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Surprise Role for Ex-Senator: Male Breast Cancer Patient
By LYNETTE CLEMETSON
New York Times, June 10, 2003
A loose-fitting shirt hid the scar and concave area that former
Senator Edward W. Brooke spoke of as he moved his hand across the space from
his right armpit to the center of his chest. In his 83 years, life has held
plenty of unexpected turns for Mr. Brooke, the Massachusetts Republican who
in 1966 became the first African-American elected to the United States Senate
since Reconstruction.
But his current journey, Mr. Brooke said, has been among the most shocking.
''When the doctor told me,'' he said at his home on a horse and cattle farm
45 miles southwest of Washington, ''all I could say was: 'Me? Come on.' ''
Last September, Mr. Brooke was told he had breast cancer. Less than two weeks
later he underwent a double mastectomy. After struggling with how to share his
experience with even his family and closest friends, he is now speaking publicly
for the first time, to bring attention to a disease that many men assume they
cannot get.
While breast cancer in men is rare, a higher percentage of men than women die
of the disease because it is typically detected at a much later stage. All men
have some breast tissue, even if it is not noticeable. The small amount of breast
tissue that exists in men may be more apparent if it swells at puberty or later
in life.
Cancer researchers estimate that breast cancer will be diagnosed in 1,500 men
this year and that roughly 400 of them will eventually die of the illness. Of
the approximately 211,000 new cases of breast cancer that will be diagnosed
this year in women, an estimated 40,000 will lead to death.
''Most general practitioners will put a stethoscope on a man's chest to listen
for a heart problem and never think to do a breast exam,'' said Dr. LaSalle
D. Leffall Jr., a surgical oncologist at Howard University Hospital in Washington
and the chairman of the Susan G. Komen Breast Cancer Foundation.
Like most men with the disease, Mr. Brooke shrugged off early warning signs.
He had pains on the right side of his chest for several months before he consulted
a physician.
The former senator, who lost his seat to Paul E. Tsongas in 1978 and who left
his private law practice in 1985, has an active retired life. In addition to
tending to the animals on his farm, he swims, plays tennis and does gardening
and landscaping work on the rolling hills of his rural retreat. He assumed the
discomfort was simply his aging body's way of slowing him down.
Even when the pain became sharper and more localized, just beneath his right
nipple, he assumed it was a pulled muscle from digging up the tough stalks of
his sunflower plants.
His wife, Anne, who had had her own breast cancer scares in their 24 years of
marriage, also paid little attention at first. Had the sharp twinges been on
the left side of her husband's chest, Mrs. Brooke said, fears of heart trouble
would have grabbed her attention. ''But I figured there was nothing critical
in that area,'' she said.
When she took a closer look and felt a lump underneath her husband's nipple,
she became alarmed. ''It was harder than any lump I had ever felt in my own
breast,'' Mrs. Brooke said.
''Had it been my daughter or girlfriend I would have made them go to the doctor
right away.''
Worried, but still not considering the possibility of breast cancer, she made
an appointment for her husband and trusted him to discuss the lump with his
doctor.
Mr. Brooke related only the pain and the strenuous gardening. The doctor checked
his ribs and took blood and X-rays, never feeling directly around the breast.
The diagnosis: likely just a pulled muscle.
Mr. Brooke said that he was headed out the door when he hesitated, turned to
his doctor and said, ''Oh, by the way, Anne says there's a lump under my right
nipple.''
Two days later, after a mammogram, a sonogram and a tissue biopsy, he received
the staggering diagnosis.
In the weeks that followed, the couple learned many things about the disease:
Breast cancer is more likely in men older than 50. Men taking estrogen or naturally
producing higher levels of the hormone are thought to be at slightly increased
risk, as are men with Klinefelter's syndrome, which results in low testicular
function. As with women, men with relatives who carry the breast cancer gene
are thought to be at greater risk. Also mirroring a breast cancer statistic
for women, black men are more likely than white men to die of the disease.
After the information overload came a culture shock in the breast care center
at George Washington University Hospital in Washington: pastel-colored rooms,
information pamphlets that pictured only women and no men in sight. In the operating
room, before the anesthesia took effect, Mr. Brooke noticed that even there
he was the only man present. ''I was sure all the women in the breast care center
thought I was there supporting my wife,'' he said.
The doctors performed a modified radical double mastectomy, removing the breast
and several lymph nodes on the right side, after learning during the operation
that the cancer had spread into the lymphatic system. It was the removal of
the lymph nodes that created the depression underneath his armpit. Though no
cancer was present in the left breast, the surgeons removed it as a prophylactic
measure and to create physical symmetry. He is now free of cancer.
In the days before and after the surgery Mr. Brooke socialized with close friends
without discussing his condition. Over the Christmas holiday he finally told
his 22-year-old son, Edward IV, who was home from Brown University. But he found
it difficult to talk to anyone else about it, so he typed out an account of
his illness, mailed it to 19 friends and family members, and then left on a
vacation before anyone had a chance to call and ask about it.
Mr. Brooke's difficulty speaking about his breast cancer is not uncommon, say
other male survivors.
''This disease runs counterculture for men,'' said Mark Goldstein, 70, a retired
communications executive from Randolph, N.J., who underwent a modified radical
mastectomy in 1988 and who works with the Dallas-based Komen Foundation to raise
awareness about men and breast cancer. ''Men tend not to socialize diseases
well, even those that are uniquely ours like prostate cancer.''
After taking several months to come to terms with his illness, Mr. Brooke can
now speak comfortably and candidly about it. He plans to work through the Komen
Foundation to encourage doctors to perform breast examinations on men more regularly
and to encourage insurance coverage for mammograms for men.
He also wants to encourage men to perform self-examinations, or at least to
ask for help from their partners or spouses.
''Anne probably saved my life,'' he said. ''If she hadn't looked at that lump,
I never would have done anything about it.''
Looking out the window of his sunroom at the peaceful green expanse outside,
Mr. Brooke said he was reluctant to become a poster boy.
''I love my privacy. Love being out here with the trees, the cattle, the horses,
reading and listening to opera,'' he said. ''But I know that my talking may
be helpful to other men who are living their lives right now, unaware that they
have this disease.''
As he spoke, he tentatively gestured again, seemingly unconsciously, at the
changed physical space beneath his shirt.
''Looking out the window of his sunroom at the peaceful green expanse outside,
Mr. Brooke said he was reluctant to become a poster boy. 'I love my privacy.
Love being out here with the trees, the cattle, the horses, reading and listening
to opera,' he said. 'But I know that my talking may be helpful to other men
who are living their lives right now, unaware that they have this disease.'
For more resources on Male Breast Cancer, click here.