The single sign of potential cancer

Rose could not hold her tears as she explained what had transpired between her and her husband.

“How can he hit me?” she sobbed. “Am I not old enough to listen? I cannot bear this, no way, I am ready for divorce!”

As a child, Rose had witnessed her mother suffer beatings at the hands of her brutal father. She sympathised but felt helpless. She vowed never to allow violence in her marriage. John, her husband, was well aware of this.

“And you know what, all this happened as a result of an innocent joke,” Rose explained. “I joked that he was a man of a single bullet because he only has one testis!” The mention of the lone testis caught my attention. It is not a joking matter. I therefore took to interrogating Rose in detail.

VIOLENT

She was 34 years old, a social scientist working for a research based NGO. Her husband, John, was 37 years old. He was an accountant. The couple had been married for six years and had two children. “So tell me more about the single bullet story,” I enquired.

Rose had detected that John only had one testis. Being aware that they exist in pairs, she informed John that this was not normal. John however reassured her that it was fine since he was able to have sex. He was also happy with their fertility because their two children had come in quick succession. “And so for me the single bullet thing was a joke but he took it so badly that he slapped me!” Rose exclaimed.

Much as I wanted to resolve the violence issue, I could not ignore the single testicle. I asked Rose for her husband’s number and asked him to join us at the clinic immediately. He was still upset and said he was not interested in resolving their dispute.

“Sir, I am actually more concerned about the single testicle. It may require immediate medical attention,” I explained. Within an hour, he was at the clinic.

I examined him and yes, he only had one testicle. Scans showed that the other one was stuck somewhere in his tummy. You see, testes form early in embryonic life a few weeks after conception. As the foetus grows, they descend and hang out of the body in their sac, the scrotum.

CAUSES AND TREATMENT

Cryptorchidism is the name of the condition in which one testicle does not descend. This happens if the temperature inside the body is too high for it to function normally.

Nature made testes hang out because they require cooler temperatures than what is inside the body to be able to function. An undescended testicle affects sperm production and fertility becomes a problem. The most worrying issue however is that undescended testes are prone to cancer.

“So I could be having cancer? What can I do?” John asked.

The treatment of cryptorchidism in adulthood is surgical excision and removal of the undescended testis. John was lost in his thoughts as I explained the next steps. Rose reached out for his limp hands and caressed them tenderly, tears rolling down her cheeks.

“Will I be able to have sex again after the surgery?” John asked. I nodded. John underwent the surgery. The undescended testis was removed and taken to the laboratory to check if it was already cancerous. It had abnormal cells but no cancer as yet.

“I still cannot figure out what led me to hit my wife,” John said on their last day of review.”

“God works in mysterious ways,” Rose answered. “He wanted this problem brought to the attention of doctors.”

“I believe God has better ways of making us discover medical problems than by causing us to inflict violence on our spouses,” I said as the couple bowed in compliance and walked away.