HEALTH / Focus on Men: I felt isolated, inside a bubble: Testicular cancer

When Stephen Gold set up his own law firm in 1981 he attracted plenty of business, but clients wondered whether he would live long enough to finish the work they had given him. Only 32 years old, he had just had a course of treatment for testicular cancer. He had lost his hair and weighed only eight- and-a-half stone.

But Mr Gold's brush with cancer is a medical success story. He was lucky enough to have his cancer detected early, have first-class treatment at a leading centre, and is alive and well 14 years later.

Impressed by the care he received, he now wants to get a better deal for all cancer patients. Consequently, in September he becomes chairman of the new Scottish section of Bacup (British Association of Cancer United Patients), the highly successful charity, which in nine years has gone from an organisation of two paid staff to one of 30, distributing 150,000 booklets a year and providing telephone counselling to 30,000.

Men apparently use the services of Bacup much less than women, even though cancer affects both sexes in almost equal numbers. The charity's spokeswoman, Nikki Hill, believes that men are shyer about discussing their health problems. 'It is common for people to talk about breast self-examination, but not nearly as common to talk about testicular cancer and self-examination. More women than men call us, many acting in their traditional caring role are ringing about their husbands or fathers. But it does not mean that men do not worry about their health.'

Mr Gold felt that it was extremely helpful to discuss his problems with others. 'It is an isolating experience to have cancer. People with whom you are normally friendly are not clear how to deal with it. Some do not get in touch because they do not know what to say; others try to talk about it, but handle it badly. Regardless of how tactful they are, there is a distance between you and them, because you have cancer and they do not.

'When you have got it, it is like being in a bubble. You can see people outside the bubble and talk to them but there is a profound difference between you. Unless you have had it, you cannot conceptualise it.'

Mr Gold first encountered cancer in 1980, when he developed a painful swelling of the left testicle. He went to his GP, who said it was a urinary infection and prescribed antibiotics. He took the tablets for two weeks, but when it did not go away he went back and demanded to see a specialist.

He was sent to a consultant urologist, who removed the testicle. 'He was very good. He told me: 'There does seem to be some disease', which I understood to mean cancer, but he quickly added that it was curable. He was sympathetic and explained the treatment in full.

'I had a course of radiotherapy and hoped, at the end of it, that I had beaten it. But in the following year, a test showed that it had returned. I had a further growth at the back of my abdomen. I had a blitz of chemotherapy for six months and that did the trick.

'I had all the usual side-effects: severe, continuous vomiting; my hair fell out; I went down to eight-and-a-half stone; even though I am 6ft 1in. But the consultant, Professor Stanley Kaye, was terrific, because he emphasised that it was a curable condition.

'The only bad experience I had with a consultant was during my period of radiotherapy. I was sitting in a clinic one day and the consultant strolled over and said in a casual way: 'There might be something showing up on the X-ray, but I can't tell you for sure.' When I pressed him, he said: 'It might be something round the liver.' I knew that if the cancer had spread to the liver, it was goodbye. Luckily, it turned out to be nothing.'

During his chemotherapy, he attended a counselling group for patients and their families, which had just been set up by Dr Kenneth Calman, now the Chief Medical Officer, but then a consultant oncologist at the Gartnavel General Hospital, Glasgow.

Mr Gold felt that he survived the experience by being very focused in his determination to survive. 'I had tunnel vision. I did not allow for the possibility that the treatment would not work. I do not know if it helped physically, but it helped emotionally. It was rather a selfish time. But my wife, Ruth, was stunning throughout.'

The new Scottish branch, in Glasgow, will have a full- time paid manager, a part- time paid counsellor and a team of trained volunteer counsellors as well as the support of Bacup's London centre. A steering committee of Scottish cancer specialists will give additional help.

Mr Gold says: 'It will offer a skilled, sensitive, caring service and time without limit. Staff in hospital or general practice do not have the time to get involved in long, conversations about the patient's circumstances. That is where Bacup comes in.'