Support Josh and Kim

​Message from Kim: 

For those who don’t know, my fiancé Josh, who is now my husband (we eloped at the courthouse in the midst of everything going on below), was diagnosed with stage three testicular cancer in June of 2017. He has been fighting this diagnosis ever since. Unfortunately, not only has his cancer journey taken a toll on us mentally and physically, but also financially. Josh’s cancer journey has required 3 months of chemotherapy treatments, 2 testicular cancer surgeries, 1 lung surgery, countless CT and PET scans, and numerous other doctor appointments, biopsies, hospital admissions, and lab draws. For a large portion of his fight against cancer, Josh did not have any health insurance. This is because he was a full-time student without a full-time job, did not qualify for Medicaid, had absolutely no insurance resources from his immediate family, and was denied any financial assistance through the hospital’s assistance program. This is a GoFundMe page to support him and all he has been through. If you are interested, please read below for a detailed summary of his very long cancer journey. I have tried my best to express what all he has been through, but honestly it is hard to even convey some of into words.

Timeline/Detailed Summary:
Josh’s journey in his fight against cancer began in the summer of 2017. After dating for nearly 7 years, Josh finallyproposed to me on May 21, 2017. We were both so happy and life was going seamlessly. Josh had just finished his second to last semester at UTK and was working as a summer intern at the UT farm. He was getting ready to start his last semester in the fall to finish his B.S. degree in Agriculture, a degree that had been hardly sought after during the previous 5 years due to changes in career interests. I had just finished pharmacy school and was getting ready to take the pharmacy board exams for licensure in anticipation of starting my dream pharmacy residency program at UTMC on July 1st.

​In early June, after working several long hours at the UT farm, Josh noticed severe lower back pain as well as groin pain. He also noticed a testicular mass. After telling me about this, I was absolutely terrified because Josh’s older brother had just been diagnosed with testicular cancer about 18 months prior. Josh did not want to go to the doctor to have it checked out as he was afraid that it was testicular cancer. After convincing him, we went to the UT Student Health Center that afternoon. They referred Josh that same day to UTMC to get an ultrasound and to see a urologist. The urologist confirmed that this was most likely testicular cancer and that Josh would need an orchiectomy. Josh then had his procedure on June 27th.

​After Josh’s procedure, it took him a few weeks to recover back to normal. A couple weeks after his procedure, I noticed he was coughing and it was increasing. He already had a CT scan scheduled for 1 month after his procedure. I called his doctor and got the CT scan moved up on the schedule as I was concerned that this could be a sign of metastatic testicular cancer. Josh had his CT scan and we did not get the news we had hoped for... Josh had multiple masses in his lungs. The odd thing though was that Josh did not have any masses in what they call the retroperitoneal (abdomen) area. This was apparently very uncharacteristic of testicular cancer. Josh was then referred to an oncologist. The oncologist recommended immediately starting chemotherapy. We were hesitant though based on his presentation and wanted to have a biopsy done first to confirm due to the uncharacteristic nature of his scan.

Josh then underwent a lymph node removal and bronchoscopy (video taken of his lungs) for visualization of his nodules and for biopsy in early August. The biopsy results returned as negative for cancer, but indicated granulomatous tissue. The oncologist thought this could likely be a lung disorder called sarcoidosis. The plan at this point was to follow the nodules and to repeat a CT scan in a month. The repeat scan showed similar results, with slightly larger nodules. Josh’s oncologist was beginning to think that this could perhaps be both sarcoid and cancer. Josh then went to Vanderbilt at the end of September for evaluation with a testicular cancer specialist. The specialist was also under the same impression, that cancer was likely playing a role. The plan was just to continue to monitor at this point. During this time, Josh began to have increasing pain in a lymph node in his groin. We went back to his urologist who confirmed that this was likely a testicular cancer recurrence. He had also been referred to a pulmonologist regarding the sarcoid vs cancer work up. The pulmonologist recommended to have another biopsy. This time a cutaneous, needle biopsy of Josh’s lung was performed into the largest mass seen on the CT scan a few days after Thanksgiving. The next week in December, while awaiting the pathology report of the biopsy, Josh had a PET scan. We got the results of the PET scan and lung biopsy a couple days later. The biopsy came back positive for metastatic testicular cancer, while the PET scan was positive for metastatic disease in his lungs and in his groin lymph node that was causing him so much pain.

At this point, it was super clear that Josh did still have cancer. His oncologist wanted to start chemotherapy ASAP. During this entire time, Josh had still been taking classes at UTK. His graduation was set for December 15th, and luckily Josh was able to walk across the stage to get his diploma. The next week Josh went to UTMC for an outpatient procedure to have his port placed so that he could have his chemotherapy administered. While there, the doctor noted that he had a fever. Josh had also been complaining of increasing lung pain, but we just figured this was because his lung masses were growing. The doctor decided to get a chest X-ray. The x-ray revealed that Josh had a totally collapsed left lung. The collapsed lung was likely due to the biopsy that he had a few days prior. Josh was then admitted to the hospital that night at the end of December to be monitored and for oxygen support. That morning Josh’s repeat x-ray showed his lung was still collapsed so the decision was made to place a chest tube. The physician also went ahead and placed his port the same day to avoid an extra surgery. Josh was in extreme pain with the chest tube in, but luckily it worked. After about 24 hours of being in, Josh’s lung reflated and the chest tube was removed. Josh was discharged home on December 29th with plans to start chemo after the New Year’s Holiday on January 2nd.

Josh started his chemo on January 2, 2018. His regimen was planned to be a 3-cycle regimen. Each cycle consisted of 1 week of chemo (“on” week), followed by 2 weeks off to allow the good cells time to recover. His chemo regimen consisted of bleomycin, etoposide, and cisplatin. Two days into his chemo therapy, Josh awoke complaining of increasing shortness of breath and was wheezing. I was super concerned that he could have a blood clot in his lung or maybe another collapsed lung. When he went in for his chemo treatment, they immediately sent him to the Emergency Department. Josh then underwent a full day of work up in the ED, being poked and prodded for hours. His CT scan did not reveal any blood clots, which was good news, but it continued to show the nodules were growing and likely making his breathing hard. They decided to admit him that night for observation. The next morning Josh’s oncologist came to see him and made the decision that Josh’s symptoms were likely due to the chemotherapy working. It was likely inflammation from the chemo starting to work and breaking up the masses. He wanted Josh to return home and finish his 1stcycle of chemo the following week.

Josh continued his chemo over the next two months (2 cycles). A few days after each cycle is when Josh would feel the worst. A few days after the first cycle, large clumps of his hair started to fall out. He did not immediately cut it, but after finding large clumps of hair on his pillow after sleeping, he decided to shave it. This was a super hard day for Josh as he has always had longer, flowy hair. We all agreed that he could totally pull off the bald look though. With each chemo cycle, Josh also had no appetite, was always nauseous, and was starting to have increasing ringing in his ears. After the second cycle, he was referred to an audiologist. It was determined that he was likely experiencing hearing loss from one of his chemo drugs, cisplatin. In discussion with Josh’s oncologist we decided that the benefit outweighed the risk since 3 cycles are necessary to treat metastatic testicular cancer. We decided to slightly reduce the cisplatin dosage to help prevent this side effect. Luckily, Josh’s ringing in his ears subsided and his hearing loss did not progress any further. During his second cycle, Josh met the head coach of the Lady Volunteers basketball team at the chemo infusion center. She was there greeting all of the patients. She was so intrigued with Josh’s positivity and his energy, that she invited him to the basketball game the following Sunday to be the guest coach. Josh was recognized at the game as the guest coach during cancer awareness week. Josh finished his last cycle of chemotherapy at the end of the March and was able to ring the infamous bell at the infusion center that day to celebrate.

The plan at this point was to wait a few weeks to allow the chemo to continue to work and hopefully kill off all the cancer cells. Josh’s mass in his groin area had shrunk considerably at this point, but still needed to be surgically removed. He had this procedure in early May. A few weeks later he had his repeat PET scan. The results were really good! Basically, all cancer cell activity was either zero or extremely low. Quite a few of the lung nodules still had some cancer activity, although it was very low. The decision was made to recheck a CT scan in a month to see if the nodules continued to shrink. This scan showed the nodules did continue to shrink, but were still there. At this time, Josh’s oncologist recommended surgical removal of the remaining masses to ensure that all cancer was removed. Josh’s oncologist then referred him to a CT surgeon. The CT surgeon recommended a thoracotomy to remove all remaining lung nodules in Josh’s right lung. Only one lung can be operated on during one surgery which is why both lungs weren’t done the same day. It was explained to us that this was one of the most painful procedures anyone could ever have and that it was quite dangerous. We scheduled the surgery very nervous, but knowing it was the next step. Prior to the surgery, Josh had pulmonary function tests to determine his baseline lung function. The results were not good. Josh’s lungs were only functioning at 50% what they should be. It was determined this was likely due to his cancer and also to the bleomycin drug that he had received.

Josh underwent cardiothoracic surgery on August 28, 2018. This was the scariest day of my life. He went in for surgery around 8AM. It was supposed to last around 4 hours, but it took 6 whole hours. After the surgery, the CT surgeon explained there was one mass that was actually attached to Josh’s diaphragm that took extreme care to remove. Several lung nodules were removed and sent for biopsy. When Josh returned from surgery, it was the most excruciating pain he had ever been in. He had another chest tube placed to remove the fluid and blood from his lung from the surgery. He ended up staying in the hospital for only 3 nights, which was a very quick recovery for this type of procedure. The recovery was super long and hard. Josh could not even get up without someone to help him. Every time he coughed, it hurt him super bad. He truly is the strongest person I know and I am amazed at how quickly he has recovered. We are now about 4 months out from surgery and he is just now approaching his baseline strength that he had prior to the surgery.

Josh had another CT scan about 1 month after his procedure which showed the nodules continued to shrink in his other lung with no further nodules in the lung where he had the surgery. Overall, Josh had ~20 lung masses excised and biopsied. The pathology report was really good. Out of all 20 masses, only 2 were cancerous, the rest were all granulomatous again. The 2 cancerous nodules were a type of cancer called teratoma, which was a good sign. There are basically 2 types of cancer, teratoma and embryonal. Embryonal responds well to chemo, while teratoma does not. Since his nodules were teratoma, this was a good sign that the chemo had killed off all the embryonal cancer. Teratomas grow extremely slow. With this in mind, the CT surgeon and Josh’s oncologist recommended “watching and waiting” the remaining nodules in his left lung as it is possible what remains is all granulomatous tissue, again signifying likely sarcoidosis. At this point, Josh is scheduled for another CT scan next month to continue to monitor his lung nodules. Since his pathology showed no embryonal cancer, he got to finally have his port removed! He also finally got the ok to begin looking for jobs so he is officially on the job hunt for his first job to kick off his long-awaited career in agriculture.

At this point in time, we still don’t know what the future holds. I mean who does though?  We know that Josh still has nodules in his left lung and we hope that they aren’t growing. We also know that he still has sarcoidosis which also holds an unknown future.  I think what we have both learned from this experience is to cherish every day you have as you never know when your life will change, and when it does change, it tends to do so instantaneously without warning. I am still in awe with how Josh has handled this entire process. He has remained strong and never wavered from his faith in God. He always says that God has been the one getting him through all of this and that he knows God put him through this for a reason. He is determined to share his story with whoever will listen and whoever needs to hear it. He frequently goes to the cancer center to talk with other patients who are still undergoing treatment to provide them some encouragement and someone to talk to. We ask that everyone continue to pray for Josh’s health. It is still a very unknown situation. Please pray that we remain strong in our faith no matter what comes our way.
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Organizer and beneficiary

Shauna Winters 
Knoxville, TN
Kimberly Keller 

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