum about men’s health awareness?

I plan on speaking about it to anyone and everyone that will listen. Men’s health is a topic that is almost criminally underrepresented in our society. I recently read a paper forwarded on to me from a Public Health friend that discussed the idea that men don’t seek treatment soon enough because they correlate properly functioning genitals with masculinity.

If something isn’t functioning properly then going to the doctor is only going to help! Why bury your head in the sand when it comes to medical information? It is a human fallacy that needs to be changed!

What advice would you give to someone newly diagnosed with testicular cancer?

Find a way to not go through this alone, whether it is support from a family member or maybe one of the resources available online. Doctors call this a “rare” cancer which from a purely numbers standpoint is true. However, you would be surprised how many other guys are dealing with the same thing. Even in something like the swimming world I have had tons of people reach out to me saying they had testicular cancer, or someone they knew did and were happy to share their experience. It is not weakness to take them up on that offer.

I actually really enjoyed reading A Ballsy Sense of Tumor as I was in the early stages of this because it was the full story (disease-wise). Other blogs were the same thing: beginning, middle, and end. The end usually consisted of clean scans and smiling faces and that is something that was really important for me to see for my own mental health.

Thank you for the kind words and to the readers, I promise I didn’t pay him to say that. What do you want all men to know about men’s health?

It doesn’t make you any less of a man to have a health issue or a problem. I really believe this is one of the top reasons why so many men are reluctant to seek treatment. It could be physical or it could be mental but as I had mentioned, our society has this archaic idea that in order to be masculine you don’t need help and that needs to change!

One final question, and possibly the most important one of this interview. Do you feel like losing a testicle will improve your swimming and odds in Tokyo 2020?

Now we are on to the hard-hitting questions — I like it! I don’t necessarily think it will improve my swimming as I was forced to take the longest break from training I have taken since I was probably 5 years old.

However, I do think it’s important to note that it shouldn’t hurt it! I still have a healthy testicle and my MCB32 Intro to Human Physiology class at Berkeley taught me, testosterone production is a negative feedback loop. What I lost in one testicle, the other should make up for just fine.

This post originally appeared on A Ballsy Sense of Tumor. It is republished with permission.