By Prof. John Boyages with Herb Wagner
COSA 2016: Three men are diagnosed every day with breast cancer in Australia and one man dies every 2 weeks said Professor John Boyages at the 43rd Clinical Oncological Society of Australia held at the Gold Coast last week.
Prof. Boyages facilitated an expert panel discussing key issues including genetics (Prof Judy Kirk), hormonal treatments (A/Prof Nicholas Wilcken) and Psychology (Dr. Gemma Gilchrist). This was the first time that a session was dedicated to male breast cancer at COSA.
The conference heard from two male breast cancer advocates, one from the US (Mr. Herb Wagner, founder of “A Man’s Pink”, a male breast cancer (MBC) advocacy organization and a representative from the Breast Cancer Network Australia (BCNA), Mr. Rob Fincher.
Patients with MBC were often treated just as for women, and often feel isolated and misinformed when given information written for women, including information on menopause, fertility and vaginal dryness”. Further, US studies have found that men were being under-diagnosed and under-treated said Prof Boyages.
“Unfortunately, the overall prognosis for men is not as good as for women because, more often than not, MBC is diagnosed at a later, more advanced stage with lower survival rates. This is in part due to the fact that many men are unaware that breast cancer can affect them and also because men, in general, are reluctant to seek medical advice, especially about a breast issue” said Prof Boyages.
The conference heard from Rob Fincher that his cancer was diagnosed late and despite aggressive treatment with surgery, chemotherapy and radiation his disease has returned.
In May 2014, Herb Wagner was contacted through his advocacy website, by breast cancer oncologist and author Professor John Boyages, who was completing a book entitled Male Breast Cancer – Taking Control.
“John asked if I would review his draft book and provide insight from a MBC survivor’s perspective and I jumped at the opportunity.”
This is the first time, John and Herb were involved together at an international congress but have submitted numerous abstracts to cancer congresses in Europe and the US which Herb has attended at his own expense to promote the cause.
The conference heard that Jemma Gilchrist noted that a problem with early detection in men is embarrassment. Research has shown that men with a breast lump often associate this with being feminine and are often treated differently by health professionals. Even though men can easily have a mammogram, this is often viewed as a female test and there is often reluctance for a man to attend a breast clinic. They also suffer from fear of recurrence and loss of self-esteem.
“I have seen many patients with MBC who have seen their doctor with a lump or a discharge from their nipple, to be told that it was a fatty lump or “man boobs” or enlarged tender breasts due to a hormone imbalance or medications,” says Professor Boyages.
A/Prof Nicholas Wilcken showed that MBC is usually hormone-receptor positive, but less responsive to aromatase inhibitors than female patients with breast cancer. Prof Kirk highlighted that an accurate family tree needs to be done for each patient and reminded clinicians in the audience to take a thorough family history looking for signs of other cancers which may be associated with a gene mutation (usually BRCA2) such as breast cancer in first degree relatives, prostate and ovarian cancer. Patients with a BRCA2 mutation who have breast cancer are also at a higher risk of a more aggressive prostate cancer and PSA screening should be done at regular intervals for men with breast cancer.
“When I was first diagnosed I didn’t want to talk about it to my friends or family. Since then I have heard any cries for help from men with breast cancer from all over the world”, said Herb who was diagnosed 11-years ago.
Herb’s Take Home Message
During the session Herb made the following four points:
“When a man is diagnosed with breast cancer there are 4 things he needs to do immediately:
- Dispel any thoughts that you are abnormal and have done something wrong. Although very rare men do get breast cancer. Remember almost 80% of us will survive to live normal productive lives.
- Eliminate the male macho stereotype that you are everyone’s rock of support and provider and that you can get through this alone. Wrong. The sooner that you accept the help and support offered by others, the better they will feel and the smoother your journey will become.
- You have 24 hours to feel sorry for yourself then that ends. You must immediately start to learn all you can about male breast cancer so that you can intelligently talk with the doctors and clinicians who are going to make decisions that will affect the rest of your life. You want to understand and have input into those decisions. If the doctors and clinicians feel that you are showing interest in being part of these decisions, they are more likely to spend more time to learn about you as an individual and how you should be treated rather than you just being a paycheck for them.
- Most importantly you must remain positive even through the difficult times of your journey”.
Review by Professor John Boyages with Herb Wagner.
Prof. John Boyages is Professor of Breast Oncology, Discipline Head, Radiation Oncology and Director of ALERT (Australian Lymphoedema Education, Research and Treatment). His books on breast cancer, including Male Breast Cancer, are available here: http://www.breastcancertakingcontrol.com.au/
Herb Wagner is an 11 year breast cancer survivor, a male breast cancer advocate and founder of A Man’s Pink, a support organisation for men with MBC. After presenting at the session on the Gold Coast last week, Herb was interviewed by 7 News, removing his shirt to raise awareness of MBC and remove stigma associated with mastectomy scars. You can view the interview on the 7 News Facebook page.
The Oncology Network Australia would like to thank John for his expert analysis and Herb and Rob for their sharing their personal experiences with our readers.