Robert (Bob) Smith is 44 and is a handsome, newly bald man with expressive eyes. Bob was diagnosed at age 43, in May of 2008. Bob had a lumpectomy of his left breast this past May and in September he completed a course of chemotherapy.
The normal guy that he is he says he waited four and a half years before he had the lump checked out a second time. Years earlier, according to his wife of eleven years, Jen Smith, a doctor had told him it was nothing to worry about. He went to the doctor at his wife’s urging and after the lump began feeling tender. Bob attributed the tenderness to wrestling with his six-year-old daughter.
His new doctor wasn’t sure what he was looking at but he had the foresight to send him for a mammogram. Bob’s was an emotionally awkward experience for this energetic, strong father of three young girls. Ushered into the Women’s section of the radiology office,” Man alert!” he remembers someone yelling as they shuffled him off to a corner room.
Seeing something suspicious, they did a second mammogram, along with a sonogram and they “Squished even harder than the first time,” says Bob. His next appointment was with Dr. Gerald Hayward at St. Agnes Hospital in Baltimore. Dr. Hayward is a cancer expert that hadn’t treated a male breast cancer patient before. Based on Bob’s test results and his family history in which breast cancer is prevalent in the women Bob’s family, with two aunts on his father’s side having died from the disease, and one of their daughters having had a double mastectomy several years ago. Dr. Hayward recommended a lumpectomy that showed Bob’s lump as a malignant breast cancer tumor. That forty-minute outpatient lumpectomy was followed shortly after by a modified radical mastectomy on May nineteenth.
After it was determined the tumor had been successfully removed, Bob visited Dr. Edward Lee, a hematologist, and Dr. Sally Cheston, a radiation oncologist, at the Central Maryland Oncology Center in Columbia, which is affiliated with the University of Maryland Marlene and Stewart Greenebaum Cancer Center (UMGCC). The two reviewed treatment options and made their recommendations which included chemotherapy followed by a five-year course of Tamoxifen. Radiation was not recommended. ”If you were a woman [at the same stage],” Dr. Cheston told him, “I wouldn’t recommend it.”
Armed with his family history, it didn’t occur to Bob or Jen that what he thought was an innocent lump could be breast cancer. As a man, he says, “You think you’re a little insulated. How could a 43-year old man get breast cancer?” The past few months have radically changed their thinking. Dr. Chester told them that men have milk ducts, but the ducts are just not developed. It is possible for men to develop breast cancer.
How would Bob be treated as a male breast cancer survivor? People just don’t know how to respond to his diagnosis, he says. “I’m not a very private person,” he says jokingly. ”I don’t care about people knowing.” Actually, he wants them to be aware and tells anyone who will listen. Some of the men have responded more openly than he was expecting. Jen’s father revealed he had a non-cancerous cyst removed within the past ten years, and another male admitted to having a suspicious lump that he was going to have checked out.
“You immediately go to your death and work your way back when you learn something like this,” Bob says. Lying in his hospital bed at St. Agnes Hospital after the mastectomy, he found himself staring out the window at a rainy Baltimore skyline, watching cars drive by in the early morning hours. He began to answer emails on his Blackberry and decided that his life needed to go on.
Bob has learned much in the past few months, including that men have a lower survival rate than women when it comes to breast cancer. He says it’s because they don’t think about it as a potential problem for their gender and, as a result, they don’t act fast enough when they do discover a lump, and then there’s a better chance the cancer will be at stage 3 or worse. No one is looking for it, and that needs to change, Bob urges “When it comes to breast cancer,” he says matter-of-factly, although understanding the reasoning but not agreeing with it, ”I want people to have it in their conscious that it’s not a ‘womens only’ disease. One person whose thought process was affected by what he said is the Wellness Program nurse at BB&T in Columbia the financial institution where Bob is a senior vice president in its commercial lending group. Bob says since his diagnosis, this nurse has made it her mission to ask men if they’re checking their breasts.
As a member of a number of Howard County boards and a part of the graduating class of Leadership Howard County 2008 (part of a national program of community leadership programs), Bob is making connections that will help him get the word out about information and treatment options for male breast cancer patients.
He calls his diagnosis a “Wakeup call from God.” If you’re a male and have a lump under a nipple, go get it checked. Be aware of it! With his left chest looking like it was attached by a plunger, Bob smiles and talks of getting a tattoo around it. “Yeah,” he says,” It’s embarrassing but it’s better to be embarrassed and have a little humor to keep you going than to lose your life.
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