The family, friends and medical professionals surrounding a teenager who was diagnosed with testicular cancer in January are commending his bravery.
Fletcher Hawkesby was just 17 years old when he was diagnosed with the disease.
His mother Gretchen Hawkesby said she acted immediately. "He said to me, 'mum, I have a lump — could you make me an appointment for me at the doctor?'
"I rang and they said to come in the next day. I sent him in by himself because I thought it was something hormonal but the doctor said he needed to have an ultrasound, and when he gets his results back he'll need a parent to be present with him."
Gretchen, a mother of four and daughter of Kiwi billionaire Graeme Hart, told 1News that in the space of a few days her son had had his left testicle removed.
"None of us had time to process what was happening," she said.
"We have just been running on what we've got. Fletcher had one really wobbly day and then he's just been amazing."
First line response is removal
Testicular Cancer NZ chief executive Peter Dickens said the first line of treatment is to remove the testicle.
"It's quite challenging — but the body is a wonderful thing. The remaining testicle will take up all the work of the other one," he said.
Despite it being a severe first line response, he said it's the way to "excise the cancer straight away".
"That's where the cancer is and it's treated just as you would with breast, prostate or lung cancer," he said.
Fletcher was due to start his first year at Otago University, where he's studying towards a Bachelor of Commerce. He was able to do the orientation week and had six weeks of the first semester in Dunedin. But by the end of March, just after his 18th birthday, the cancer markers were back up again.
The week before, the entire family got together to celebrate Fletcher's birthday. His older brother, Miller, who is studying in the US, was also able to be there.
"The family flew down to Dunedin to celebrate his birthday. My eldest was in town with a bunch of uni mates from the US, it was both sets of grandparents and all the siblings," Gretchen said.
"It was really memorable because we got to see how happy he is down there. He'd settled in and made a bunch of new friends."
But the following week, life looked very different.
"He had a CT scan which showed there were 6-7 nodes of cancer in his lungs," Gretchen said.
Fletcher then started his first round of chemotherapy on Easter Monday. He's now had nine weeks of chemo.
Gretchen said Fletcher had more blood tests yesterday and will have another scan next week. Then the wait for the results begins.
"That will show the lungs are clear hopefully."
She said Otago University has allowed him to study remotely in Auckland.
"He's really tired but still studying and has three exams in the next two weeks."
Gretchen said his friends have been "amazing" and Fletcher is hoping to start semester two back in Dunedin to see them all again. He'll also have his older sister, Jemima, who is also studying at Otago, supporting him.
"He's got amazing friends who have been flying up to visit. We've had more cookies, brownie and flowers in the house than we've ever had," Gretchen said.
A family with a heart for health
The Hart family have been involved in health philanthropy for years. Gretchen worked on the board of the Starship Foundation for 12 years. Her parents, Graeme and Robyn, recently made a $6.5 million donation to Starship. They have also donated to the Testicular Cancer NZ charity.
Starship Hospital will always hold a special place in the Hawkesby and Hart family.
"One of our friends' children, Frankie, died there just over a month ago," Gretchen said.
"She was diagnosed with an inoperable brain tumour — she was eight and died four months later, when she was nine."
The families go back a long way.
"Her mum Marielle was Fletcher's babysitter when he was six-months-old," Gretchen said.
"Frankie was in Starship and Fletcher had visited her there — he had a picc line in, she had a picc line in, and he gave her a little kiss to say goodbye.
"It was quite confronting for him, he felt guilty that he was going to make it and she wasn't."
Fletcher's journey is also personal for Dickens. His son and Fletcher were in the same rowing team together at Auckland Grammar. Dickens got in touch with the family when he heard about Fletcher's diagnosis.
"He reached out when he heard Fletcher's testicle had been removed — I didn't realise that was his role until he got in touch," Gretchen said.
"He said if you need any support we are here."
Gretchen said the people in the medical community who have helped out "have been incredible".
"Last week on Wednesday, Fletcher woke up really unwell at 3am and he ended up being diagnosed with norovirus. He was 24 hours in hospital with a drip and that was quite a scary time," she said.
"He had to go to acute oncology at Auckland Hospital because chemotherapy lowers your immunity. When you are being treated with chemotherapy, any kind of infection can take you out."
She said at his height of 6 foot 3, he didn't fit in the hospital bed, "so the nurse went out and got him a bigger bed".
Teens encouraged to check regularly
Dickens said testicular cancer isn't a disease that can be picked up by screening.
"So you have to wait for symptoms to show up. It could present as a painful lump on your testicles," he said.
The disease is primarily found in younger men, between 18 and 44 most commonly. "The main message is for young men to get to know their testicles and to check them once a month in the shower," Dickens said.
"If they do, treatment for testicular cancer is more than a 95% treatable rate."
He said it's important for young people to have a trusted adult they can go to if they have a health issue, particularly if it's an embarrassing one.
"Around 175 men are diagnosed with the disease each year. And eight will die. The longer it's undetected, it can spread quite rapidly.
"It's really important they seek medical advice as soon as possible," he said.
He said the next line of treatment, chemotherapy, has "a really high cure rate".
"Obviously it's incredibly challenging, so we provide free counselling to men across the country affected by testicular cancer and a nurse-led 0800 information service that men can call."
Dickens said welfare grants are also available to those who have experienced hardship following a diagnosis.
"All of these services are possible because of donations to our charity."
For information and support visit the Testicular Cancer NZ site or call 0800 735 343.
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