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This Man Survived Breast Cancer
Ted Allen
Esquire Magazine, August 2000
In "This Man Survived Breast Cancer" contributing editor Ted Allen sheds some light on a virtually unknown killer, male breast cancer. "Hardly anyone is aware that men can get it--not even most doctors," says Allen, who, together with executive editor Scott Omelianuk, also authors the periodic Things a Man Should Know column and the eponymous series of books, the latest of which is Things a Man Should Know About Marriage (Riverhead Books). "When I first looked into this disease, had trouble finding anybody who could talk about it, because there is precious little data about this type of cancer and virtually no information about the social issues surrounding it," says Allen. "But when I did find some men who are struggling with it--through an Internet news group--information just started gushing in I think that attests to the frustration that a lot of these men feel--that there's so little support for them out there. It was a privilege to hear their stories."
This year in America, fourteen hundred more will learn they have it. All of
them will be shocked and dumbfounded. And some of them will die.
This is a story about numbers. And then, decidedly, it is not. The first of
these numbers is seven: one man plus one woman plus four kids plus a dog named
Happy.
You pull out of Portland, Oregon, that misty and muscular little city bisected
by the Willamette River, that town of rain and Powell's Books and gold-rush
hotels with Wild West murals in the lobby, and you point yourself toward the
Pacific. Past the Intel plant on Highway 26, where they developed the new one-gig
Pentium chip, code name Coppermine, down the littered byways of Exxon and Wendy's
and Safeway, could be anywhere, U. S. A., and it is. And then, about twenty-two
miles outside town, you're or Pacific Avenue in the suburb of Forest Grove,
and you're turning in to a trailer park, and the street is wide and clean, and
the yards are landscaped--one garden has painstakingly sculpted spiral topiaries--and
there are those rows and rows of mailboxes nailed neatly to planks and mounted
on poles, must be a hundred or them. And you stop in front of a blue double-wide,
number 68, with a line of rosebushes cut back for the winter and a vine-covered
trellis and a varnished cypress sign hanging by two little chains from the porch
roof. And into the sign has been routered, in cursive, the words "Lyons'
Den."
This is the home of Dave and Teresa Lyons. And you find, after knocking on the
door and being admitted to the cozy living room by a seven-year-old in his pj's
and a two-year-old Labrador-spaniel mix, a big, loving, chaotic family. There's
the two foster kids (eleven and four), whom we'll call Melinda and Jack. There's
Jacob and David, their natural-born sons (nine and seven). There's Ashley and
Raymond, whom the couple is watching so their mother can go to work. Six kids
and a puppy. Three bedrooms. One paycheck. There are Sounds of computer games,
barking, and occasional shrieks of toddler outrage; there are shelves sagging
with National Geographics and videos and toys; there's Dave's collection of
Hot Wheels cars--he especially favors purple ones. There are Olan Mills portraits
of Jacob and David arranged stair-step on the wall, both looking left and upward,
toward a third portrait: Jesus. And on a blue love seat, the closest thing to
a sofa that will fit in the crowded room, sit Dave and Teresa.
Dave has positioned his right arm upon the back of the sofa, with his forearm
hoisted skyward. He flexes his fingers as if he's crunching a squeeze bulb.
He does this with his arm, with the squeezing, for hours on end.
David Bayne Lyons is thirty-six years old. He is soft-spoken and gentle, and
he radiates a goofy sense of humor. He's possessed of a boyish aspect and wiry,
thinning black hair, wears blue jeans and a purple T-shirt and glasses and Nikes.
He grew up in Fremont, California, where his father was an electronics technician
and his mother served it up in school cafeterias. He and Teresa were married
in 1986 in a quickie chapel in Reno--the kind of place where you return the
plastic bouquet after the ceremony--and kept it a secret until they could seal
the deal with a church wedding later that year. "We tied a double knot,"
says Teresa, "so it won't come untied." They are both devout Seventh-day
Adventists, and they eat no meat and neither smoke nor drink. Dave works in
the class-1 "clean room" at Intel, where you will find only one half-micron
of dust per cubic foot. There, in a white Gore-Tex bunny suit (that's what he
calls it: his "bunny suit"), he cranks out the microchips that have
powered the nation's techno-revolution. "Mostly what we do is we put the
wafers on the machine and push start," he jokes.
They are the most regular of American families, a loving family, a salt-of-the-earth,
giving sort of family, as you can plainly see, and things are pretty good. But
it's been rough these past three years--very rough. The warning signs, .they
came way, way back. Back when Dave was just a teenager. And the signs, despite
Dave and Teresa's desperate efforts to get answers, they were flat-out ignored.Breasts.
You should know that despite your possession of a Y chromosome, you have them.
Two of them, most probably. They may not be perky or pendulous; nobody is likening
them to peaches or proposing to shake your tree. But you have them. Call them
pecs if you like, but your pectoral muscles, the ones that power your lateral
arm strength, facilitating push-ups, the ones that wrap around your rib cage,
those are just part of the picture that makes up the larger entity we know as
your chest. On top of those muscles is fatty tissue. That fatty tissue, between
the muscles and the skin--those are breasts. Your breasts.
See, there was this lump. In Dave's chest, right side. Painless at first. He
mentions it to his doctor, who assures him it is a cyst, or something or other.
Boys get those in puberty, they go away, don't give it a second thought. So
he never gives it a second thought.
Not until quite a few years go by. Not until the day in early 1990 when he is
driving to work and notices that his shirt is sticking to his chest, wetly,
on the right-hand side. He reaches down, checks, sees red on his hand. He reaches
again and squeezes a little, to ascertain whether the fluid is coming from where
he thinks it is coming from: his nipple. It is. After work, he brings it to
Teresa's attention. She looks. He squeezes and more pinkish fluid comes out.
Oh, my God, she thinks. What's happening? Something takes shape in her stomach;
she will later describe it as a heavy ball of dread. She wipes away the fluid
with a tissue.
The doctor sees him a week later and forwards him to a specialist in breast
diseases. What the specialist in breast diseases tells him: Don't give it a
second thought. This pattern will persist, with each new job and each move and
each insurance change and each new GP--four doctors, eight years, a mantra of
blithe reassurance. And eventually, Teresa says, the pooh-poohing from one medical
professional after another takes hold and causes the ball of dread to shrink,
to recede.
And then, in late 1997, Lyons is roughhousing with his boys, and he finds himself
pushing them away from his right side because somewhere along the line, pain
has come into the picture--a throbbing ache that radiates from the pectoral
area to the right arm. And then there's that dinner at Round Table Pizza, which
features a play structure for kids; one of the tots drops a toy between the
play structure and a wall, and Dave, reaching for it, brushes the right side
of his chest against a sharp corner. "The only pain I can think of that
comes even close," he recalls, "is getting hit in the testicles."
And Dave is worried. And Teresa is worried. And this time, they resolve, something
is damn sure going to be done.
An appointment is made, and Dave drives to a clinic. There he is told to put
on a gown, open to the front, which feels strange. He's a man, after all, he
goes to the swimming pool without a shirt; why not here? But he complies.
Perhaps you're not aware of this: A mammogram is achieved by stepping up to
a machine with a hard plastic clamp, a sort of vise. The breast is pulled into
the clamp by a technician and held there. The clamp then squeezes down, flattening
the breast so that it's thin enough to produce a clear X-ray picture. The clamp
is rotated, the breast is compressed again, and another picture is taken. This
can be done with a man as well as with a woman, but unless you're a man with
some meat on you, it's difficult to get much into the clamp. Also, as any woman
who's ever had one can tell you, it hurts. The technician pulls as much of Lyons
as she can into the clamp and compresses until her hand will no longer fit between
the plates, down to about half an inch.
She notes that his is the hairiest chest she has X-rayed in some time. They
laugh. The crack makes Dave feel a little better.
After the X ray, there is an ultrasound.
And the radiologist tells Dave he does not like the looks of this thing. Not
at all. This thing, he tells Dave, it measures 2.2 centimeters. It has edges
that are bumpy, like a piece of cauliflower. Garden-variety cysts don't have
edges like that, plus, they're hollow, with fluid inside. This thing, he says,
it has blood vessels in it.Talking with Dr. Patrick Borgen is like chasing a
felon on a perp walk. He can squeeze in a meeting only on foot, striding from
one appointment to another at Memorial Sloan-Kettering Cancer Center in New
York. So much cancer, so little time--Borgen seizes his days at six or seven
in the morning, stretches them to eight or nine at night, toils weekends. Most
cancer doctors live like this. He has a house in the fancy-pants suburb of Bedford,
New York, around the corner from Paul Shaffer; doesn't see much of home, though.
His kids attend school with Glenn Close's kids. He's been profiled in Biography's
magazine, and he's been a guest on the Today show.
Borgen is the breast-service chief in Sloan-Kettering's department of surgery.
He is a nationally recognized authority in the field of breast cancer at one
of the nation's best cancer hospitals. He has seen thousands upon thousands
of breast-cancer patients since the 1980s and has saved thousands of their lives
and has lost many, too, and of these thousands upon thousands, about 140 of
these breast-cancer patients were men.
You are surprised to learn that men can develop breast cancer? That selfsame
disease that ravages millions of women the world over? You did not know this?
Don't feel bad. Your doctor doesn't know, either. Even breast specialists don't
always know, as Dave Lyons learned.
In his entire lifetime of practicing, chances are, your general practitioner
might identify one case. He will be shocked and astonished. He will telephone
his colleagues. He will not know what to do.
Why this uncertainty, this lack of information? Simple, really: "You look
for common things, commonly," says Portland oncologist Ralph Weinstein.
"Men, they feel a lump, they don't know they can get breast cancer, they
go, they see their doctor, he doesn't know men can get breast cancer,"
Borgen says. "Their doctor tells them, `Well, let's see if it goes away.
Come back in six months.'"
By the numbers, from a particular way of looking at public health--and this
is a story about numbers--male breast cancer is a completely insignificant disease.
More than 180,000 women will be diagnosed with breast cancer in the United States
this year. Forty thousand will die. By contrast, the number of men who will
contract the disease is about fourteen hundred, with four hundred fatalities.
More people are killed by falling off roofs or scaffolding each year. If Borgen's
sample of 140 patients sounds small, it is, though it's also more male breast-cancer
patients than any other facility in the United States has treated.
So is this yet another damned disease a man needs to worry about catching? Not
really. Not much. But a little.
When boys and girls are still in the single digits, their breasts are essentially
the same--undeveloped ducts just under the nipple and areola. At puberty, girls'
ovaries produce hormones (notably estrogen) that cause the ducts to grow and
lobules (milk glands) to form at the ends of the ducts. The lack of estrogen
prevents this growth from happening in boys. But they retain those vestigial,
atrophied ducts.
Women have vastly more breast cells than men, which is part of the reason why
they're much more susceptible to breast cancer. But men aren't home free, particularly
men with a family history of breast cancer (even among female ancestors) and
men with the common disorder gynecomastia (an enlargement of the male breast)
or the rare genetic condition Klinefelter's syndrome. Age is also a risk factor
(most patients are diagnosed in their fifties and sixties), as are exposure
to radiation, liver disease, and estrogen treatments, such as those used by
prostate-cancer patients and transsexuals.
The causes of breast cancer, as with most cancers, are not firmly known. Some
breast cancers are related to inherited mutations of the genes that suppress
tumors. Estrogen and other hormones are thought to play a major role; most breast
cancers feed on these hormones. Ironically, the whole reason Borgen became interested
in male breast cancer in the first place was the potential such research into
hormonal differences between the genders could offer.
The good news: Male breast cancer is often easy to detect. It always occurs
immediately behind the nipple, in the milk ducts that, because men are men,
never develop. So that's where you look. (In women, cancer can occur behind
the nipple, but far more often it strikes in the upper lobes of the breast,
closer to the arm.) Sometimes male breast cancer causes inversion of the nipple.
It may cause bleeding there, too, although that happens in only about 20 percent
of cases. "A bloody nipple discharge in a man who hasn't had any history
of trauma is breast cancer about 90 to 95 percent of the time," says Borgen.
Yet, harmless cysts are common enough that it hardly makes sense to go around
mammogramming and biopsying every guy who comes into the doctor's office complaining
about a bump (numbers, yet again). What's needed is something simpler: for more
doctors to become at least dimly aware of a constellation of symptoms. You figure,
male patient, in his fifties or sixties, family history of cancer, painless
mass behind a nipple, gynecomastia, let alone nipple inversion or bleeding--"these
should all play a role in someone's index of suspicion," Borgen says. All
of the above, he says, "that should set off a lot of bells, buzzers, and
whistles." That's all.Dave and Theresa spend Thanksgiving 1997 with Teresa's
parents. They feel no need to mention the impending surgery, basically an investigative
lumpectomy. It is scheduled for December 9. The surgeon is in no particular
hurry.
On D-day, the doc is almost jolly, despite his conviction that the Lyonses are
wasting their time and, more important, his. He performs the lumpectomy. Local
anesthetic. Dave feels no cutting, no pain; he does feel a touch of nausea,
a tugging. He hears these sounds: the suction machine, the snipping of scissors,
the clanking of instruments on a tray.
The proceeds: a lump of flesh, size of a grape.
It's a dull word, lump, suggesting something stupid, inanimate. Another term,
mass, feels similarly vague, faintly threatening, maybe, but clinical. Growth,
that's worse than mass. Cyst sounds like something disgusting on your toe that
doesn't belong, but harmless; something that's removed and forgotten.
And then there's tumor.
"Oh, yeah; this is fine," the surgeon says. "I'll be able to
tell you this is not cancer."
Seven days pass.
On December 16, there is a chemical spill at the Intel plant. Dave, being a
member of the emergency-response team, dons a protective suit and helps clean
it up. Wearing the suit causes a man to sweat prodigiously, so when the job
is done, Dave's supervisor sends team members home for a shower. Dave reaches
the trailer about noon, scrubs up, and sits down at the kitchen table with Teresa.
It is a pleasant surprise for her; Dave rarely comes home in the middle of the
day. The phone rings; Teresa answers. It is a man. He asks for Dave. It is the
surgeon. "And so I handed the phone to Dave and I just collapsed in a chair,"
Teresa says. "Dave sat down and his face just turned white, I mean white
as a sheet. If I could have sunk down any more, if I could have fallen off the
chair--I was just in shock. I didn't even have any words. I couldn't cry. I
was just too ... too shocked to cry, I guess. And I said, `It was cancer?' And
he goes, `Yes.' And we just sat there looking at each other. "I said, `Honey,
you can't go back to work.' He said, `I have to. What am I gonna do? Sit around
here and mope all day?'"
Teresa tried hard not to start crying. They stood there hugging each other for
probably five minutes. And he said, "I have to go." You can't even
describe the awful sick feeling you have, the sinking feeling, like a ship is
going down," Teresa says. "And I thought, Oh, my God, he's gonna die.
And there's no way I can raise my kids on my own. The kids are playing; how
do you explain to them that Daddy's got cancer? All we knew was that they didn't
get it all. There was still more there. The margins had been positive."
The second surgery, a modified radical mastectomy, comes without delay this
time. It takes three and a half hours. The lymph nodes feel unusually large,
the surgeon tells Teresa. You better pray there wasn't cancer in those nodes,
he tells her. When the nurse removes the bandages the next morning, a huge flap
of skin comes off with them. On the right side, Dave's chest is not just flat;
it's deeply indented, purple and red from the trauma, staples and sutures everywhere,
two eliptical scars coming together and trailing up to e armpit, from which
a clear tube drains fluid into a bulb.
After a time, the doctors and nurses leave.
Dave and Teresa are shocked and angry; the wounds look sloppy to them.
"They took my nipple, Dave says.
The surgeon hadn't mentioned that. There was a time not long ago at all when
male breast cancer was commonly treated with a procedure called orchiectomy--the
surgical removal of the testicles, or castration. Theory was, scale back the
level of male sex hormones in the body, upon which many cancers greedily feed,
and the tumor will regress. It works.
Happily, they can do that sort of manipulation now with drugs. But nearly any
man who develops breast cancer will need a mastectomy, the removal of all the
offending breast tissue, the nipple, and the areola. Of course, cancer is often
not content to stay put. If it metastasizes through the lymphatic system, the
body's "pool filter" network, which drains upward from the breast
through a string of lymph nodes under the arm, those nodes must come out, too.
And when you take out enough nodes under an arm, a condition called lymphedema
can result, in which the lymphatic fluid that accumulates in that arm has no
nodes to escape to. The arm swells, sometimes painfully, making manual work
difficult. There's no cure, just massage techniques and compressive bandages
that help force the fluid back out of the arm.
For many men, of course, the surgery is just the beginning. There's chemo and
radiation, too. Lyons was lucky enough to dodge those bullets, but he got a
nasty case of lymphedema--that's why he holds his arm skyward on the back of
the couch, flexing his hand, squeezing the lymphatic fluid back into his torso.
Considerably worse, both for him and his family, have been the side effects
of his primary medication.
Four weeks after his mastectomy, Lyons sees his oncologist for the first time.
The prescription: tamoxifen, a frontline treatment for breast cancer that blocks
cancer-cell receptor sites for estrogen, upon which they would otherwise feed
and grow. The drug is effective for many people, but it can cause serious side
effects in men: depression, hot flashes, sleep problems, lack of libido, impotence.
"We read that the-loss of libido was awful," Teresa Lyons says, "but
the worst part were the mood swings and depression." Dave rubs his eyes;
his left hand shakes slightly. "It's been pretty hard on my family,"
he agrees.
Nine months into the drug therapy, Teresa's parents are visiting, staying with
the Lyonses in their crowded trailer. Teresa's mom ignores Dave's pleas that
she stop cleaning, scrubbing, washing. He blows up. "He told her that he
didn't like having her in our house, and that she needs to mind her own business,"
Teresa says. Mom starts crying. Dave rips his arm from Teresa's grasp and runs
out of the house into a frigid night. In a T-shirt. Half an hour later, she
finds him pacing the block, still seething.
Around the same time: Tough day at the plant, nothing's going right, and the
emergency-response team is paged to perform an emergency drill. Lyons goes ballistic.
He peels the ERT sticker from his employee badge, storms up to his supervisor,
smacks the sticker onto the supervisor's chest, and hollers, "I don't have
time for this crap!"
"I don't talk to anybody that way," Dave says, "much less my
supervisor."
You've got to get this taken care of, Teresa says. You're going to lose your
job, she says. You're going to ruin our lives because of your anger. The doctors
up his dosage of Paxil, an antidepressant, and Lyons evens out pretty well.
"He's still hotter under the collar than he ever was," Teresa says,
"but it's under control now."
And his prognosis? As with any man, it should be no worse than it would be for
a woman. The previously held notion that breast cancer is more deadly in males
turns out to be largely a function of delayed diagnosis. Of medical ignorance.
When that lack of knowledge is surmounted, male breast cancer is exactly the
same disease. "If you correct that delay," Borgen says, "then
the disease is every bit as curable, as treatable, as female breast cancer is."
Dave had a long, long delay in diagnosis.
"There should not be a reason why men have an inferior chance for cure
than women," says Dr. Weinstein. "If it's done right."The day
breaks clear and chilly on the banks of the Willamette on September 27, 1998,
and at 7:00 A.M. the Lyons family arrives in downtown Portland for the Susan
G. Komen Foundation's 5K Race for the Cure. There are thirty-three thousand
people there.
Weeks prior, they had been told that Dave could not compete because, by acclamation
of the foundation's members, the race is a women-only event. "We're bosom
buddies," a member told Teresa. Dave, clearly, is bosom free, but Teresa
is not sitting still for this. She scores two and a half hours on a local radio
call-in show. The host, Lars Larson, is outraged; the callers fume. The foundation
is embarrassed.
Dave is extended an invitation to run as an "honorary participant."
The "honorary" thing galls him and Teresa, but they show up, albeit
with chips on their shoulders, and they bring more than $200 that they've raised
from friends and neighbors and people from church. Dave still has to tussle
at the sign-in table to get his hands on a competitor's shirt and cap emblazoned
with SURVIVOR--the volunteers want to give him a different shirt, the kind worn
by spouses. He wins out.
When Dave was first diagnosed, he recalls, "I was too embarrassed to tell
anyone." Now, at the race, he elects to keep the shirt untucked. "If
anybody bugs me about it," he vows, "I will pull up my shirt and show
'em!" Along the route, a few of the onlookers point at Dave. Some snicker.
The Komen Foundation is a hugely successful operation--there are now 109 cities
hosting Race for the Cure--and is obviously a well-meaning one. But its raison
d'etre, like that of the entire breast-cancer system--research, fundraising,
public relations, psychological support--is breast cancer in women. The movement
has been incredibly effective. Borgen calls it the strongest lobby in the country,
stronger than the NRA. But it appears unprepared to deal with the 1 percent
of cases that happen to be male.
Recently, the John W. Nick Foundation, named for a Wall Street broker who lost
his life to breast cancer, created a ribbon honoring both men and women with
the disease (it's pink and blue), but few have ever seen it. Dave and Teresa
Lyons felt so alone in their struggle that they launched a support group, the
Male Breast Cancer Awareness Group, in Portland, one of the few anywhere in
the country. Its first meeting was in October of 1999.
No such endeavor has yet to take wing anywhere near East Windsor, New Jersey--at
least not to Bill Sherman's knowledge. Sherman, a high school guidance counselor,
naturally felt shocked and frightened when he was diagnosed with breast cancer
in 1996, and so he sat in on a women's group. "And I was--I don't want
to say shunned, that's a strong word," Sherman recalls. "But I never
felt welcomed. I just didn't feel welcomed, so I didn't go back."
Even if there were more men's groups, there's that peculiarly male tendency
toward stubborn self-reliance and insecurity at play here, too. "Women
pick up the phone and call fifty other women," says Borgen. "They
network, they say, `Oh, I know a good radiation guy, I know a good surgeon,
I know a good acupuncturist.' Men don't do that; men sit at home. It's almost
like asking for directions; men just don't do it."
Sherman is asked if he's ever met another male patient. "Met?" he
asks. "Uh, no. Nope. I'm on the Internet, but I have not met any."
Back at the 5K race, Dave makes it to the finish line, where the woman who is
supposed to record his time won't take his ticket. "Are you the person
who's supposed to take this?" Dave growls. "Sor-ry," the woman
says sarcastically.
The fact that the fight against breast cancer has become something that women
own is in large part a function of the fact that they have every right to own
it. Just not entirely.
"I had women telling me, `We don't want men in this group; it's a woman
thing,' "Teresa says. "I mean, even before the race was half over,
we were feeling defeated. I didn't even want to turn in the money."
But they did turn in the money. And Dave got a prize.
And a short time later, they got a vastly better reward. The best possible reward.
The most meaningful, inspiring, exciting outcome possible. Which is to say,
through their actions, they quite possibly saved a man's life.Eugene, Oregon,
is about two hours south of Portland. It has long been something of a hippie
haven; during the anti-WTO brouhaha in Seattle, Eugene activists staged their
own boutique protest downtown. Richard Gilbert, though, he watched the protests
on TV with something of a gimlet eye, being that he's not a hippie; he's a sixty-six-year-old
real estate broker who nurtures seventy-year-old, holly trees and drives a twenty-year-old
Benz. He's also more your typical candidate for breast cancer than Lyons, being
rather a large man of more advanced years.
My daughter says, `Dad we've already decided you re gonna die of a heart attack,
not cancer,'" Gilbert cracks. "She's very candid."
Also, Gilbert suffers from a case of gynecomastia, a risk factor for the disease.
In late September of 1999, Gilbert was carrying his wife s sewing machine up
a flight of stairs and bumped it against the left side of his chest. It hurt.
Shortly thereafter, his wife, Nancy, recalls, he went to his doctor on a routine
matter and mentioned the chest pain. "And the doctor said, `Well, let's
just watch it.'"
Three weeks later, the Portland Oregonian published a small story about Lyons's
dustup with Race for the Cure. The story got picked up by the Eugene Register-Guard
on October 7. Gilbert read it over breakfast and faxed it to his doctor. The
next day, the mammogram. "They squeezed the hell out of me," Gilbert
says. On October 12, the ultrasound.
"Nodular palpable abnormality just to the ten-o'clock position of the left
nipple," the radiologist wrote of the tumor, about the size of a pea. "Should
be biopsied ... suspicious for malignancy."
It was. And it was. On October 29, the modified radical mastectomy.
Nancy, it should be noted, is not Richard Gilbert's first wife. The woman he
was married to before, Roxy, died of brain cancer. Her deterioration lasted
five years.
In part because of that, Nancy imagines, her husband decided to act early.
Still, the improbable activism of the Lyonses can't be overlooked. Because the
mild-mannered couple--hardly political rabble-rousers--were hell-bent on participating
in a women-only event and because they formed a support group and got their
story into Gilbert's local paper and because he saw it and faxed it to his doctor,
a malignant tumor was detected and removed.
"I think we might have made a difference for a few people," Teresa
allows.
Gilbert's lymph nodes turned out to be clean. He now will check in with an oncologist
every three months for the next two years, every six months for three years
after that. "I feel like I've been reborn because of this experience,"
Gilbert says. After his surgery, he drove up to visit the Lyonses. He brought
them an azalea and Morsecode flashlights for the boys.
It turns out that Gilbert also is a Seventh-day Adventist. Coincidence? "That
might be the wrong word," Lyons says.It is now late February 2000. A Thursday.
Dave Lyons gets in his 1986 Chevy Celebrity and drives forty minutes to the
oncologist, as he must do every three months. And afterward, he is advised that
he has reached something of a milestone: He remains clear, and now, for the
next three years, he need go only every six months.
Lyons is incredibly fortunate, relatively speaking. Despite the fact that his
cancer had a generous number of years to riddle his body unperturbed, his doctors
believe it did not spread.
"I believe that I was healed," he says. Of course, faith would be
meaningless if it were easy. "That fear, it's always there," Teresa
admits. "This could show its ugly head again. We believe he was healed,
but we also know that--reality--that it could come back."
Little Jack, the four-year-old, interrupts for the umpteenth time and approaches
Dave's knee. The boy's been living in their home for only a week; already, he's
calling them Mom and Dad.
"Dad," Jack wants to know, "where are my socks?"
"I don't know," Dave says. "Where'd you take them off?"
"I took them off in the bedroom."
"Well, they must be in the bedroom, then."Ten Names. Ten men. TEN
NAMES. Men who are fighting or have beaten this disease--to the extent that
one beats cancer--and who shared their stories with us: Bob Riter, Ithaca, New
York; Bob Jones, Yardley, Pennsylvania; Denton Ortman, York, Pennsylvania; Sam
Hurwitz, Spokane; Charles Blosten, Littleton, Colorado; Stephen Meredith, Woodinville,
Washington; James Lowery, Cordes Lakes, Arizona; Hellmut Golde, Seattle. And
two more in the Portland support group: Bob Miller and Lowell Gere.This is a
story about numbers.
Five-year survival rate for men with breast cancer with no metastasis: 90 percent.
Five-year survival rate when spread to regional lymph nodes: 75 percent.
Five-year survival rate with distant spread: 20 percent.
Relative delay in diagnosis of men versus women: eighteen months.The Numbers
Results from an informal, non-scientific survey of 104 male breast-cancer patients
treated at Memorial Sloan-Kettering Cancer Center, New York, between 1984 and
1999:
* Percentage of patients who, prior to diagnosis, were unaware that men could
develop breast cancer: 86
* Percentage of patients who were not diagnosed until they had sought a second
opinion, often because the initial physician was uncertain of what he was seeing
and asked the patient to do so: 77
* Percentage of patients who confined specific discussion of their diagnosis
to immediate family: 20
* To family and very close friends: 60
* Percentage of patients who felt "significant" embarrassment at being
diagnosed with a disease typically considered to affect only women: 40
* "Some" embarrassment: 15
* Percentage of patients who were frustrated by the lack of community support
mechanisms for men: 80
Question: What was the most frustrating part of your diagnosis and treatment?
Answer: Overwhelmingly, patients felt frustrated by the lack of information
in the press and on the Internet concerning male breast cancer, and by the lack
of other men with whom they could discuss their situation.
For more resources on Male Breast Cancer, click here.