Good article here by Rubin
Steroid test has truly positive result Mets farmhand Emmanuel Garcia got early warning of cancer from PED screening
PORT ST. LUCIE, Fla. -- The moment he entered Triple-A Buffalo trainer Brian Chicklo's office, a grave sense of impending bad news overcame Emmanuel Garcia.
"I was like, 'What? Am I getting released? Did one of my family members die?'" Garcia recalls in his French-Canadian accent. "I knew something was wrong right away."
Chicklo handed the New York Mets farmhand an official letter from Major League Baseball informing Garcia he tested positive for high levels of human chorionic gonadotropin, which is illicitly used after an anabolic steroid cycle to jump-start the body's production of testosterone.
The following day -- on June 3, 2010, when phenom Stephen Strasburg's final minor league start would draw 14,744 fans in Buffalo, and a day after a dirty takeout slide had ended Daniel Murphy's season with the Triple-A club -- Garcia's 50-game suspension would be announced unless he appealed. His presumed guilt would be displayed nationwide in newspaper transaction wires, staining his reputation forever.
Manny Ramirez had been nabbed for alleged hCG use the previous year.
Garcia, who had manned shortstop in all seven of Team Canada's games at the Beijing Olympics before later converting to the outfield with the Mets, certainly looked guilty. A day before being confronted, in a weigh-in with Buffalo Bisons strength coach Kenny Powers, Garcia had exceeded 200 pounds for the first time in his life. Teammates noticed a pronounced difference in his appearance from spring training.
"I had added 15 pounds, but I really thought it was just by working out and eating," Garcia says.
"Jacked," Mets catcher Josh Thole, then a Buffalo teammate, labels Garcia's physique at the time.
The 25-year-old Garcia had only two alternate explanations. One was the futile defense that someone perhaps had spiked his twice-a-week protein shake.
The other possible explanation came to light after Mets minor league medical coordinator Mark Rogow, who had been visiting the Bisons at the time, quizzed Garcia about his medical history, specifically about his groin.
"Have you ever had an operation there?" Rogow asked.
"Yes, when I was 7 years old," Garcia replied.
Garcia told Rogow he had a surgical procedure to address an undescended testicle, and his family had been warned he had a 20 percent risk of testicular cancer later in life as a result. Rogow then offered testicular cancer as a possible cause of the test result.
"I told everyone, 'Listen, if I took anything, I will tell you right now. I'll do my 50-game suspension and I'll just serve whatever I deserve. But I didn't take anything,' " Garcia says. "Either way, I was sad. Right away, either I'm going to do a 50-game suspension and tear my reputation in baseball, or I have cancer."
Garcia does not know if his teammates uniformly believed him, but Thole says, "There wasn't enough time to say, 'Why did you do that?' Immediately he came back with the conclusion it could be a cancer thing."
"He just went to his computer and started researching, trying to figure out what was going on," says Mets infielder Justin Turner, Garcia's roommate at the time. "I felt terrible for him, and I wasn't even going through it. I couldn't imagine what he was going through. He was like, 'I swear. I didn't do anything.' I took his word for it, you know?"
Ultimately doctors concluded that the letter from MLB had given Garcia an early warning of the presence of a cancerous tumor. The diagnosis satisfied the Mets that Garcia had done nothing wrong, but it also greatly alarmed them; Sean Kimerling, who'd handled pregame duties for Mets telecasts on WPIX, passed away on Sept. 9, 2003, from testicular cancer at age 37.
The doctors believed Garcia's cancerous growth, known as a seminoma, had formed in his right testicle only about a month earlier, meaning it was detected very early. Even after learning of its existence, Garcia could not locate the tumor by touch.
He underwent surgery on June 23, 2010, in New York to remove his right testicle. Unable to walk comfortably the next two weeks, he recuperated in his native Montreal, under the care of his mother, Marie-Claude Garcia, and 21-year-old brother, Eric.
Garcia's mother, a guidance counselor and former top-10 junior tennis player, had emigrated from France to Canada two years before he was born. As a 20-year-old, she had lost her mother to breast cancer, and raised six younger siblings while her father worked as a contractor to support the family.
She had broken down when the call from her son came from Buffalo with the news, which he delivered in French.
"She started crying right away," Garcia says. "Even when I came home, I remember one time, she announced it to one of her aunts from France -- a [distant] relative. She was crying, really sad, because she didn't want to lose me."
Beginning Aug. 15, Garcia underwent daily radiotherapy treatments in Port St. Lucie for 30 days -- sitting on his back on a suspended table as a globe orbited his midsection and beamed a laser at his sides and back. He never experienced the fatigue that was predicted to overtake him with those treatments, perhaps because he's a professional athlete in his prime. As a result he requested, and was cleared, to take batting practice and work out in the mornings at the Mets' Florida complex. The month flew by.
Most members of the organization had not noticed, or had no clue why, Garcia had disappeared from Buffalo.
Garcia eventually returned to game action in the Colombian winter league, playing for Edgar Renteria-owned Caimanes de Barranquilla ("like the Yankees of that league," Garcia says).
Garcia is now back in Florida for spring training, and a CT scan and blood work came back clean Wednesday, signaling he has been cancer-free for six months. He played in a minor league game Thursday for the first time since he was diagnosed with cancer, as a DH in a Double-A exhibition game on a back field in Jupiter, Fla., against Florida Marlins farmhands. Teammates who were aware of his ordeal offered congratulatory handshakes. Others then inquired why.
Every six months for the next two years, Garcia will have a CT scan to ensure cancer has not returned. After that, annual blood tests will suffice. Garcia was told the recurrence rate is less than 5 percent. The average age of men affected by testicular cancer is 35. It is the most common cancer in young men.
According to Dr. Leonard Gomella, chairman of the Department of Urology at Thomas Jefferson University Hospital in Philadelphia, 8,000 to 10,000 men are diagnosed with testicular cancer each year in the United States.
Garcia's ability to have children will be unaffected, which delights him.
"Testicular cancer is one of the success stories in the battle against cancer," says Gomella, who helped treat ESPN analyst John Kruk for testicular cancer 17 years ago this month, while Kruk played for the Phillies. "Testicular cancer used to kill the majority of the men in the 1950s and the early 1960s. Over the last 30 to 40 years, we've learned how to treat it effectively. So now, 95 percent of men survive testicular cancer no matter what the stage is, no matter if it's early, or if it even spread.
"Of course, everyone knows the biggest example in the world is probably Lance Armstrong, who had one of the most aggressive types of testicular cancer. He actually had brain involvement. That's how aggressive it was. And he's completely cured and has gone on to six or seven Tour de Frances."
The random performance-enhancing drug test on Garcia had been conducted in April 2010, after Garcia broke camp with St. Lucie. That was a level below where Garcia thought he deserved to be assigned. After all, Garcia had played with Double-A Binghamton the previous two years.
"If I would have played in Double-A, I could have never found out about it," Garcia says, concluding the Binghamton testing might have been later in the year and he happened to be in the right place at the right time to be selected for the test. "It's just weird. To be honest, baseball just saved my life. I can say so, because I couldn't feel anything. The drug test really found it out."
Dr. Gary Green, Major League Baseball's medical director and a clinical professor at UCLA, estimates there have been fewer than 10 positive tests for human chorionic gonadotropin within the majors and minors in the last several years despite "thousands and thousands" of performance-enhancing drug tests annually of players.
While not authorized to speak about any individual player, Green adds generally that "maybe one or two" of those positive tests led to the discovery of testicular cancer, a positive if infrequent byproduct of a process designed to catch cheaters.
"I know that some other drug-testing organizations may have had one or two also that have happened," Green says, referring to the Olympics and other sports. "That's why whenever we see an hCG positive, before we discipline the person we recommend they get a full medical workup. … It is a complicated area, because people do take hCG to cheat.
"I've been involved with drug testing for probably more than 20 years," Green continues. "Drug testing is often portrayed in a negative light with accusations of false positives. It's nice to see a drug test that had a positive outcome."
As Garcia waited a half-hour last week in urologist John Nehme's office to learn if he had successfully passed the six-month mark cancer-free, he was getting unnerved.
"I'm really nervous," Garcia says, "because the next step, if it's not gone, I had to do really the big thing -- chemotherapy and stop baseball. So it was either that or I was healthy.
"He smiled at me and I knew right away.
"Actually, it was only 10 months of my life," Garcia concludes. "I learned about it in June of last year, and two weeks later I'm having surgery. The thing about that: It was a little bump in my life. It was an obstacle. What it did to me, it really made me think life could be short. I don't take anything for granted anymore. I'm really grateful for life now. Even my first spring training game [Thursday], I played that game like it was my last one."
Follow Adam Rubin on Twitter: @AdamRubinESPN
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