After a lifetime of struggling with the devastating long-term effects of childhood cancer, Dave Cassar admits he was close to giving up.
“I just thought, this is no way to live,” the 42-year-old said.
In 1978 when he was just 10 weeks old, Dave was diagnosed with neuroblastoma.
“It was stage two and basically right in my pelvis. It was attached to a hernia and my bladder and right epididymis – they took all of that out,” Dave said.
After the surgery came a year of chemotherapy, which finished when Dave was 15 months old.
The aftermath of cancer treatment
Although Dave had survived, it soon became clear that, like many childhood cancer survivors, he had not escaped unscathed.
“I had a lot of blood tests as I grew up and they told me that it was a very good chance that I would be infertile,” he said. “I was basically in a bit of denial and trying to avoid it. I really wanted to pretend it didn’t happen and that I didn’t have any problems.”
“It also affected my testosterone – it was always a little bit lower than it should have been.”
Growing up on a farm in country NSW, Dave never felt quite comfortable in his own body.
“I kept it hidden – my direct family knew, but I didn’t really tell anybody else. It felt like a weakness to have lost my fertility – it was a very uncomfortable thing that I kept really tight to my chest,” he said.
“Growing up, the psychological effect on me was as bad as anything else. I hated school. I preferred to be at the farm by myself, away from people.
“In high school I left school and did a trade, which was probably me escaping from everyone else maturing.”
Despite everything, Dave managed to build up his self-esteem as an adult.
“I somehow managed to build up a rock-solid confidence by telling myself that I could do anything, and I used to ride and race motorbikes, which gave me so much confidence,” he said.
I think the impact would have been so different if it happened to me as an adult – I would have had more resources to deal with it, it wouldn’t have been the only thing I’d ever known.
– Dave Cassar
Renal cancer diagnosis
Then, when he was 35 years old, Dave was diagnosed with renal cancer.
“That’s when everything changed and I had to go under hormone replacement therapy for my low testosterone,” he said.
“I was feeling dreadful. I basically couldn’t go on.”
Like many survivors who go through cancer as young children, Dave didn’t know where to turn.
“I needed to address it like a well-informed adult and because I felt so bad from the testosterone deficiency and I wasn’t getting the right help, I just couldn’t. I had to find a psychologist because nothing worked,” he said.
“I think the impact would have been so different if it happened to me as an adult – I would have had more resources to deal with it, it wouldn’t have been the only thing I’d ever known.”
Embracing a new life
Struggling physically and mentally, Dave reached out to the long-term cancer effects clinic.
“The oncologist said they needed to fit me into the clinic. We kept in contact via email until there was a chance for me to get into the Re-engage program,” he said.
It turned out to be the best thing he could have done.
“It changed my life completely; I wish I had done it sooner,” Dave said.
“There were such awkward topics that I had tremendous difficulty discussing with someone else, but she could navigate it so well. She was pre-empting things that I was feeling. She was expecting me to have different things that I did actually have.
“Every bit of contact I had, I became much more comfortable talking about the subject to medical professionals, and then to the psychologist and my family, and I started to be able to speak a lot more smoothly about my experiences.”
Through the program, Dave was referred to an endocrinologist, who was finally able to provide him with the right treatment.
“The difference is tremendous. The referral to the endocrinologist changed my life,” he said.
“My relationships completely changed – my parents and my partner say they’re so happy I can finally talk about it. The Re-engage program gave me the ability to acknowledge and admit it, and deal with it.”
“If it wasn’t for my oncologist, my GP, the Re-engage program and my psychologist, I wouldn’t be here.”