Tits-on-a-boar: A male’s thoughts on his own breast cancer (Guest Post)

“Tamoxifen?” the pharmacy clerk asked me when I presented her with the prescription for the first time. “Are you sure? That’s generally used as follow-up for …”

“Yeah, yeah, breast cancer,” I told her. “That’s me." The one guy you’ll regularly see getting refills of this stuff. I guess I’m coming back for the next five years.

Hers was a pretty common reaction. Since my diagnosis last summer, I can pretty much drop others’ responses to news of my breast cancer into three roughly equal categories. The first being those who quite kindly express sympathy and offer support and encouragement; the second being those who express disbelief, laugh or think I’m kidding (I have to admit that I have a rep’) and, my favorite, those who look at me with an air of expertise and solemnly declare that “oh yes, men get breast cancer, too,” as if they are imparting some new nugget of knowledge to a heretofore uninformed audience.

Yeah, no shit, Sherlock. Do you wanna see my mastectomy scars?

When I found the lump “on my chest” (as many of us are more likely to say than “breast”) last summer, I knew there was a problem. This was not my introduction to the concept of male breast cancer. Sadly, my favorite uncle died from metastasized breast cancer the morning of the ultrasound visit at which my wife and I were to learn we were having a son. Now a spectacularly brilliant, 6-foot-3 honor student, about to begin college as a physics major (yeah, I’m braggin’), my son carries that uncle’s name. It’s homage to a kind and gentle giant of a man … and now serves as an unintentional reminder of what caused his death.

Uncle Philip was like many men and didn’t necessarily react when he discovered a lump on his chest. He was well into Stage 4 when he was diagnosed. His story is what caused me to react quickly. It also set off the appropriate alarm bells with the medical professionals with whom I’ve dealt since then.

The general practitioner immediately sent me to the hospital for an ultrasound and what the radiology tech graciously called a “man-o-gram.” The results came packaged in a bright pink folder (gee thanks, Susan G. Komen folks).

When the radiologist himself asked that I come see him before I leave the building, I pretty much knew what was up. Sitting in the dark room with an array of flat-panel screens in front of us, the ugly blob on my chest stood out in sharp contrast. Kinda like Sarah Palin at a MENSA convention, it clearly didn’t belong there.

“Worrisome,” he said. “No, make that extremely worrisome.” And, with those words, I joined the elite ranks of the 1-percenters. Alas, not those who’ve been the focus of the Occupy Wall Street movement. No such luck on my part. No, I am among that small group of breast cancer patients who happen to pee standing up.

Screw the biopsy. I want that thing OUT of me.

Within days, I was in surgery for a lumpectomy. I should have just started with the full trim job. The margins weren’t clean. This time I opted for a bilateral mastectomy. I, a 53-year-old, six-foot-four-inch tall, happily married father of two, was a getting a mastectomy. I grew up the ‘70s. I did my best to be a sensitive, New Age, kinda guy, sympathetic to the plight of women … but who ever thought I had to get frickin’ breast cancer and a mastectomy to prove it??!?!?

There are actually about 1800 of us diagnosed each year. Many of them had been aware of a lump, but concluded – or worse, were told by medical professionals – that it was nothing to worry about, “merely a cyst, or a fat deposit.” Had it not been for my Uncle Philip, odds are good I’d have ignored it, too.

The importance of being open
Probably the most common question I get from others in “the breast cancer community” (community?!?!?!? Man, that’s a shitty place to live and the taxes are way too high), is how I feel about discussing the diagnosis with anyone outside of a close circle of friends and family. A lot of people want to know if there is any embarrassment or concern about whether I would be viewed as being less of a man, having been diagnosed with what is generally regarded as a “woman’s cancer.”

Nope. Not one bit. First off, given that modern cancer treatments usually involve the surgical removal of the offending body part, I’m actually pretty happy I didn’t get a more “manly” cancer. If I had to give up something, middle-aged moobs are the first thing I’d offer on the sacrificial altar.

There is no emotional connection. Very little of our physical, psychological or sexual identity is wrapped up in ours. Reconstruction – if we opt for it – involves a tattoo.

Chemo bald? Hey, for us, it’s not a crisis. These days, it’s just hip.

It’s pretty much tits-on-a-boar cancer for us guys.

Second, I have nothing to be ashamed of. Given the family history, I was diagnosed with the predictable genetic mutation. Had I known, I would have learned years ago that my chances of developing breast cancer rocketed from the 0.05% risk faced by the general population of men to just about seven percent.

I’ve made it something of a mission to be open and honest about the whole thing … perhaps to the discomfort of those who are listening. I’ve written about it, even to an audience usually focused on – of all things – bicycle racing.

I’ve also done several radio interviews, a few newspaper articles and, most recently, spent a morning discussing male breast cancer and a patient’s view of chemo with a nursing class at the local university. I am, by any definition, something of a loudmouth.

If by potentially “embarrassing” myself, I can convince one guy who finds a lump on his chest to take the thing seriously, it’s well worth it. If I can get one nurse to argue with a doctor who might have just uttered “probably a cyst,” I’ve scored a win. I’ve already talked several of my cousins into getting screened to see if they, too, are a member of the “8765delAG club” (an inside joke for all of you geneticists out there).

If I’d have curled up and not spoken up, it would have been fundamentally dishonest. What’s worse, I would dishonor my uncle's memory, whose own experience quite probably saved my life.

This one’s for Philip … both of them.
__________

Charles Pelkey is a Wyoming attorney, who began a transition into a new career after spending more than 25 years as a journalist, serving as a radio host, newspaper reporter, press secretary to former GOP Senate whip Alan Simpson and as an editor at the cycling magazine VeloNews. He was diagnosed with an invasive ductal carcinoma and underwent a double mastectomy in the summer of 2011. He received chemotherapy for four months, before a relatively rare and unexpected cardiac side-effect from Taxol prompted his oncologist to end treatments about a month early. His heart appears to be none the worse for wear and his hair and eyebrows have finally grown back. Having lost his magazine job on the same day his diagnosis was confirmed, Pelkey is now practicing law on a (more than) full-time basis in Laramie, Wyoming, where he lives with his wife of 25 years, Diana, and their two children, 17-year-old Philip and 12-year-old Annika.