Gerard Bourguignon – A One Year Survivor
In early July of 2009 I felt some discomfort in my right breast, but did not think much of it until it did not go away for several weeks. When I felt the area around my right nipple, I noticed a small lump that was not present in my left breast. Because both my wife and I have been involved in biomedical research, particularly related to cancer, we were aware that breast cancer can occur in men – although at a very low frequency. Consequently, I asked my primary care physician during my annual physical in late July to check the lump I felt in my right breast. After he palpated both breasts and felt the lump, he ordered a mammogram and ultrasound to be done in the next few days. The results indicated a suspicious mass which then lead to a biopsy being done in the next week.
In August the biopsy results indicated the lump contained invasive ductal carcinoma cells and surgery would be necessary. I was very fortunate to have one of the best breast oncology surgeons in the area (Dr. Cheryl Ewing) perform the operation – a modified mastectomy. Unfortunately, she was unable to spare the nipple since the tumor was located in very close proximity. Analysis of the sentinel node indicated that the cancer cells had not spread to the lymph nodes. Since the tumor cells were found to be estrogen receptor positive, I started hormonal therapy with Tamoxifen. My medical oncologist also ordered the Oncotype Dx test to be done and the results indicated that there was no significant benefit from undergoing chemotherapy and/or radiation therapy. I obviously was very relieved. I did not have to deal with the very unpleasant side effects of chemo- or radiation therapy – at least not at this time.
Since I have been undergoing hormonal therapy with the standard dose (for women) of Tamoxifen, I have not experienced any significant side effects – no hot flashes, just muscle tightness and some muscle cramping. It is a bit disconcerting that there is so little information available regarding the optimal dose, frequency and duration of Tamoxifen treatment for men. Unfortunately, there has generally been very little research done on male breast cancer – primarily due to its low frequency and the need to devote the primary research effort to female breast cancer which represents 99% of all breast cancers.
My six month and one year check-ups have not detected any signs of the cancer recurring. However, in September of this year (2010) I was diagnosed as having a pituitary tumor (a prolactinoma) which apparently is releasing high levels of the hormone, prolactin. Although it is too early to be sure, it is quite possible that the high levels of prolactin caused, or helped to cause, the breast cells to grow abnormally. Fortunately, I am currently able to treat the prolactinoma medically with a drug (Cabergoline) that has been shown to stop the excess prolactin production in about 80% of the cases treated.
In the meantime, I have been actively involved with several breast cancer fund raising groups and have been working to increase awareness of male breast cancer in my local area. Almost every man (and women) I speak with about my situation say they either have no idea that men can get breast cancer or that they never consider it could happen to them. As you may know, the statistics show that most male breast cancer patients are diagnosed at a relatively late stage and consequently have a rather poor prognosis for recovery. In fact, the mortality rate for male breast cancer is now higher than that for female breast cancer.
In addition, I believe it is very important for men to realize that there is a definite link between prostate cancer and breast cancer. Hopefully, there will be much more research and awareness of male breast cancer done in the near future. In this regard, it is encouraging that a survey of male breast cancer patients has been recently initiated by Dr. Kathyrn Ruddy at Harvard Medical School. Furthermore, it seems to me that the large breast cancer fund raising groups (eg. Susan G. Komen and Avon Walk for the Cure) should consider devoting 1-2% of their funds to male breast cancer research and treatment.
Finally, it is definitely very important for those of us dealing with breast cancer to maintain a good optimistic outlook and attitude. One way to do this is by participating in a male breast cancer support group, either in person or on-line. I am very pleased to do that through this website set up by Herb Wagner and his family. If you would like to contact me directly, my email address is firstname.lastname@example.org; and I welcome any communication from anyone dealing with breast cancer. “Be Aware, Be Well and Be Positive.”