Male Breast Cancer

male-breast-cancerMale Breast Cancer is a rare disease. In Ireland the lifetime risk of being diagnosed with breast cancer is about 1 in 1,000.

While you may be thinking: Men don’t have breasts, so how can they get breast cancer? In fact the truth is that boys and girls, men and women all have breast tissue. The various hormones in girls’ and women’s bodies stimulate the breast tissue to grow into full breasts. Boys’ and men’s bodies normally don’t make much of the breast-stimulating hormones. As a result, their breast tissue usually stays flat and small. Still, you may have seen boys and men with medium-sized or big breasts. Usually these breasts are just mounds of fat. But sometimes men can develop real breast gland tissue because they take certain medicines or have abnormal hormone levels.

As part of the Pink Edition of the RTE Guide for Breast Cancer Awareness month 2016, Stephen Smith speaks about his experience with the disease.

“Only 1% of all diagnosed breast cancer is in men as far as I know” says Stephen Smith, “although my doctor told me recently that he’s seeing more of it in men”

The engineer from Celbridge in Co Kildare became one of those unlucky few in 2009, when he was diagnosed with infiltrating ductal carcinoma. Ironically, he hadn’t been feeling sick beforehand indeed became a gym enthusiast three years earlier, prompted by the arrival of his 40th birthday.

“One evening I was brushing my teeth and my wife said, ‘What’s wrong with you left nipple? It’s inverted.’ I said so what, but she said it was a bad sign, it could mean breast cancer. Women know these things. And I did have a lump on the left side of my chest, the size of a walnut but it wasn’t sore.

“So I went to mu GP the next day. He said he’d like a specialist to take a look at it. The day after that I saw a breast surgeon who said he’s like to do an biopsy.  It all happened very quickly, bang bang, bang. They rang two days later and asked me to come in. That’s when they told me: infiltrating ductal carcinoma, that’s the technical term.

Stephen admits that such news “takes you back a bit, hearing something like that.” But, he adds, the very next sentence from the specialist was crucial: “He said, ‘It’s very treatable.’ That was important from my point of view. I’m an engineer, I have a practical approach to life and as soon as I heard we could fix this, I was okay.

“What really brought it home was telling other people about the diagnosis: my wife and family. They were nearly more upset than I was. You don’t expect a 43-year-old to be telling you something like that.”

The following week, ten days after first going to the doctor – “It was all very swift, ” he recalls now – Stephen had surgery.

“I also had to have a second surgery,” he says, “because when they tool out the tumor, they found it had drained into other lymph nodes. If cancer gets into your lymphatic system, it can transfer to anywhere in the body: lungs or kidneys. So as a precautions they went in again and took out all the lymph nodes under my left arm.”

This was followed by six sessions of chemotherapy, then 30 sessions of radiotherapy. Stephen was also put on the cancer drug herceptin for about a year. He describes it as “similar to chemo, but not as aggressive and more targeted – it’s very effective.”

The chemotherapy, he says, was tough going: “There were three week gaps between sessions. Chemo slows you down, your immune system is slowed down: my hair fell out, it messes with your digestive system. You don’t feel great!”

There was a further complication as a consequence of the second surgery on his lymph nodes. “It lead to swelling, which is a common enough thing. So now I permanently have a compression sleeve on my left arm, which presses the lymph fluid back into the body. But it’s not too bad, it’s been well manages over the years and  I went through quite intensive physiotherapy afterwards.”

Looking back now, seven years “in the clear”, he laughs wrily about the fact that his cancer arrived soon after he adopted a healthier lifestyle. “The funny thing is that there’s a gym at work and I’d always be walking past it, never going in, but when I turn 40 I thought I’d better start using the gym and looking after my health. So I’d go in every day, nothing extravagant, maybe the cross-trainer for 30 minutes. Then just a few years later, my surgeon was telling me that apart from the cancer, I was really healthy! He said that would really stand to me and make me resilient during the treatment, although I was out of work for about a year.”

These days, Stephen goes to both his oncologist and surgeon once a year. There is a very, very small chance of the cancer returning – a survivor is never completely clear. “But” he adds, “I’m nearly eight years on now – that’s pretty good. And I guess anyone can get sick at anytime. I’m a reasonably positive person, I’d have an optimistic outlook; I just get on with it and live my live.”

While life goes on, Stephen accepts that something like this will inevitably affect a person. He says, “For a few years afterwards, I thought about it more than when I was actually going through it. When you’re in the moment – there are things to do, you have to make sure to be there for your scans, take your tablets, do whatever. The mechanics of it. It’s only afterwards, when it’s receded into the past that you think, “Janey mac, that could have killed me.’ It starts to prey on you a little more.

“But I suppose it does feel like I’ve had a second chance at life. I certainly enjoy things more, the little things. You look at the sea coming in , simple things you mightn’t have thought were important, ant they do resonate a bit more. You appreciate them.”

Article was originally published in RTE Guide October 8-14 edition 2016. Interviewer Darragh McManus.