Breast cancer in men: taboo hinders early detection – 12/27/2023 – Health

São Paulo musician Rodrigo Fassina, 41, has always led a healthy life and had good eating habits. He even practiced kung fu for years, in addition to not drinking or smoking.

But in 2021, still during the pandemic, she noticed a small lump on her right nipple. His wife also noticed that this region was retracted. Faced with the signs, he didn’t think twice and a few days later he decided to go to the doctor to investigate what it could be.

“The doctor said it could be an ingrown hair that got inflamed and if it didn’t get better on the third day, I should look for it again,” he recalls.

On the third day, the lump did not decrease and when he returned to the specialist he was informed that it could be a nodule. “He advised me to look for a mastologist, a surgeon. I went to the doctor, he ordered tests, a mammogram and an MRI,” he says.

The musician also needed to undergo a biopsy, as doctors suspected a malignant tumor.

Rare disease in men

After receiving the results, Rodrigo was surprised, as he was diagnosed with a HER2 positive tumor, considered one of the most aggressive types of breast cancer. He received the news with some surprise, as he had always heard that the condition was more common in women and not in men.

However, according to Inca (National Cancer Institute), men also develop the problem and it is estimated that the incidence in this group represents around 1% of all cases of the disease.

When looking for a mastologist, who was not a cancer specialist, he was told that he should have surgery, but preferred to seek a second opinion.

“I went to an oncology surgeon and the doctor said that the cancer already had a first and last name,” he says.

He began treatment with chemotherapy and after six sessions, doctors would assess whether it was necessary to opt for surgery.

The specialist also informed him that there was not much literature on breast cancer in men and that they were going to treat it like cancer in women.

“There were two tumors that totaled six centimeters. I started undergoing chemotherapy sessions and it decreased by two centimeters. When I finished the sixth chemotherapy session, my tumor was smaller than 0.5 centimeters”, says the musician.

He also had to undergo a mastectomy to remove the tumor and act preventatively.

Father also got sick

During treatment, he reports, he tried to maintain positive thinking and believed he would be cured. However, an unexpected fact caught his and his family’s attention. During the third chemotherapy session, Rodrigo’s father began to feel very ill.

“He had an ulcer and needed urgent surgery. When they went to operate, they saw that my father already had metastasis in his liver,” he says.

According to Rodrigo, his father probably already had prostate cancer, which progressed to other regions, but was almost asymptomatic.

“Either he didn’t feel it or he didn’t say anything. He was hospitalized, he couldn’t recover and he didn’t even have time to study this cancer. Doctors believed it could have originated in the prostate and pancreas”, he says.

Precisely because his father’s problem was silent and because he was reluctant to go to the doctor, the musician is grateful and knows the importance of seeking an early diagnosis.

Shortly afterwards, his mother also developed strange symptoms and was diagnosed with hyperplastic thrombosis. The tumor evolved into colon cancer and today she continues undergoing treatment.

Because of this, he needed to undergo genetic tests to investigate the causes of the problem and try to mitigate the emergence of new cancers in the future.

Even with these complications from his parents, Rodrigo continued with the necessary care and managed to recover. After almost seven months, he was discharged and performed a show playing Freddie Mercury to celebrate in the hospital.

To this day, he celebrates the success of the treatment and warns that more and more men should seek doctors and take care of their health.

“The feeling of finiteness makes you not want to waste time. Time is either for you or against you. Cancer is not a death sentence”, he highlights.

Cause and treatment

This type of cancer occurs because of disordered cell proliferation. The cells can reach the mammary duct (nipple nipple) or breast lobes (the region above the nipple).

Just as it occurs in women, breast cancer in men can be multifactorial, caused by a sedentary lifestyle, obesity, excess alcohol, smoking and hereditary genetic conditions.

It can also occur due to the use of anabolic steroids or other hormonal substances in excess.

“Any man who has and uses hormones also increases the risk. The hormone always interferes with the mammary gland to stimulate tumor cells”, explains Fabiana Makdissi, mastologist and oncological surgeon at AC Camargo hospital.

Although not all cancers have a hereditary genetic origin, in breast cancer it is necessary to take into account the increased risk in men.

“For breast cancer, only 10% of cases are related to hereditary genetic origin, however, in men, this number can reach up to 40%”, says Rodrigo Castanho de Campos Leite, mastologist at Hospital de Amor, formerly the Cancer Hospital of Barretos.

The condition is more common in men aged 50 to 60, but it can affect younger people, as happened with Rodrigo who, at the time, was 39 years old. Therefore, it is important to pay attention to the symptoms and see a doctor quickly.

According to experts, with an early diagnosis, the chance of cure is 95%. Signs that serve as a warning and deserve attention are lumps behind the areola, nipple retraction, discharge and orange peel-shaped skin.

When the patient is diagnosed with this type of cancer, the doctor will carry out an assessment and indicate the best treatment to be given. It will take into account the grade of the tumor, disease progression and hormonal issues.

The therapeutic line may be an initial surgical procedure, removal of the breast and investigation of the lymph nodes, which are small structures the size of a bean seed that help in the body’s defense. In addition to surgery, chemotherapy and radiotherapy may be recommended.

“In the case of a disease that has already spread to another region, surgery does not play the main role, but medicine does. This is already a palliative treatment. Surgery has a hygiene nature”, reinforces Leite.

Men don’t take care of their health

Rodrigo’s attitude of seeking a doctor when suffering from an inconvenience is an exception in the routine of men, according to experts interviewed in the BBC News Brasil report. Taking care of men’s health is still a problem and often seen as a taboo by many of them.

This was even confirmed in a survey carried out in November this year by the Brazilian Society of Urology, which showed that 46% of men over 40 only go to the doctor when they feel something. This number increases to 58% if they only use the SUS (Unified Health System).

Another survey by the Lado a Lado pela Vida Institute, entitled “The Health of the Brazilian”, carried out in partnership with QualiBest, also showed that 51% of those interviewed consider stressful routines to be the main obstacle to taking better care of their health. While 32% said that access to healthcare is the biggest problem in pursuing medical care.

“In relation to breast cancer in men, we do not have a screening table like there is in women. If any changes appear in the breast or nipple, the indication is that they seek help, even from their own urologist”, highlights the AC specialist Camargo.

Roni Fernandes, vice-president of the Brazilian Society of Urology (SBU), states that men only look for a specialist when they feel something serious and that they do not go to the doctor looking for asymptomatic diseases.

The doctor also reinforces that just as the gynecologist is the woman’s doctor, men should have the urologist as their main doctor, carrying out periodic consultations and annual exams.

He also warns, as the problem goes far beyond breast cancer.

According to him, many do not even know how to wash their penis properly and, because of this, they have to amputate their genitals.

“It’s a social thing. We need to invest in awareness and public policies. Around 400 to 500 men lose their penis every year because they haven’t taken care of it”, concludes the SBU urologist.

Still according to experts, the lack of health care has to do with social issues, sexism and even shame.

“What we observe in the case of men is that they generally already present with skin changes and palpable lymph nodes. There is this delay in looking for a doctor, perhaps due to a bit of prejudice about having a disease in the breast. But this ends up harming the chances of a cure”, reinforces Leite.

When to start going to the doctor?

Care for men’s health should begin when men are still children, continuing into adolescence.

When puberty begins, it is ideal for those responsible to refer the young person to a urologist or a hebiatrician, a specialist in the care of adolescents. This way, he can receive guidance on sexuality, health care, hygiene and undergo routine exams.

Care must still be taken into adulthood, when starting sexual relations, and also when getting older.

From the age of 50, it is always recommended to examine the prostate to reduce the risk of aggressive cancer, which is very common in this age group.

The text was originally published here.