"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."
They're used to me now. I don't even have to ask for my 'script. The pharmacists all recognize me. I'll be coming back for those refills of this stuff for the next five years.
The pharmacist's initial reaction was a pretty common one. Since my diagnosis more than a year ago, I can pretty much drop others' responses to news of my breast cancer into three roughly-equal categories: the first, those who quite kindly express sympathy and offer support and encouragement; the second, those who express disbelief, laugh or think I'm kidding (I have to admit that I have something of 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") in the summer of 2011, I just 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 on the very morning of the ultrasound visit at which my wife and I were to learn we were having a son. Now a spectacularly brilliant, 18-year-old, 6-foot-3-inch honor student and physics major (yeah, I'm braggin'), my son carries with him that uncle's name. It's an 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 first found that lump. He was well into stage IV 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 since dealt.
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 a dark room, facing an array of flat-panel screens, the ugly blob stood out in sharp contrast with the rest of my chest. Kinda like Sarah Palin at a MENSA convention, it clearly did not 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.
"I guess you could start with a needle biopsy, but..." he offered.
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. The second time I opted for a bilateral mastectomy. I, a 53-year-old, 6-foot-4-inch, happily married former athlete and father of two, was a getting a mastectomy.
Look, man, 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 1,800 of us diagnosed each year in the U.S, and an estimated 2,190 will be diagnosed in 2012. 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.
"It's probably just a cyst, or a fat deposit," more than a few have been told.
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, my 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 nothing more than a pair of tattooed nipples.
Chemo bald? Hey, for us, it's not a crisis. These days, it's just hip.
To me, it's pretty much tits-on-a-boar cancer.
Second, I have nothing to be ashamed of. Given the family history, I was diagnosed with a very predictable genetic mutation. Had I known, I would have learned years ago that my chances of developing breast cancer rocketed from the 0.05 percent risk faced by the general population of men to just about 7 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 I 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.
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