The embarrassment that can be a killer

He loved food, the preparation and cooking of it, and already looked to be well on his way towards achieving his dream of becoming a top chef.

James was 18 with his whole life opening up in front of him and he had already charted a career path for himself. He was in the third year of a course at North West Regional College and he worked diligently and creatively towards making the most of his gifts. The last photograph taken of him in hospital, just hours before he had to be moved into the intensive care unit, shows him sitting up on his bed, watching a cookery programme on TV.

In many ways he was a typical teenager, full of vitality and in love with life and football, but still probably a little shy at times. Boys can be especially like that, of course, when it comes to situations they think might embarrass them. And therein lies the danger, when a rare cancer can strike in a private part of the body.

The teenager liked to be involved with the youth centre in Strathfoyle, where he was very popular and had many friends.

But when it came to the discovery of a lump on his testicles, the embarrased young man said nothing - neither to family nor his closest friends. Instead, he simply hoped that it would go away of its own accord.

By the time his parents found out about the lump, James was in a Belfast hospital where his life would end - just six weeks after his discovery that something was not right in his body.

Towards the end, everything happened in the space of six days.

“The first I knew was the early hours of the Wednesday morning. The Thursday before he found out, he went to the Waterside health centre. He lost two and a half stone in three weeks. He lost another half stone by the Monday. They asked him if he had any lumps or bumps and he said he hadn’t.

“They thought he had an overactive thyroid gland,” said mum, Angela.

He was given medication but continued to get worse.

“One day I went out and came back and he was throwing up bright red blood. We were told to take him to Casualty and were there for 13 hours. They found he had tumours in the lungs.”

James was taken to the acute medical department where something had shown up on the X ray.

Angela recalls: “They said for a young person of that age it could only be coming from one place. They did scans and tests and on Wednesday, at tea time they said he had an aggressive form of testicular cancer.”

His father, David adds: “It’s generally treatable; if it’s treated in time there can be a positive outcome if they find something and do something about it. Even when he was transferred to Belfast, they thought it was curable. Lance Armstrong is evidence of that. In his case, it had spread to his lungs and brain.”

James finally admitted that he had known of a lump on his testicles but told his mum: “How was I supposed to tell you that?”

His mother responded: “I told him I could have taken him to someone who would know about these things,” but he just said; ‘I thought it would have gone away’.”

Such was the aggression and rare form of the cancer that, when James died, he was surrounded by the hospital consultant Dr McAleer, and 12 junior doctors.

“Dr McAleer was fantastic,” says David. “There was nothing that could be done, the tumours were massive.”

At 3.30pm on June 14, 2010, the 18-year-old lost his fight for life. It had all happened so quickly, lasting just six weeks from when James first thought he had found a lump, to his death.

His mother explains: “He was diagnosed on the Wednesday and went to Belfast on the Thursday. He took bad on the Sunday night. I was taken into a side room and was told he was critically ill. They transferred him to the main unit and said the next 24 to 36 hours would be critical.”

His father says: “We had always expected that to happen, that he would have to go to the ICU at some stage, so this wasn’t unexpected. But James deteriorated in a matter of a few hours.”

David continues: “It’s every parent’s worst nightmare. He didn’t speak to me about it either. Not once did he say anything about his health. It started so quick and ended so quick. We miss him like crazy.

“I would tell any young person that if they find something on their body that they are not familiar with, go to the doctor’s. And if they don’t want to talk to their family, talk to their friends.”

Such was the devastating effect on the local community, that James’s death prompted others to launch an educational programme to encourage young men to check themselves for the possible signs of testicular cancer.

Noel O’Donnell helped set up the Jimmy B project in James’s memory.

Both parents, as well as James’s two brothers and two sisters, are fully supportive of the project which they describe as “fantastic”. To date there has been a football tournament in Strathfoyle and the project to promote cancer awareness has visited a couple of other centres.

Mr O’Donnell also hopes that it can be taken into schools.

Angela says: “They decided to do something so that young fellas wouldn’t be embarrassed and could talk to people if they needed help.”

Cycling great Lance Armstrong is someone who knows the pain of a testicular cancer diagnosis - and he also knows how important it is to be open with family and friends.

He knows how vital it can be to tell someone else if you have any concerns at all. He admits that the pressure to get himself checked out came from a neighbour that he had confided in.

Armstrong was later diagnosed with late-stage metastatic testicular cancer that had spread to his abdomen, his lungs and his brain.

Treatment left him without a head of hair or enough muscle mass to pedal his bike up a small hill. The experience left him alive and grateful, but certainly vulnerable and more than a little lost.

In spite of these circumstances, Lance won the first of seven Tours de France just a few years later. Armstrong describes the flurry of opinions, doctors, options and fears as “the desperation of diagnosis.”

He was still recovering from treatment when he founded the Lance Armstrong Foundation (LAF) - an organization born from his determination to ensure that no one go through that “desperation of diagnosis” alone.

He has told his story: “I was diagnosed with Advanced testicular cancer on October 2, 1996. I had ignored the symptoms for months; pain comes with professional cycling, so it was easy to dismiss the soreness in my groin, headaches and difficulty breathing.

“I reluctantly went to the doctor after my testicle had swollen to three times its normal size. I owe a lot to my neighbor—a friend and doctor who insisted I get it checked out. By the time I was diagnosed, the cancer had already spread to my lungs and brain, so it is fair to say I was in bad shape.

“Here I was, young and healthy and riding better than ever and, suddenly, I have cancer. I was worried about losing my career and, frankly, my life. I didn’t know how to tell my mom, and I was scared and angry.

“My mom and a core group of friends helped me spend countless hours reading information and asking questions. It’s really important, and I can’t stress that enough. You must be your own best advocate to be sure the treatment you are getting is best for you.

“I also think that a person with cancer needs to seek out support from friends and family. I had a group of people there for me—to listen to me, cheer me on or remind me that I wasn’t really alone. I was lucky to know that other people were invested in my survival; you can never overestimate the benefit of that kind of support and friendship.”

Thanks to James Bradley’s family and friends and the Jimmy B Project, that is the sort of message being taken to community centres and schools across the Londonderry area, so that young people will learn to take action when they suspect something is wrong with their bodies and never to let embarrassment force them into taking risks with their lives.