Ryan has truly learned one thing in life: no matter how much you plan out your life, it will never go the way you anticipate.

Ryan’s story begins back in 2018, when he proposed to his then girlfriend, now wife, Ashlie. They were on cloud nine as the wedding planning began, and soon after, they signed to begin building a new townhome together. After moving in together in July 2019, they set their eyes forward on their wedding date on May 9, 2020.

If only they knew the wrench that would be thrown into their plans.

After the pandemic began in March 2020, Ryan and Ashlie would have to put their big wedding on hold and wait a little longer. After realizing their rescheduled date in September 2020 would not be post-pandemic, they continued to still get married on September 5th, 2020, in front of immediate family, and eventually have their big celebration with friends and family in June 2021. Not quite what they planned, but hey - that’s life.

Ryan and Ashlie planned to start trying for a baby right around the time of their big wedding celebration. Ryan also told Ashlie that he wanted to go back and pursue his MBA later that fall, which Ashlie was fully supportive of. Ryan knew having a baby and tackling graduate school would be difficult, but knew he would find a way to conquer both challenges. Ashlie quickly got pregnant in late June 2021, and at her 9-week ultrasound, they received the biggest shock of all - they were having twins. Not just any type of twins - boy/girl twins!

Ashlie’s pregnancy was very healthy despite having a pre-term labor scare at 24 weeks. After being hospitalized for 3 days and receiving excellent care, Ashlie held on until 31 weeks and delivered their beautiful 3 lb 13.3 oz babies, Kinsley and Ryan Jr. After a 30-day stay in the NICU, which was quite the emotional roller coaster, Ryan and his wife brought their babies home.

Navigating parenthood was certainly the toughest job yet for Ryan. Working full-time, taking on an MBA, and being a husband and father to two babies brought on incredible stress. At the same time, he was beyond grateful for these amazing blessings in his life and, in a way, enjoyed the opportunity to balance so much at once. Ryan couldn’t see anything slowing him down in his life at that point. Until April 2023 came along.

On a flight home from a work trip, Ryan started noticing some irregular pain in his right testicle. Not giving it too much thought, he carried on with normal life and didn’t seek medical attention. However, about a week or so later, he continued feeling that pain, and after doing a self-check in the shower, he discovered an actual bump on the right testicle. That was when Ryan knew something wasn’t right and called his primary care physician.

After his doctor performed an exam, he sent Ryan for an ultrasound immediately, per protocol. His results showed a small tumor on the right testicle that had internal vascularity - a definite concern that needed urological consultation. After meeting with a urologist, he was advised that an orchiectomy was needed - quickly. Ryan took the doctor’s first opening in the operating room that following morning, May 4th, which happened to be his wife’s 30th birthday. How terrible he felt that, on a day in which Ashlie should be celebrated, she was sitting in a waiting room full of worry.

Pathology results came back, and Ryan’s urologist called to let him know that testicular cancer was confirmed and that it was one of the more aggressive types called non-seminoma. Here he was at 29 years old, trying to understand how he was supposed to take on a cancer diagnosis while juggling everything else in life. His urologist, an absolutely exceptional doctor, advised that he did not specialize in treatment post-orchiectomy, and would research another doctor in the surrounding cities/states that could take Ryan on. Living in the suburbs of Philadelphia, Ryan knew that there had to be an expert not too far from home; this is when Ryan discovered Dr. Phil Pierorazio and the amazing people at Penn Medicine in downtown Philadelphia.

When Ryan and Ashlie met with Dr. Pierorazio for the first time, they instantly knew they were in great hands. Dr. Pierorazio advised him of the 3 options at this time: ongoing surveillance, proactive chemotherapy, or robotic Retroperitoneal Lymph Node Dissection (RPLND). Ryan left that appointment with his wife, they grabbed lunch, and anxiously discussed what in the world he should do. Does he do surveillance and take the chance that maybe his cancer is gone? Does he receive one round of BEP chemo and risk over-treating himself? Or does he take a second trip to the operating room and get a robotic RPLND, which would most likely prevent any future spread, while simultaneously risk losing his ability to reproduce? Robotic RPLND had very attractive statistics for curability, but the possibility of there being a 5% chance he could lose his fertility certainly had Ryan considering the surveillance route. He and his wife had future plans to try for a third child, so that was a crucial risk if he chose RPLND. This was an extremely difficult decision process for him, and knowing how quickly this cancer can move, he had to make a decision quickly.

After researching the options, reviewing the statistics that Dr. Pierorazio provided, and talking to his wife about which treatment would be appropriate, Ryan ultimately decided that getting the RPLND from an expert like Dr. Pierorazio was in his best interest and scheduled to have it done on June 27, 2023. A big reason for the decision was his fear of chemotherapy and the effects it would have on him. Ryan was also extremely confident going to a high-volume center like Penn, where this procedure has been performed many times. Surgery went very well, and Ryan was discharged the following morning. After some significant post-op pain, and lots of rest, Ryan made a full recovery and was back to living his normal life within 7-8 weeks. In the weeks following surgery, Ryan would receive two blessings: his pathology results revealed all lymph nodes removed were negative for disease, and his fertility was preserved. He hugged his wife tightly and couldn't be more thankful for Dr. Pierorazio and his team.

Post-RPLND, Ryan entered the surveillance program at Penn in August 2023, where he was now in the hands of another TC expert, Dr. David Vaughn. After his introductory appointment, Dr. Vaughn sent Ryan for routine tumor marker bloodwork. Ryan knew this was part of the surveillance plan, and that he had nothing to worry about. Besides, he’d just had an RPLND that came out negative, and the chances that cancer would re-occur were extremely unlikely.

Why worry? Well, just like with so many other life events, Ryan was caught off-guard.

His first round of tumor markers showed an elevated hCG, signaling that there was a sign of disease somewhere. Dr. Vaughn had Ryan repeat labs several times in the following weeks to confirm that it wasn’t a fluke lab result. His levels remained elevated, and it was time for Ryan to start mentally preparing for his worst fear - chemotherapy. Ryan’s CT scans came back negative, but that’s when Dr. Vaughn told him that the disease was present somewhere in his body microscopically. Only 2 months after receiving RPLND, Ryan was now reporting for chemotherapy, receiving three rounds of BEP.

Chemo was brutal for him. During his first 3 weeks of treatment, Ryan was also working and finishing the last few weeks of an MBA class. Once those two paused, Ryan was able to spend the remaining 6 weeks just focusing on beating cancer. His wife and his parents took turns accompanying him at his treatments, and catering to his every need. The nurses took amazing care of him, and Ryan made sure to try and make them laugh at every treatment. He figured he would make the best of his time in that infusion lab, as he could only deal with what life threw his way. However, a majority of the days, he was struggling. Some days he came home and felt stuck in his own body, barely being able to speak or interact with those around him. Yet some days he came home from treatment, ate a sandwich, and took his kids for a mile walk in the stroller. Ryan worried about his 1 ½ year old babies seeing him like this, slouched on the couch, no hair, and just not his true self. Thankfully, he knew they were too young to remember these visuals one day. His hCG levels had returned to normal after only 3 weeks of chemo. After 9 grueling weeks, being poked and prodded, Ryan got to ring the bell, and felt a sense of relief different from the one he felt after RPLND.

As of November 20, 2023, Ryan has been in remission from testicular cancer, and continues to be seen by Dr. Vaughn as part of the surveillance program. Ryan sees life through a different lens now. Never in a million years did he think he would have embarked on this cancer journey, and faced the decisions, the highs, the extreme lows, and everything else that comes with this terrible disease. But his message to others who are going through this journey: you are NOT alone. Embrace the TC community that surrounds you, whether it be through social media groups or resources through your medical team. Lean on your family. Don’t be afraid to be open about your diagnosis. Thanks to the facebook groups online, Ryan met another TC survivor in his area that had RPLND at Penn before him, and was able to lean on him as a resource before and after surgery. In fact, Ryan and him became good friends and routinely grab lunch/dinner together with their wives. The community is larger than you think, and he advises anyone going through it to reach out to him for support.

After rescheduling his wedding two times, unexpectedly having twins, and facing a cancer diagnosis all before 30 years old, Ryan is no stranger to the unexpected; it’s certainly taught him to be ready for life’s curveballs, and to always live life to the fullest. But most importantly, it taught him to always go with his gut feeling when something doesn’t feel right, because his cancer journey could have been much worse had he not taken action.

Ryan Rayfield: Expect the Unexpected