Jim Mielziner knows he wasn’t the oldest man to be diagnosed with testicular cancer. That dubious distinction belongs to a 96-year-old African American man. But Jim is the oldest man by at least 7 years on the Testicular Cancer Support Group Facebook page. That being said, only 4% of testicular cancer cases occur in men over 65. Most people don’t endure the problems he had, even older men, but he survived and so can others.

EDITOR’S NOTE: Jim’s story is a direct contrast to young Tristan’s story which was posted on November 27, 2024, and highlights the fact that, though testicular cancer is the most common form of cancer in men ages 15-44, it can strike at any age. Regular self-exams and early detection can help save lives and are crucial to reduce the burden of treatment.

Here is his story.

Jim and his wife Charlotte were on a cruise in the Mediterranean Sea. It was one of those unfortunate trips where almost anything that could go wrong, did. Their departure out of St. Louis was late causing them to miss their connection out of Chicago as well as the next one booked by the cruise line. One of Charlotte’s bags got lost during this change of itinerary. (It didn’t show up until 5 days after they got home!). When they landed in Munich on their third route, Jim retrieved a text from the cruise line saying, “This flight won’t work. Don’t get on it!” Too late. They missed their ship leaving Barcelona and had to be driven 5 hours to the ship’s next port, missing the first day and a half onboard. The thought of “what else could go wrong?” crossed both their minds. The “powers that be” said, “Hold our beers!”

Jump ahead a couple of days and things were finally going well except that Charlotte had to buy new clothes. She didn’t mind! That night when Jim was showering before dinner, as he was washing his genital area, his left testicle seemed much larger than normal. Coming out of the shower, he asked Charlotte to take a look. As Charlotte so lovingly and jokingly has declared since then, “It was really impressive!” Jim went to see the ship’s doctor who made sure it wasn’t a strangulated urethra and then told him to make sure he saw someone as soon as he returned home. He called from the ship to set up an appointment with the urologist he was already seeing for his slow-growing prostate cancer and within a week his return, he had his left testicle removed and diagnosed as 90% seminoma and 10% teratoma testicular cancer. This was 3 weeks before his 69th birthday.

The good news was that the doctors believed the cancer was contained to the testicle; Jim began an active surveillance plan, undergoing check-ups every three months to monitor for any signs of recurrence. The bad news was that on the third checkup, nine months after lefty’s removal, two “suspicious” lymph nodes were discovered in the abdominal region where T.C. usually manifests itself outside of the testes.

Chemotherapy was prescribed; 4 rounds of EP (Etoposide and Cisplatin) were recommended because 3 rounds of BEP were deemed too difficult to tolerate in an “elderly” man. Other than being “too short for his weight”, Jim felt he was in good shape, having been athletic all his life. He figured he could handle the four rounds of chemo, even with each round entailing 5 days of treatment. He knew it would be tough, but he was good at succeeding at anything he put his mind to. Twelve weeks! He was confident he could do this. How bad could it be? Only time would tell.

On the eve of his first treatment, he went to his hair stylist and told her to shave everything off, the modicum of hair on his head and his full beard. It was not really a good look for him, but he wanted to feel like he was the one in control, not the cancer nor the chemo. Unfortunately, he felt he looked like the love child of Uncle Fester and Howie Mandel! He and Charlotte had read about the challenges of chemotherapy, preparing themselves as best they could. What they found was that as prepared as one might be, everybody reacts differently, and sometimes one must be reactive rather than proactive.

His first treatment went all right, as did the second. He was tired, drained and washed out, but all in all handling it fairly well. By day three, he was unbelievably bloated, and when the nurse had him step on the scale, he had gained 17 pounds! This amount of water retention was excessive and very dangerous. They couldn’t give him his treatment, instead hospitalizing him to run tests and try to control the fluid buildup. The tests showed his lungs and heart were beginning to fill with fluid, causing acute congestive heart failure (CHF) and making it difficult to breathe. Doctors gave him medications and decreased the volume of fluids included with his chemo. They resumed his treatment the next day, keeping him hospitalized to monitor his reaction. Treatments three, four and five on days four, five and six occurred without any further problems and he was released from the hospital. The CHF had not caused any damage, but the lower left lobe of his lungs had collapsed and never recovered.

He relished his time between his first and second rounds, feeling worse for the first several days but gradually feeling better as he approached round 2. He even posted a picture on Facebook with a cut-out headline from an unrelated newspaper article that said, “Ready for Round Two”. Little did he know what was further in store for him during this wild ride. The five days of round two came and went without too much trouble. Jim felt further and further drained as the treatment progressed, which was nothing out of the norm. He slept a lot and tried to eat even though nothing sounded or tasted good. He drank Ensure and ate oatmeal, eggs and a few bites here and there of other foods. Day 5 was finally over, and he expected to feel worse for several days and then gradually recover, as he had before.

Instead, on the fourth day of recovery, he told Charlotte that something didn’t feel right. It was a horrible feeling, not at all like the first round and much worse. Charlotte knew something was dire as Jim, the proverbial jokester, hadn’t said anything humorous in a couple days! An ambulance took him back to the hospital and while sitting in the ER waiting room, he began to wonder if his reactions were just the cumulative effect from round two of chemo.

No, he knew something just wasn’t right. After finally being seen and tested, he was diagnosed with COVID; Chemo and COVID are not a good combination. He was admitted into the hospital again, this time to the Intensive Care Unit, a place he would call home for the next fourteen days as he developed more, varied and different problems.

Over those 14 days, besides COVID, he developed one problem after another, including extremely low platelets, low magnesium, low potassium and low white blood cell count. It was difficult to determine which problems were caused by COVID and which from chemo. They were taking blood several times a day and he had been stuck so often, his arms looked like black and blue pin cushions. Feeling worse, he became lethargic to the point of being semi-comatose. He was aware of things occurring around him, but didn’t want to open his eyes, let alone respond to anyone in his room. His daughter later told him she had never been so concerned about anyone or anything in her life. She and Charlotte started going over all the paperwork in his den, hoping against hope that getting all the family’s paperwork together would prove to be unnecessary, but afraid it might be.

On the eleventh day, Charlotte arrived at Jim’s room to see several nurses meeting on the left side of his bed quietly discussing another new problem. His arm was swollen from wrist to elbow. This turned out to be the most severe occurrence yet, besides COVID, of course. They had put two IVs in the same vein, retaining the first one in case the second wouldn’t take. It had become very difficult to find an accommodating vein even using a vein transilluminator! In between the two IVs, a blood clot and a “double” antibiotic-resistant infection had developed. It was determined that surgery was necessary and the sooner the better. Amazingly enough, once the blood clot, infection and the entire vein were removed, Jim started to improve almost immediately! After a couple more days of monitoring and getting his body back to some semblance of physical normalcy, he was almost ready to go home, but not quite!

The incision on his left arm was about six inches long and rather deep. It had to be packed so it could heal from the inside out. Had they closed it up, he ran a big risk of developing an abscess. Additionally, the infection had to be treated so as not to spread or worsen. This medication had to be given intravenously because the dosage was six times what could be given in pill form. So much for his going home. He was sent to a Skilled Nursing Facility (SNF) where he spent another eighteen days while the incision healed and the antibiotics were administered.

Gradually, he started returning to his old self. His sense of humor returned, and he would walk up and down the halls talking to people who felt like talking, trying to cheer up some of the people who were in worse shape than himself and doing physical therapy to get stronger. He was told by one of his physicians that for every day spent in bed, it would take three days to get back to his original strength! It would be a long road to recovery, but he knew “slow and steady,” would get him there eventually.

About two weeks into his stay at the SNF, his oncologist, Dr. Atif Shafqat, came to visit and told him and Charlotte that in his twenty years of treating testicular cancer, this was the most complex case he’d ever had and that, while the Hippocratic oath says, “First, do no harm”, the harm he had been caused was so severe that, after consulting with the TC guru, Dr. Lawrence Einhorn, Dr. Shafqat’s mentor, further chemo was contra-indicated. Ah, but there was a silver lining! All tests showed that the suspicious lymph nodes had disappeared, and Jim was officially in remission!

What a great word, REMISSION!! Jim felt relief and, looking back, he isn’t sure how he would have handled any more chemo. He finally returned home one week before his seventieth birthday and just in time for Thanksgiving. He and his family had a lot to be thankful for. He continued his physical therapy and once again began three-month surveillance checkups, which have since been lengthened to six-month checkups as he just celebrated 27 months in remission!

What did he learn, and does he have any advice for guys who find themselves diagnosed with testicular cancer?

First, act quickly! Testicular Cancer is a very treatable and survivable disease, but the sooner you act the better.

Second, make sure you have another person with you to advocate for your care during all appointments. Jim firmly believes he would not have survived without the help, support and advocacy of his wife, Charlotte. She read up on the disease and was able to “nudge” the medical staff into doing things that otherwise might not have been accomplished as quickly to help him. A second set of ears is important, because after you hear the word CANCER, your brain may not retain much else your doctor says.

Third, if you don’t understand something, ask; if it isn’t explained to your satisfaction, keep asking. If you don’t say something the medical staff may think you understand when you haven’t a clue. Knowledge is power! Power is strength! Strength will overcome your cancer!

Fourth, follow all the directions the team gives you. Your staff is well-versed in treatment, and they are working hard to save your life. Let them!

Fifth, while it is easier said than done, try not to worry about the things you can’t control. It’s a waste of effort that may be better used to fight the disease. Jim reads about so many people worrying over their upcoming checkups and tests. Nothing you do will change the results prior to finding them out. Once you’ve found out, then fight as if your life depends on it; because it does!

Every body reacts differently to cancer and to chemotherapy, so one person’s symptoms may not manifest in another patient. It’s tough to know which of Jim’s lingering symptoms are due to cancer treatments versus COVID versus old age or some combination of these factors. He still tires easily, has trouble walking long distances and going up steps. His moderate case of tinnitus has not been helped by hearing aids, and joints in various parts of his body ache fairly constantly. He does believe that these problems are a small price to pay to be alive and to enjoy his two grandchildren growing up!

Finally, his last comment to all you youngsters experiencing this problem is that if he can get through all this and survive, any of you can do this too. You are not alone! Look for help and support from family, friends, websites and support groups. You can do this. Best of luck and remember; REMISSION is a wonderful word!

Jim was Diagnosed with Testicular Cancer at 68 Years Old