Devon Choi had a great job, a terrific group of friends, and had just run the Boston Marathon – the first of six 26.2-mile races he hoped to complete in major cities around the world.
So, when the East Boston resident felt a lump on his left testicle while showering in May 2023, he shrugged it off. Choi was 25 years old and in terrific shape. How could there be anything seriously wrong with him?
“I joked with a couple friends that maybe I had testicular cancer, but mostly I kept it to myself,” recalls Choi, now 27. “Looking back, maybe I was in denial. I was young and strong and had been healthy my whole life. It was easier to ignore it.”
Only when he felt the lump again a month later did Choi decide to get it checked out. He found a urologist, had an ultrasound and bloodwork, and learned he had elevated tumor markers in his blood. The urologist told Choi that while these proteins are often a sign of testicular cancer, only a biopsy would confirm it. On July 11, 2023, Choi had surgery at a general hospital in which his left testicle was removed, and a biopsy was conducted.
The doctor’s suspicions were right: Choi had stage III testicular cancer that had spread into his lymph nodes. While testicular cancer is still very curable at later stages, aggressive treatment would be necessary. Offered a choice of more surgery or chemotherapy, Choi wasn’t sure what to do.
This was when a sibling – and serendipity – entered the picture.
The right choice
Choi’s parents lived in Hong Kong, where he had spent most of his childhood. His sister Stephanie, however, was a medical school graduate then doing a research fellowship in Boston. She encouraged Choi get a second opinion on next steps from specialists focused on testicular cancer and suggested him to the Lank Center for Genitourinary Oncology at Dana-Farber.
From the moment he arrived at the Lank Center and met oncologist Michael Serzan, MD, Choi felt confident he was in expert and empathetic hands.
“What makes Dr. Serzan phenomenal is his ability to communicate,” explains Choi. “He showed me all the possibilities, explored them with me, and gave me the comfort and confidence that I could make the right choice.”
After weighing options with his sister and Serzan, Choi elected for chemotherapy, which has a high success rate for patients with testicular cancer. During the course of three months in 2023, he underwent four cycles of outpatient treatment at Dana-Farber Cancer Institute – Chestnut Hill. Chemotherapy, however, can permanently affect fertility. Because he hopes to one day have children, he banked sperm through the Adult Oncology Fertility (Oncofertility) Program at Dana-Farber.
The chemotherapy regimen included five consecutive days of infusions every three weeks, plus every other Monday. Choi grew exhausted after the first 21-day cycle and had to stop running between them. He spent the time between the remaining cycles on his couch battling headaches and nausea, but the treatment was successful.
“Within just a few weeks, we saw evidence that combination chemotherapy was highly effective at eliminating the metastatic testicular cancer cells,” says Serzan. “Throughout the treatment journey, it has been our privilege to witness Devon’s determination to achieve a cure for his cancer and raise awareness in the community.”
A few of Choi’s lymph nodes were still enlarged after chemotherapy, which left him with another decision to make: his care team could monitor them through regular scans or Choi could have them surgically removed. Feeling it would give him more peace of mind, Choi worked with Serzan to find a team at Dana-Farber that performed a minimally invasive robotic surgery known as retroperitoneal lymph node dissection to remove the affected lymph nodes.
A few weeks after the February 2024 procedure, Choi was going out with friends. By that spring, and to his relief, he was also able to run – slower, but relatively pain-free.
Combatting the stigma
His cancer journey has given Choi a new perspective on life as well as a heightened sense of determination. Running six of the seven high-profile and highly competitive Abbott World Marathon Majors (WMMs) has gone from a bucket-list item to a non-negotiable goal.
In October 2024, with his clinical team’s blessing, Choi ran the Chicago Marathon. He sent Serzan emails and photos before and after the race, which proved a far different experience than the Boston Marathon.
“It was a tough race, but I kept telling myself that if I could get through chemotherapy, and surgery, I could get through this,” says Choi. “That was my reference point to keep moving forward, and in the end, I actually wound up with a faster time than in Boston.”
Still cancer-free after more than two years, Choi has since also completed the Tokyo Marathon, leaving Berlin, London, and New York to finish his WMM dream. He has a new job in medical equipment sales as well as a girlfriend who is halfway through her own WMM list. They hope to complete it together.
Advocacy has become another important part of Choi’s life. He knows that the stigma around testicular cancer is one reason he did not seek treatment earlier, and that when he did so, he was lucky the cancer had not metastasized beyond his lymph nodes. Choi is thus sharing his story and encouraging other young men to practice self-exams and take quicker action if they feel a lump.
“We’ve done a good job in our society talking about being proactive with breast cancer screening and self-exams, but I think we should focus that same attention on testicular cancer,” says Choi. “Testicular cancer is most prominent in males aged 18-30, who are in college, dating, and starting to get jobs. They don’t want to think about it or deal with it, but they need to know it’s important to check themselves regularly and have the courage to act if they find something.”