Tom's cursed. He wants to die. Tom never gets what he wants.
More seriously, the dudes immune system has been exposed to every festering biome one could imagine. He eats copious amounts of dumpster delights, to the point he's a fat shit. He's a parasite on two legs, and survives on minimum effort. He's got another 5-10 years left, bare minimum.
It's as other people have said. It's one of the cruel indifferences of the cosmos that the cockroaches live long while the good die young. A shame, but not even tooter is immortal. Until then let's watch his pathetic gaffes through life, incompetent anger at everyone around him, incontinent bowel control as he shits himself and the floor, and his increasingly muddled mind degrade further. It's certainly a fascinating study.
Maybe this surgery he claimed turned his ovaries into testicles was actually a highly experimental surgery to combine human and cockroach DNA.
While it seemed initially successful, a race of cockroach-human chimeras, essentially a race of Tommies, was deemed pointless if the idea was to preserve the best, or even just the mediocre of the human race.
For a pedophilic dogfucker who has rapidly denying health, it's unbelievable that this cockroach still is alive and kicking like a pest.
He's so undeserving and undesirable for Heaven or Hell. Satan or God will refuse to take him because of how he was. Nobody would ever dare to touch the cockroach stink, junk-hoarding, pedophilic, dog-fingering old bastard.