for post-operative chemotherapy. “But the gene test afterward showed that this was not a random cancer, but was caused by an aggressive gene [mutation] BRCA2.” BRCA2 and other genetic anomalies are inherited, and Don discloses that his mother died of ovarian cancer and his sister succumbed to cancer. In cases like these, oncologists do advise a follow-up course of chemotherapy and Don complied. While any cancer diagnosis comes as a shock, men in particular are surprised to learn they can be at risk for breast cancer. Nevertheless, their risk factors are much the same as those for women. According to Datko, inheriting a gene mutation like BRCA1 or BRCA2 is significant. Men with a strong family history of cancer among female relatives, similar to Don’s, may want to consider getting tested for the gene mutation. Other risk factors to men include having higher estrogen levels than normal, like in men who drink alcohol daily or who are obese, or having had prior radiation therapy to the chest. But Datko cautions, “It is [also] important to remember that many men diagnosed with breast cancer have no risk factors, just like in women.” Another important recommendation that applies as much to men as to women is do not try to go it alone. Regardless of age or gender, the support of friends, family or even a knowledgeable and willing advocate is vital to recovery. “It is very important for men to bring someone with them to at least the initial appointments with their surgeon and medical oncologist. These initial visits are long and can easily be overwhelming,” says Datko. Don describes the vital role his wife played. “She was great; she was the advocate for me. [Patients] hear all this stuff and … can’t catch everything the doctors are saying. Your brain is fogged up from chemotherapy and everything else. She kept asking the questions, keeping the doctors straight, getting me to appointments. You sure need an advocate; you can’t do it alone… I’ll say!” Physicians, as well as patients, stress the importance of support. While Don credits his wife and his “church family” as pillars of his support systems, others seek out support groups or patient advocates. Datko notes, “While in-person support groups for male breast cancer are rare, the internet has made it easier for men to STYLE 2017
connect with one another. One of my male patients really benefitted from Imerman Angels.” [http://www.imermanangels.org] Jonny Imerman, a survivor of testicular cancer diagnosed at the age of 21, knows too well the emotional upheavals that accompany rigorous cancer treatment. Since his recovery, he has dedicated himself to seeing that no one faces a cancer challenge without companionship. His organization maintains a database of thousands of volunteer cancer survivor mentors. Each cancer fighter is paired with a mentor who experienced the same cancer type. “[My patient] was connected by phone with another man across the country who had previously been treated for the same diagnosis,” says Datko, lauding this valuable resource. Also, the impact of diagnosis can trigger strong reactions in men, which may include denial, depression, anxiety and other psychosocial distress. Scott points out that these reactions can lead men to defer seeking timely treatment or to discontinue treatment before five years, often due to adverse effects like fatigue, sleep disorders, decreased libido and weight gain. “I know two other men who have had breast cancer,” Don says. “One is in remission but the other is in fatal stage IV because of not going to the doctor.” Don, a veteran of the Naval Air Force with a Vietnam medal, states emphatically, “I think the biggest barrier to men getting diagnosed and treated for breast cancer is they feel they are immune to this or somehow less of a man because they would get breast cancer. But it’s not true! This is a cancer; it doesn’t pick or choose. Cancer doesn’t care who you are … what color or sex or anything. Go to the doctor; you CAN get breast cancer!” Breast cancer oncologists applaud men like Don who spread this lifesaving message and help other men overcome any stigma they feel. Don knows firsthand that the fight against breast cancer “isn’t just something you do on the football field or in front of a television to make a statement. [You can’t] just say you’re doing this for the ladies. Warn other men.” Elissa J. Tivona is a busy journalist and academic. She has traveled internationally to present her work in peace and conflict stud- ies but is always grateful to return home to beautiful Northern Colorado where she lives, writes, and teaches at CSU.
Unfortunately male breast cancer tends to be diagnosed at more advanced stages than women. The most common stages at diagnosis for women in the United States are stage I and II, largely due to mammogram screening and awareness campaigns. Many men are diagnosed at stage III or IV, because many men do not report symptoms at first.
Farrah Datko, M.D.
Breast Cancer Medical Oncologist at UCHealth
Published on Aug 31, 2017