Breast cancer a concern for men too

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SYRACUSE — When Jerry Greenwood felt a lump in his breast, he immediately assumed it was cartilage or a piece of bone from some minor, unrecognized football injury.

Maybe "a pimple that grew in instead of out," he conjectured.

He lived with it for months without mentioning anything, never even considering the possibility that he may have breast cancer. Eventually, he showed it to his wife who promptly took him straight to the doctor.

"I really think she saved my life because it did turn out to be breast cancer," he said Tuesday.

Still, it was hard for him to believe. He'd always thought it was a cancer unique to women, the female equivalent of prostate cancer.

"I was kind of breathless," he recalled of the 2004 diagnosis. "My first reaction was: 'I better get a second opinion because these guys don't know what they're talking about.' Then we settled down and the biopsy came back as cancer and I had to believe it. There was no other choice."

According to the National Cancer Institute, breast cancer in men is rare and accounts for less than 1 percent of all incidents of breast cancer. It can afflict men at any age, but most often strikes those between 60 and 70 years old. Greenwood is now 73. He was 66 when he was diagnosed.

Breast cancer statistics:
  • Male breast cancer accounts for approximately 1% of all breast cancers
  • About 2,140 men will be diagnosed with breast cancer in 2011
  • About 450 men will die from breast cancer in 2011
  • Breast cancer is about 100 times less common among men than among women
  • The lifetime risk of getting breast cancer is about 1 in 1,000
  • The chance of developing invasive breast cancer in a woman's life is a little less than 1 in 8 (12%)
  • About 230,480 women will be diagnosed with breast cancer in 2011
  • About 39,520 women will die from breast cancer in 2011
Courtesy of American Cancer Society

The father of five decided as soon as the disease was confirmed that he wanted a mastectomy.

"You want to take care of it," he said. "That was your first reaction: 'Let's go to work.'"

While it didn't take place that early on in his treatment, he did undergo the operation, in addition to radiation and chemotherapy. Greenwood is currently on oral chemotherapy and receives intravenous treatment every three months.

"For me, it's never going to go away," Greenwood said. "It's arrested at this point. It's metastasized into my bones and threatening my lungs, which is where breast cancer goes. But right now, it's arrested and I'm very grateful for the technology that's been able to serve me."

But it has been interesting to be what sometimes feels like the lone man in a woman's world. When Greenwood went for his first appointment, the nurse called his name and was surprised when a man responded.

"When I was talking to my oncologist at the very outset of this, he said: 'There's nothing in the literature about how to treat breast cancer for men, so we're going to treat you like a woman,'" Greenwood recounted. "I said: 'OK. Just treat me.'"

Dr. John Ward, an oncologist at the Huntsman Cancer Institute at the University of Utah, said the disease behaves the same way in men that it does in women and is also treated in much the same way — with maybe one exception.

"I've never had a man want a breast reconstruction," Ward said.

While the doctor said it is "uncommon" to see the disease in a man, the institute still sees its fair share of male patients.

"I think it's a surprise but they quickly, at least the men I see, seem to understand and accept the fact that it's an unusual thing and they're not embarrassed," Ward said. "But they don't think about it and I don't think it's something most physicians typically think of either."

Because the number of men with the disease is relatively low, Ward doesn't think regular mammograms for men will ever be largely recommended. And while the presence of the gene BRCA 2 can be an indicator of high risk for male breast cancer, it's mostly important men realize it is something that can happen to them.

Risk factors for breast cancer in men:
  • The risk of breast cancer goes up as a man ages
Family history of breast cancer
  • About 1 out of 5 men with breast cancer have close male or female relatives with the disease
Inherited gene mutation
  • A mutation in the BRCA2 gene probably accounts for about 1 in 10 breast cancers in men
Radiation exposure
  • A man whose chest area has been treated with radiation has an increased risk of developing breast cancer
  • Heavy drinking increases the risk of breast cancer in men
Estrogen treatment
  • Estrogen-related drugs are sometimes used in hormonal therapy for men with prostate cancer, which may slightly increase the risk of breast cancer
  • Obesity is probably a risk factor for male breast cancer
Courtesy of American Cancer Society

"It's being aware that it happens and acting if you feel something funny," Ward said. "If there is one of those apparent genes in the family, you should have an increased suspicion."

Greenwood underwent testing for the gene, but found he was not a carrier. Still, he said he will occasionally call one of his three sons and ask them to check and report back.

After receiving his diagnosis, Greenwood, a retired pediatric optometrist, fulfilled a lifelong goal of learning to fly. He took lessons and earned his license and was grateful for the distraction.

He said he also found the support of those around him as indispensable as medical treatment and encouraged anyone — male or female — to find a group of those also battling the disease to connect with.

"I would say to any men out there who have breast cancer, don't be afraid of being the only man in the group," Greenwood said. "(Women) are very accepting, very friendly. It's like a club. A very exclusive club."

He acknowledges there are differences. For him, the experience of losing his breasts was not as difficult as he knows it can be for women. He wears a T-shirt when swimming in public places, but, for the most part, "It never did bother me much in terms of appearance."

He also knows men often have a way of trying to downplay potential problems. It was close to a year from when he first noticed the lump and when he showed it to his wife.

"Women seem to understand that men can get (breast cancer) a lot better than men," Greenwood said. "Men, in my experience, will deny it for a while."

Now he encourages those around him to conduct self- exams, noting that it's easy to do it, especially the same way he did — "in the shower when you're soaping up."

"No one ever thinks of breast cancer," Greenwood said. "You just don't think it. It just doesn't happen. Baloney. It does happen."



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