An enduring legacy

IU's testicular cancer expertise grows through a pioneering researcher and the lives he touches

Indiana University School of Medicine student Eamon Eccles plans to graduate in May with the goal of becoming a doctor and helping people through some of life's toughest moments -- a passion shaped by several of his own life experiences and time at IU.

At age 19, Eccles was an undergraduate student at IU Bloomington, spending the summer between his freshman and sophomore years practicing his golf skills in hopes of making the men's golf team, when he noticed a hard lump in his testicle.

He tried to ignore it, but the pain started to interfere with his ability to exercise and even move.

Eamon Eccles in his white medical coatView print quality image
Eamon Eccles. Photo courtesy IU School of Medicine

"I just went into denial about it," Eccles said. "Told myself, 'Oh it's fine; it's nothing' -- and the pain just became more and more debilitating to the point that I couldn't swing a golf club, and then I couldn't run, and then I found it harder to raise my left leg and walk."

When Eccles told his parents about his symptoms, they rushed to Bloomington to take him to the emergency room. His diagnosis was confirmed days later: testicular cancer.

"At the time, I thought I might die," he said. "I remember my parents both started crying -- and my dad does not cry. He's a rural, southern Indiana, don't-show-any-emotions guy. I just got very stoic, like 'let's do what we've got to do.' It was really emotionally draining, especially at the beginning with so many unknowns."

From death sentence to breakthrough

Testicular cancer is one of the most diagnosed cancers among young men. Decades ago, it was a death sentence.

But today, thanks largely to the pioneering work of IU School of Medicine physician-scientists, 95% of all men diagnosed with testicular cancer are cured.

Lawrence EinhornView print quality image
Dr. Lawrence Einhorn. Photo courtesy IU School of Medicine

One of those pioneers is Dr. Lawrence Einhorn, a Distinguished Professor and Livestrong Foundation Professor of Oncology at the IU School of Medicine.

Einhorn, who had attended IU as an undergraduate and to complete his medical residency, returned to IU in 1973 as the first oncologist on faculty. He was just shy of his 31st birthday.

He treated patients with all types of cancer, but he was especially interested in tumors that had shown some response to chemotherapy: leukemia, lymphoma, testicular cancer and small cell lung cancer.

The IU School of Medicine was a particularly great place to explore one of those interests further.

Young men with testicular cancer were flocking to Indianapolis' University Hospital, which opened in 1970 as a teaching hospital affiliated with IU. Patients arrived from around the United States because urologic surgeon Dr. John Donohue offered radical, heroic surgery that other doctors wouldn't even consider. He even managed to save 20% of patients whose disease had spread to the abdomen, but many of the patients he operated on still developed a recurrence.

Einhorn had an idea for how to treat testicular cancer and teamed up with Donohue to work with some of his patients -- beginning a partnership that would change testicular cancer forever.

Einhorn's idea involved an experimental drug. Cisplatin had been tested on a wide range of cancers as part of an early phase trial but proved to be ineffective and terribly toxic. It might have been permanently shelved, but Einhorn noticed that the drug was killing cancer cells in a very small subset of patients with testicular cancer.

About a year later, in 1974, that idea -- a new chemotherapeutic regimen using Cisplatin -- cured a patient with advanced metastatic testicular cancer, a medical breakthrough.

Einhorn's work didn't stop there.

In the decades that followed, he continued to refine the cure to spare patients some of the most awful side effects. He also substantially reduced the length of the treatment from two years in 1974 to a mere nine to 12 weeks today.

Cisplatin is now used in the initial treatment for 11 types of cancer.

Meanwhile, Einhorn remains the international expert on testicular cancer, and patients seek him out at the IU Melvin and Bren Simon Comprehensive Cancer Center from around the globe.

A pivotal connection

Eccles had been interested in medicine -- and specifically cancer -- long before his own diagnosis. He'd wanted to become a doctor since 2007, when Eccles lost both grandparents to different types of cancer while he was in the fifth grade.

"That was a really tough year for me and my family," he said. "I thought, 'I want to be a doctor to help people like my grandparents.'"

Thankfully for Eccles, his own cancer was caught early. Bloomington urologist Dr. Paula Bunde, an IU School of Medicine alumnus and adjunct clinical assistant professor of urology, performed surgery, essentially curing Eccles without the need for radiation or chemotherapy.

Afterward, Bunde called him with more good news: He was going to be referred to an expert physician at the IU Simon Comprehensive Cancer Center in Indianapolis as part of a five-year surveillance plan to ensure his cancer didn't return.

"She said, 'Have you heard of Dr. Einhorn?'" Eccles said. "'That's who you're going to be seeing up in Indy.'"

IU Simon Comprehensive Cancer Center exterior at dawnView print quality image
IU Melvin and Bren Simon Comprehensive Cancer Center. Photo by Liz Kaye, Indiana University

Eccles had. He'd learned about Einhorn and his cure for testicular cancer as part of a specialized undergraduate science elective on biological processes in cancer drugs.

The referral to Einhorn was a connection that Bunde went out of her way to make happen.

"Eamon was just a really neat young man, and he expressed at the time that he was pre-med," Bunde said. "I felt like this was a chance for this young, aspiring doctor to meet someone who is a pioneer in the field, and it would give him the chance to see if this is the thing he wanted to go on to do in the world."

The new patient-doctor relationship had the effect Bunde was looking for: It solidified Eccles' interest in oncology.

"I'm thankful Dr. Einhorn didn't send me to one of his colleagues," Eccles said. "Dr. Einhorn is a prolific, big-name doctor. Many other colleagues could've taken what was essentially a well-visit. He let me shadow him. It was an incredible experience."

Einhorn was impressed with Eccles as well.

"He was inherently bright," Einhorn said. "Eamon asked the types of questions a fellow would ask. I think the fact he had cancer made him a student of cancer. He expressed an early interest in medicine and oncology."

A bright future

Eccles recently returned to the IU Simon Comprehensive Cancer Center as an IU medical student to complete an elective clinical rotation.

One day, when a physician he was working with asked him to go see a patient, Eccles came upon a familiar place.

"I look at the door I'm about to go into to talk to this patient, and I just stop for a second, and it hits me that this was the first room that I was seen by Dr. Einhorn in when I was his patient," Eccles said. "Same clinic, same room. I was just on the opposite side of the door.

"I felt that same pit in my chest again, that I'd felt when I got diagnosed actually, and then really quickly I had to flip the switch and remind myself that this isn't about me. The patient that I'm about to (see), I'm sure they would appreciate hearing my story. But they have their own story."

Description of the following video:

I felt that same pit in my chest again that I’d felt when I got diagnosed, actually. And then, really quickly, I had to flip the switch and remind myself that this isn’t about me. The patient that I’m about to walk into, I’m sure that they would appreciate hearing my story, but they have their own story.

During the summer between my freshman and sophomore years of college when I was 19, I was actually playing a lot of golf and trying to work my way as a walk-on on to the IU men’s golf team. I felt a pull and I actually thought I had given myself a hernia. And, upon a self-check, I felt a really hard mass or a lump. And, at the time, I didn’t want to believe that it could be cancer. Because, at 19, you don’t think that that can happen to you. So, for lack of a better term, I went into denial about it — told myself ‘Oh, you know, it’s fine, it’s nothing.’ And the pain just continued to become more and more debilitating to the point that I couldn’t swing a golf club and I couldn’t run. And then I found it harder to raise my left leg and walk just because of the mass effect of it.

TEXT ON SCREEN: Eamon’s parents came to Bloomington and took him to an emergency room. Within days, his diagnosis was confirmed: testicular cancer.

So before I had ever been diagnosed with testicular cancer, I had actually taken a class at IU Bloomington called ‘biological processes and drugs’ through the Hutton Honors College. And an entire segment of that course was spent talking about Cisplatin, and how this doctor Lawrence Einhorn had developed this groundbreaking chemotherapy regimen that really transformed testicular cancer from a death sentence in young men to a highly curable form of cancer.

TEXT ON SCREEN: After a successful surgery, Eamon was referred to Lawrence Einhorn, M.D., at the IU Simon Comprehensive Cancer Center for follow-up visits.

So during my fourth year of medical school — actually just a few months ago — I was on an elective rotation at the Simon Cancer Center and I remember I was with a physician for the day and this physician had told me to go see a patient. I look at the door I'm about to go into to talk to this patient, and I just stop for a second, and it hits me that this was the first room that I was seen by Dr. Einhorn in when I was his patient. Same clinic, same room. I was just on the opposite side of the door.

So my experiences with cancer have definitely shown me and allowed me to experience first-hand how terrifying the unknown of a diagnosis can be. And I never want to compare my level of empathy with the level of empathy of any of my colleagues or any other physicians, but I know that personally, I know that the level of empathy that I can show to them now is infinitely more than what it could have been had I not gone through this experience.

TEXT ON SCREEN: Eamon remains cancer free and is on pace to graduate from IU School of Medicine in May.