On an unseasonably warm North Carolina day, Raven McCrindle went outside to do some yard work. Days of sunshine and spring-like temperatures had caused the grass to awaken from dormancy.

Raven says, “While I was outside mowing the lawn, a bug bit me on my inner thigh.”

A Life-Saving Bug Bite

Before long, the bug bite led to thigh swelling, itching and pain, so his wife, Patricia, suggested he go to the nearby urgent care for some antibiotics.

The provider prescribed Raven a seven-day corticosteroid — a side effect of which was possible testicular swelling.

“I get regular checkups, prostate exams, blood work. I’m very fit and do my best to manage my health, so I wasn’t worried, but I did keep an eye on it,” Raven reveals.

Following his seven-day steroid trial, Raven’s right testicle returned to the normal size, but the left one remained swollen. Months passed.

On February 15, 2023, Raven experienced sudden testicular pain and nausea. Concerned, Raven’s wife insisted he visit WakeMed Urgent Care – Garner since she thought the swelling and other symptoms might be an indication of an infection.

Raven shares, “So, I went back to the urgent care. Dr. Ronald David Krull was on duty and decided to perform a testicular exam. He mumbled, ‘That doesn’t look right.'”

By this point, Raven was experiencing a slight hint of pain and feeling a little fatigued, but otherwise, he felt completely fine and dismissed the symptoms as repercussions of his bug bite.

To be extra cautious, Dr. Krull sent Raven to WakeMed Raleigh Campus Emergency Department via ambulance. It was 10:30 Wednesday morning.

Dr. Krull explains, “Mr. McCrindle reported two days of testicular swelling and pain. He had a substantial fever, firm mass in his testicles and a very swollen scrotum. I sent him to WakeMed Raleigh Campus Emergency Department for potential cellulitis infection of the scrotum and genitals.”

A Life-Changing Visit to the Emergency Department

The emergency department care team scheduled him immediately for a scrotal ultrasound. Within minutes, a physician walked into Raven’s room and informed him that he would need to remain in the hospital since the team required additional testing for a proper diagnosis — a computed tomography (CT) scan and blood work.

Raven recalls, “I felt puzzled. It wasn’t like I was lying there with a gunshot wound or multiple fractures from a vehicle collision. I didn’t feel that bad. Still, I said yes to more tests.”

Around noon that Thursday, February 16, Raven was introduced to Pallavi Kopparthy, MD, a WakeMed oncologist. She informed Raven that he had testicular cancer.

“As an oncologist, delivering a cancer diagnosis to a patient for the first time is a crucial moment,” explains Dr. Kopparthy. “It is a delicate balance between being realistic and honest while also emphasizing available treatment options and providing hope. Mr. McCrindle demonstrated remarkable grit and resilience in the face of adversity, and it is patients like these who inspire us all to courageously confront the unknown. It was a pleasure taking care of Mr. McCrindle. “

Raven, too, remembers that shocking moment.

“I was a 55-year-old retired Marine and prior Iowa farm boy. I was as strong as an ox. I could offload a ton and a half of gravel from the back of my pickup truck. Yet, I went from Wednesday thinking I had a bug bite to Thursday finding out I had an aggressive cancer.”

The next morning, February 17, Raven met Vijay Chaudhary, MD, chief of oncology at WakeMed Cancer Care – Hematology & Medical Oncology.

“He informed me that I had a fast-spreading cancer that would likely reduce my life expectancy to one year if left untreated. He also shared that they’d caught it at an early stage — IIA — and that if I consented to treatment, I would need an emergency orchiectomy, the surgical removal of both of my testicles and sperm cords, followed by chemotherapy.”

Dr. Chaudhary expounds, “The majority of men who present with localized testicular cancer are cured with orchiectomy. A minority of patients will need further chemotherapy or radiation or surgery. Each of these options have their own risks versus benefits. They need to be thoroughly discussed with the family to meet their intended goals, so the family can make a more informed decision about treatment approaches, risks, side effects, potential for cure and concern for a second malignancy.”

Raven was introduced to Matthew Lyons, MD, FACS, the WakeMed urologist who would perform the orchiectomy, and the surgery was scheduled the same day. He was discharged to recover at home on February 18 with follow-up scheduled for February 27.

Taking in the gravity of the situation, Raven and his family were crushed, yet they were also impressed with the speed of his diagnosis and the level of professionalism and care shown throughout the entire diagnostic process.

Raven comments, “The WakeMed teams taking care of me over that 96-hour period deserved praise beyond anything I could say. They were all loving and caring and understanding in ways that I still cannot comprehend.

“My world was literally shattered, so it was hard to take it all in. I was grumbly, but they were patient and would answer the same questions and explain the same information over and over again.”

Testicular Cancer Signs and Symptoms

Testicular cancer is often a silent killer. For many men, there are no symptoms at all. For men with symptoms, they are often subtle and may include:

• a painless lump or swelling on either testicle
• testicular swelling
• pain, numbness or discomfort in the testicle or scrotum
• a dull ache in the groin or abdomen

Dr. Chaudhary shares, “Testicular cancer is more common in men between 18 to 35 years of age. It can sometimes affect older men, such as Mr. McCrindle. Testicular cancer typically presents as a painless lump or a dragging sensation with a proportion of patients experiencing pain/discomfort. If patients have these symptoms, they should seek medical attention with their primary care provider for a testicular examination and scrotal ultrasound (if indicated).”

Testicular Self-Exam

The best way for a man to identify testicular cancer in the early stages, when it is most curable, is to perform a monthly testicular self-exam. This involves four steps.

A Brutal, but Necessary Chemotherapy Regimen

Because Raven’s cancer was so aggressive, oncologist Vijay Chaudhary ordered an intensive chemotherapy regimen to begin March 13, 2023.

“We wanted to proceed with a chemotherapy regimen that would provide Mr. McCrindle the highest likelihood of cure since he had a stage IIA testicular cancer,” says Dr. Chaudhary. “According to the literature and data in 1970, 70% of men survived testicular cancer. In recent years, we have taken the forefront in treating men with malignancies of the testicles. Treatment involves a multidrug chemotherapy regimen in most cases of advanced testicular cancer. This high-dose chemotherapy regimen is a standard of care approach in cancer centers across the world. Usually, patients with advanced testicular cancer are cured after chemotherapy, and the five-year survival rates approach 99% for patients with localized testicular cancer. For stage IIA and IIB testicular cancer, prognosis depends on the extent of the disease and a number of disease-related markers. We expect 95% cure rates for stage IIA and IIB testicular cancer patients, including Mr. McCrindle. We come to these averages by pooling from large-scale, multi-center, national/international collaborative clinical trials. Patient disease specifics are pulled into a database, and five-year survival is assessed. We do expect patients to be in the favorable range of expected disease response and cancer-specific survival.”

In four cycles, Raven underwent treatment eight-hours-per day, for five consecutive days, followed by two weeks of rest and then another week of grueling treatment.

Raven says, “I went from healthy and young to literally getting winded walking from the bedroom to the living room. I endured severe fatigue, headache, hair loss and more. I can’t begin to describe the severity of the vomiting, but the good part is that WakeMed had meds for that, and they worked.”

At one point, Raven went into septic shock and was admitted to the hospital for 10 days. His neutrophil count had dropped to zero. His white and red blood cell counts also fell to critical levels.

Raven recalls an emergency department physician explaining, “You’re a petri dish that every germ wants to get a hold of, and if one gets to you, you’re dead. Our job is to make sure that doesn’t happen.”

Happy Moments and Hopes for a Bright Future

Over the course of treatment, Raven and Patricia relied heavily on WakeMed MyChart as their gateway to access medical information and get their questions answered speedily. They found it a saving grace.

Along the way, they met many genuine people, including Chris, a team member in the front office who always had a word of encouragement. They also made friends with several couples during the many hours they sat in chemotherapy — sharing, laughing and passing the time.

Looking back on the experience, Raven comments, “It was a rough ride. It wasn’t one of those, ‘I’ll just suffer through it situations.’ I was fighting for every breath and couldn’t even bathe myself, but we completed it, and, in the process, we made lifelong friends.”

Today, Raven is hopeful.

Raven has completed the initial, three-month regimen,” reveals Dr. Chaudhary. “We are now waiting for CT scans, in particular, of the lymph nodes in the abdomen. Testicular cancer spreads predictably. Once it spreads beyond the testicles, it affects the draining lymph nodes in the abdomen and pelvis which is why we do a CT scan of the abdomen and pelvis to assess for spread and accurately gauge the disease stage at presentation, so the prognosis for the patient could be discussed and presented prior to chemotherapy.”

Raven and Patricia anticipate a return to the life they love — sailing, fishing, canoeing, biking, spending time with their dogs, recreational vehicle (RV) traveling and, most importantly, spending as much time as possible with their 16-month-old granddaughter.

About WakeMed Cancer Care – Hematology & Medical Oncology

At WakeMed Cancer Care – Hematology & Medical Oncology, we understand that being diagnosed with a blood disorder or cancer can feel overwhelming. Recognizing the fear and uncertainty a patient may be experiencing, we are committed to walking alongside our patients, to support, guide and render the most compassionate care for as long as we’re needed.

The most important member of our community is you. That’s why we created a community of caregivers who surround our patients with proven medical and surgical expertise, state-of-the-art-technology, world-class nursing care, advanced physical rehabilitation services and specialized support services.

No matter your condition or stage, our multidisciplinary team treats your cancer with the latest technologies and the highest standards of clinical quality.

Every patient’s cancer journey is unique. And, so is your care.

About WakeMed Emergency Care

The WakeMed system of emergency departments is one of the largest and busiest in North Carolina. As a result, we’ve pretty much seen it all. Our doctors are board certified in emergency medicine, are backed by the highest designated Trauma Center available and bring with them the depth of experience that you would expect from the area’s leader in emergency care.

So, rest assured that no matter where it hurts we’ve got you covered.

About WakeMed MyCare 365

At WakeMed MyCare 365, we offer the ultimate in convenience. With locations around the Triangle open every day of the year, our care teams are available to see you whenever and wherever you are. And, if that’s still too far away, we offer virtual visits. Just select your location and call to schedule your visit. Each of our locations offers walk-in urgent care services along with primary care, so you can get the type of care you need any day of the year — whether it’s a routine check-up, sick visit or a minor injury. Our unique model allows you to become familiar with the entire care team, meaning you will never have to wait to be seen because your provider is busy or on vacation.

About WakeMed Urology

WakeMed Urology offers an outstanding team of urologists and urology surgeons who offer the most advanced urological services at locations throughout Raleigh, North Raleigh, Cary, and Garner, NC.

Plus, we have a 24/7 staffed Kidney Stone Center so you can get the help you need quickly.