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HOW AM I GOING TO SURVIVE THIS?
Patients with MBC rely on strong support systems to get them through the ordeal of treatment. A number of men who have written about their disease say their religious faith has helped them. Others find different sources of support. Patients with male breast cancer use their disease to educate by speaking out, making public appearances, or communicating through the Internet. One patient, younger than most, wrote that he talked with everyone he could about his disease, that he wasn’t embarrassed about being a male with breast cancer, and that he used these conversations as a type of self-guided therapy to help him accept his diagnosis:
… approximately five days after diagnosis, I came to terms with the cancer. Only one word describes [this], and that is acceptance. I had a kind of an epiphany in a non-religious way. I accepted the fact that there was nothing I could do, apart from having the operation and any treatment thereafter. It was that simple, and I became very positive from that time on. This helped [me] tremendously for what was to come.6
Family members who have had cancer themselves rally to help their relative with MBC. Sometimes a wife and husband both develop breast cancer. A recent article in The Philadelphia Inquirer described just such a situation. First, Franny Koniers was treated for breast cancer, and her husband, Chris Koniers, was so supportive that he even shaved his head when his wife lost her hair during treatment. Then he found out that he had breast cancer too. “‘I was, of course, shocked. A little scared,’ says Koniers. ‘I knew [Franny] had been through this – and that millions of other women had,’ he says. ‘That made me realize that I could do this, too.'” His wife added, “‘Our feeling was, here we go again!’ … ‘We were stunned, but we also were determined to see this through together.'”7
THE AMA’S NEW MBC POLICY
At the American Medical Association’s 2009 House of Delegates annual meeting, the organization passed a new policy recognizing that breast cancer affects males as well as females. The
AMA is now supporting education about the risks, signs, and symptoms of male breast cancer, and it also supports insurance coverage for MBC monitoring and diagnostic methods.8
“Male breast cancer is rare, but it tends to be diagnosed at later stages,” said AMA Board Member Edward Langston, MD. “Heightened awareness of the increased risk in certain men may result in earlier detection of male breast cancer. Clinical breast examinations are effective at evaluating breast cancer symptoms, but mammography may also help.”8
SPECIAL MALE CONSIDERATIONS
The men who live with and survive breast cancer have a number of gender-specific adjustments to make. While some use their disease to educate and help others, other men keep their diagnosis to themselves. Some men decide to have double mastectomies because MBC has such a strong genetic component. There are men who undergo breast reconstruction, while others do not because they want to wear their scars proudly. And then there is the blogger who, about to undergo a mastectomy for breast cancer, is disappointed and angry about all the behavioral changes he will have to make to avoid lymphedema. Although he is irritated about not being able to give blood and having to avoid the sun, the thing that bothers him the most is that he has to forego the tattoo he was long planning for his upper arm!9 ONA
Bette Kaplan is a medical writer in Tenafly, New Jersey.
REFERENCES
1. Korde LA, Zujewski JA, Kamin L, et al. Multidisciplinary meeting on male breast cancer: summary and research recommendations. J Clin Oncol. 2010;28(12):2114-2122.
2. Fentiman IS, Fourquet A, Hortobagyi GN. Male breast cancer. Lancet. 2006;367(9510):595-604.
3. Cancer risks in BRCA2 mutation carriers. The Breast Cancer Linkage Consortium. J Natl Cancer Inst. 1999;91(15):1310-1316.
4. Dr. Z’s Zombie-A-Go-Go. It’s been a bad week. http://zombieautumn.blogspot.com/2009/05/note-this-was-written-on-thursday-may.html. Accessed June 15, 2010.
5. Cutuli B. Strategies in treating male breast cancer. Expert Opin Pharmacother. 2007;8(2):193-202.
6. Stephan P. Personal story of male breast cancer. About.com. http://breastcancer.about.com/od/malebreastcancer/a/sean_cooper.htm. Updated July 19, 2008. Accessed June 15, 2010.
7. Friedman S. A couple of survivors. The Philadelphia Inquirer Daily Magazine. http://www.philly.com/inquirer/magazine/20100506_A_couple_of_survivors.html?viewAll=y. May 6, 2010. Accessed June 15, 2010,
8. AMA adopts new policies at annual meeting. http://www.ama-assn.org/ama/pub/news/news/ama-adopts-new-policies.shtml. June 15, 2009. Accessed June 15, 2010.
9. Dr. Z’s Zombie-A-Go-Go. Monday, May 18, 2009. http://zombieautumn.blogspot.com/2009_05_01_archive.html. Accessed June 15, 2010.
