TC Survivor and Malaysian TCAF Ambassador, Surendra Ananth, Shares His Journey with Testicular Cancer

July 26th, 2023 would be a day that changed Surendra’s life forever. At that point, he was 33 years old and in the peak of his career as a young litigation lawyer focused on human rights work. He was also physically active.

Rewinding 6 months back to January 2023, Surendra had occasional pain in his left lower back and abdomen. He never took it seriously. The issue persisted. In March 2023, he decided to see a gastroenterologist. Various tests were done, including a colonoscopy and an endoscopy (not fun at all). No problems were identified, so Surendra just accepted the occasional pain hoping it would fade away eventually.

It did not. Coming back to July 26th, 2023, he suddenly had a sharp pain in one testicle. He rushed to the hospital emergency room concerned it was testicular torsion (he had one before back in 2011). An ultrasound was done. The urologist then broke the news to him, that it was most likely testicular cancer.

At that point, he did not know how to feel. He did not expect it at all. His father was with him. The urologist assured him that it could be stage 1 and that it is highly curable. Surendra was immediately scheduled for an orchiectomy in 3 days. Marker tests and a CT scan were also scheduled in 2 days. He went back hoping it was just stage 1.

Again, he was wrong. The CT scan revealed the cancer had spread to his lymph nodes in his abdomen and chest. After the surgery, the pathology confirmed it was the two most aggressive types of testicular cancer: embryonal carcinoma and choriocarcinoma. He was diagnosed as stage 3b and was immediately set down for chemotherapy (BEP X4) in two weeks.

The initial period was difficult. It was one bit of bad news after the other. But in the two weeks leading to chemotherapy, Surendra did a lot of reading and joined support groups on Facebook, where he learned that the cure rate was still high. He went through chemotherapy without much difficulty. He stayed physically active throughout the 4 cycles, doing basic yoga and walking as much as he could. He had the close support of his family, especially his parents, who constantly cared for him.

Following another scan after the chemotherapy, the lymph nodes in his abdomen were still enlarged. A retroperitoneal lymph node dissection (RPLND) was recommended. There are, however, no high volume centers in Malaysia. RPLND is a major surgery and the international recommendation is for it to be done with an experienced surgeon. Thanks to the support of his friends, he managed to secure a slot to do a robotic RPLND with Dr Ginil Kumar in Amrita Hospital, India. Dr Ginil is one of the few surgeons in the world who can do a robotic RPLND in a post-chemo setting.

The surgery was successfully done on December 26th, 2023. It took more than 10 hours as one of the tumors was stuck to the vein leading to the kidney. Dr Ginil managed to remove it without having to remove the kidney. The biopsy revealed that all the lymph nodes removed had no evidence of cancer. Surendra thought his long battle had come to an end.

But alas, he was wrong again. He now had to deal with a lympathic leak, a rare side effect from the RPLND. The lympathic leak of over 1 liter a day did not subside. He had to return to Malaysia with a drainage bag and tube attached to his abdomen. He got admitted in a hospital in Malaysia to resolve the issue.

It was no fun at all. Strict no fat diet and unable to go out. After about a month, the situation did not improve. He underwent a lymphangiogram, which managed to resolve the leak. This was towards the end of January 2024. Surendra was finally free.

Since then, he has gotten back to work. He also slowly started getting back to his physical activities, especially hiking which he enjoys so much.

Whilst undergoing treatment, Surendra promised himself that he would advocate for testicular cancer awareness. There was little to no awareness in Malaysia. He joined the Testicular Cancer Awareness Foundation. He has been giving talks in various radio stations in Malaysia on testicular cancer awareness.

With TCAF, they have come out and printed awareness brochures to be distributed in Malaysia. He hopes to do more.

Surendra is now on surveillance. He has to do scans every 4-6 months. He tries to live life to the fullest. Previously, he worked hard around the clock hoping to enjoy life much later. That is not how life works. You have to learn to enjoy every moment, even the bad moments. They are part of life. Don’t wait too long to do the things that make you happy. He has a trip to Japan planned soon in September to hike Mt Fuji and he hopes to travel to New Zealand in March 2025 for his pilgrimage to visit the sites used in the Lord of the Rings (undoubtedly, the best piece of art ever made).