Men Have Breasts and Can Get Breast Cancer
Not me. This isn't happening to me, I thought. But in September of 2012, I was diagnosed with breast cancer. The thing is, I'm a man, and men don't have breasts or get breast cancer!
Yes we do.
By the time they caught it, the cancer cells had broken out of the ducts and spread to the lymph nodes; I had what's called invasive ductal carcinoma. I had noticed a lump in that area more than a year earlier but didn't really think anything of it. I have had cysts and moles removed before that always came back negative, so surely this couldn't be anything worrisome, right?
I went to see my doctor about something else and thought I would mention that I had discovered this "thing" on my chest. "Should I have someone look at it?" I asked. "Oh yes," she said, and scheduled me for a sonogram at the local breast cancer center for women. When I arrived, I was told I'd be having a mammogram! I couldn't imagine how they were going to do that, but they did; then I had the sonogram. They spotted something, because next, I was scheduled for a biopsy of the left breast and armpit.
Two days later I get the call. "We found some cancer cells." I was told I would be hearing from a cancer care coordinator to schedule appointments with a surgeon and an oncologist. So now I'm thinking: Am going to have a mastectomy? Men don't get mastectomies!
Yes we do.
Then I recalled seeing a documentary 20 years earlier about the famous 70s actor, Richard Roundtree, who played John Shaft in the "Shaft" movies. I remembered how I almost fell out of my chair upon learning that he had breast cancer and had a mastectomy. I couldn't believe that men could get breast cancer. Indeed it's rare -- fewer than 1 percent of all breast cancer diagnoses are in men, and he was the only other male I'd heard of having breast cancer. Yet knowing that I was not alone was comforting.
After meeting with the surgeon and the oncologist, my care plan was set. I would have a mastectomy of the left breast and have several lymph nodes removed. The cancer had spread too much for the less-invasive option: a lumpectomy. Then I would undergo six rounds of chemotherapy, 28 rounds of radiation and take a pill (tamoxifen, an estrogen blocker) for five years. I would also need to get scanned once or twice a year to make sure they had gotten it all. They told me to look at the journey ahead more like a marathon, not a sprint, and said I would do just fine.
At my first post-operative appointment with the surgeon, she told me they had removed a 2 ½ inch tumor and 28 lymph nodes. She also noted that the tumor had been growing in me for about 2 1/2 years (something I already, deep down, knew). She then advised me that I had a really good chance of developing lymphedema in my left arm as a result of having 28 lymph nodes removed. Lymphedema is a serious condition that arises when your lymphatic fluid gets trapped in the body's tissues, the arm in my case, causing swelling and even pain. There is no cure for it, just treatment such as compression garments and physical therapy. It took about two years for it to show up, but now I've got that, too. Prior to surgery, I told my surgeon that I play guitar and asked if the lymphedema would affect that. After surgery, she told me she was very careful not to damage the muscles in my chest and that she literally plucked the lymph nodes out with her fingers instead of cutting them out, to preserve my ability to play.
I did surprisingly well with the first line of chemo and had no major side effects. I did lose hair and nails, but still had an appetite and didn't experience digestive problems. I actually felt pretty good, but I think that was due to all the prednisone, a steroid, they gave me. The radiation treatments were no picnic, but I got through them too, with a slightly burned upper left chest. The major side effect from the radiation was fatigue.
As 2013 came to a close, it was time for my first "scan" to gauge my progress. I had been on tamoxifen for a couple of months and was hoping for the best. My oncologist called and scheduled me for an appointment on Christmas Eve to go over the results. I kind of wondered why we couldn't just do it over the phone, so I prepared myself for bad news. My wife Cathy and I went to see him and he explained that the cancer had spread to my bones, with lesions showing up on the vertebrae in my neck and back. The good news was that these lesions were on -- not inside -- the bones, he said. They also did not appear to threaten my spinal cord or nerves in that area, and were treatable with more chemotherapy, osteoporosis drugs and possibly more radiation. Upon further analysis, because there were some concerning spots in my upper neck vertebrae, I had another dozen or so rounds of radiation in the neck area.
Instead of conventional chemo that is infused through a port in the skin, my doctor put me on a chemo pill of sorts called Xeloda. But after a few months, another scan showed signs that the cancer was continuing to spread, so we stopped the drug and reassessed.
The oncologist gave me the option of getting a second opinion, saying: "You'll probably get six different opinions from six different oncologists." I told him I was comfortable with his opinion and did not feel like I needed a second opinion. Still, he encouraged me to get one, so he referred me to an expert who specializes in DNA sequencing -- analyzing and dissecting cancer cells to determine how best to target and tackle them.
The second oncologist had me scanned for any new tumors that he could biopsy and fortunately for me, there were no new tumors and they cannot biopsy the bone lesions. They decided to look at my original tumor again and found that the type of breast cancer was HER2-positive, which is what it was determined to be from the start. So now the option was: stronger and more targeted chemotherapy drugs that specifically go after that type of cancer cell. I felt like we were back at square one.
This second line of chemo was a cocktail of three different drugs taken for six months, followed by two new drugs for another six months. My post-chemo scan showed some signs of healing on the affected bones -- and it was the first time I had heard the word "healing" in over two years. But due to some blood test results, we have switched to yet another drug called Kadcyla (sounds like Godzilla -- the only way I can remember the name), which I've been on for six months and will continue for another six months. I will be getting another bone scan in the near future and again, am hoping for the best.
I'm confident that early detection would have allowed me to avoid all that I've been through so far. When the surgeon told me the age of the tumor, I thought long and hard, trying to remember exactly when I first noticed the thing. She said 2 ½ years, so I mentally went back 2 ½ years and recalled it was May of 2010 when I first noticed the small lump while drying off after a shower. She nailed it.
If I had said something to my doctor as soon as I discovered it, I probably would've only needed a lumpectomy and a short round of radiation. I cannot stress enough how important it is for men to say something to their doctor if they feel something new or unusual on the breast. The male and female breast are engineered in virtually the same way, but men have less mass. That actually makes it easier to detect a lump on men than women. But men don't think it can happen to them, because they don't have breasts. Yes, we do have breasts. And yes, we can get breast cancer, too.
I have remained pretty positive throughout this journey thanks to my wife Cathy, my family, friends, employer and all of the support groups available to me. I was honored by the Megan S. Ott Foundation in Indianapolis, for being its first male breast cancer survivor. I was invited, along with other survivors from IU Health Cancer Centers, to unveil the pink ribbon at a special breast cancer-themed Indianapolis Colts game. What's more, the health care providers who have worked with me have been amazing. They constantly remind us that I am getting the most cutting-edge treatment available, that there is hope and that I am not alone in this battle.
John Danyluk, 58, lives in Indianapolis with his wife of 24 years, Cathy. He works in the insurance industry and is a male breast cancer survivor.
