Over the years I have had a disposition to remembering trivial and for the most part useless information particularly of a technical or scientific nature. I was therefore aware that men could get breast cancer. When I felt a hard lump near my right nipple after showering I concluded that it was either malignant or benign. As it was extremely sore after examination I felt that it would be prudent to see my doctor as soon as possible. It had not been noticed previously because I normally shower at night when the lump was bigger and softer.
As I was shortly due for my flu jab it prompted me to make an early appointment with my doctor. After the examination he went carefully through the various diagnoses with me which of course included breast cancer. He’d had two similar cases of breast cancer in males so he was not unfamiliar with the disease and consequently gave referrals for a mammogram and a CT scan. It was a Monday and he made an appointment to see me on Saturday after these were completed and he had the results. In any event I was able to make appointments for both procedures the following day and I was told on completion they should be with my doctor by 5pm that day. That evening at home I waited patiently, albeit apprehensively, for the phone to ring and when nothing was heard by 8pm I assumed no news was good news. However it was not to be. The following morning at 10am I received a phone call from my doctor asking if I could see him as soon as convenient. What was a possibility had become a probability and my spirits sank to the lowest I have ever experienced. Anyway I recovered quickly and toddled off to the surgery. When I arrived he had already made an appointment to see a surgeon that Friday to confirm his diagnosis of cancer and recommend the treatment. Subsequently the specialist confirmed that the growth was likely malignant and the options for treatment were carefully discussed and considered. A biopsy was agreed and this was performed the following Wednesday, the diagnosis from which was conclusive.
Arrangements were made for me to have the mastectomy with a partial axillary clearance two weeks after the biopsy. I was last to go on the slab and after the operation started to recover about 8pm. I came through the operation well and the next day was very frisky although mobility was rather restricted. The following day it all caught up with me and I was very subdued. Come time for my departure from hospital the following Monday I was glad to be away as I was getting bored, particularly being in a single room. While all was well. Grahame, I’m not sure what you mean here. I still had a surgical drain which had to be changed daily and was with me in the pocket of a work apron for some six weeks after.
The pathology from the operation indicated an aggressive tumour but showed no spread to (instead of infection of) the nodes. Consequently the surgeon, in conjunction with the oncologist, felt that a course of chemotherapy might be warranted as a precautionary measure. With the drain removed I presented myself at the oncology clinic and six cycles of treatment was recommended and accepted. While I came through these without serious affects, from the fourth treatment onward I became very tired and needed up to an hour to compose myself before driving home. The chemotherapy left me with minimal hair loss but no other side effects.
The pathology also indicated that I would respond to Tamoxifen and I was put on this treatment which was to last five years. I had some rather uncomfortable side effects from this particularly during the first six months. After this I settled down, although some of faculties I enjoyed previously were impaired. I suffered little discomfort. During this period I saw the surgeon and oncologist alternately every three months which was later extended to six months. At my final review, I had a blood test for a tumour marker and a bone scan. The latter identified lesions in my sacrum and on several ribs which, in view of my medical history strongly suggested metastases. Having come through the trauma of breast cancer with flying colours this set me back somewhat and when I had picked myself off the deck a CT scan was recommended. Also I was taken off the Tamoxifen and put on Arimidex. Before concluding the consultation the oncologist advised that she would let me know if the results supported the conclusions from the earlier procedure. While I heard nothing over the next four weeks I began to increasingly fret which peaked on Good Friday when I realised I would have pull myself together otherwise I would become a cot case. During this period I remembered about two weeks before the bone scan that I had fallen from a chair whilst repairing a light globe in the bathroom. I had fallen heavily on my bottom and on my back/head and in fact had nearly become unconscious - this event was consistent with the areas of the lesions. After the long weekend I contacted my own doctor who advised CT scan had not confirmed the presence of metastases while not completely ruling them out. I have since had two further bone scans both of which supported the observation that they were probable due to the fracas in the bathroom.
For the last three-and-a-half years I have been a volunteer with The Cancer Council New South Wales and have found this very rewarding. The work largely involves relating my personal experiences to men who have recently been diagnosed with breast cancer. These are infrequent and I have generally spoken to about two a year. In addition Sydney University has a four year conversion course to medicine for postgraduate students who have completed studies in other disciplines. With two lady volunteers we recount our experiences to the students and take questions.
Generally I have come through the experience well with little drama. While not a fatalist I am persuaded that the ticker will ultimately take me and the breast cancer has only been a hiccup in my life cycle. However I have been frustrated by the lack of information available with this disease on men and when the opportunity arises to broadcast the fact that it can affect them. It is a marvellous conversation killer in men’s company - they never know how to respond. While most will contend that they know of the disease in men they do not want to talk about it as it will never affect them - a case of self denial? Women are little more responsive and will normally admit when they do not know that breast cancer afflicts men and are generally happy to discuss it, albeit on a rather cautious level.
My oncologist is a woman while my physician and surgeon are men. She seems to have a greater understanding of my personal needs and feelings than do the men. As I mentioned earlier I had some uncomfortable side affects when I started the Tamoxifen. This was reported to both the male doctors who concluded that I wanted the treatment stopped and were most insistent that I continue. This was not my intention as I only wished to keep them informed of my well being. However the oncologist read it correctly and was sympathetic to my plight.
In conclusion my main concern is the general lack of knowledge in the community that men can get breast cancer as there is a general perception that it is only a disease that affects women. I feel that the medical profession and to a lesser extent the health professionals are partly responsible as it is normally omitted from public literature or discussed openly. However in the final analysis men must share most of the blame because of the general apathy towards their personal health and the Australian ethos about masculinity that is instilled in them from birth. I am an active member of Breast Cancer Action Group NSW.
