Breast cancer; it's not just a woman's disease
David Norlach is one in a thousand.
The chances are about one in eight that a woman in the United States will be diagnosed with breast cancer during her lifetime, according to BreastCancer.org. For a man, the risk is about one in 1,000.
Norlach is one of those men.
Back in May 1997, he was getting ready to play golf when he noticed that his right nipple was inverted and looked yellow. A few days later, he felt a pea-sized lump on that breast.
“I told my wife, Shirley, about it, and I said, ‘Just for the heck of it, I’m going to go see our doctor,’” he said. His primary care physician, Ann Gryboski, MD, MPH, examined him and suggested he get a mammogram.
“I said, ‘You want me to get what? Men don't get mammograms,’ and she said, ‘Well, I’m not quite sure what this is, but let’s just check it out.’
“Shirley and I went over to Cape Cod Hospital, where they did the mammograms then, and I was the only guy in there. All of the women looked at me. It was kind of funny.”
What happened next wasn’t funny.
After the mammogram, a doctor did a biopsy and had results within half an hour.
“He told me I had breast cancer. I said, ‘Men don't get breast cancer,’ and he said, ‘Not many do, but you have it.’ ”
Advocate For Awareness
Norlach had a modified radical mastectomy and was told the mass was cancerous but hadn’t spread. Oncologists told Norlach that neither radiation nor chemotherapy was needed.
Norlach, 81, who lives in Yarmouthport, goes for exams every year, but there has been no recurrence. The experience turned him into an advocate for awareness about men’s breast cancer.
“I’m a firm believer in early detection. That doesn’t mean any time you have a hiccup or a burp you run to a doctor. If something unusual shows up that has not been there before and it can’t be explained in a short period of time or doesn’t go away in a short period of time, the only thing that keeps you from going to a doctor is fear – fear that it might be something that you don't want it to be.
“By not going, you create a situation where if it is something, you run the risk of really hurting yourself long term, maybe even dying. It’s worth the visit to find out.”
A Doctor’s Perspective
Peter Hopewood, MD, a Falmouth-based surgeon, agrees about the importance of self-detection.
“If you feel a lump anywhere in your body – your armpit, your neck, your breast, your testicle – get it checked,” he said. “Most of those are going to be benign, like little cysts. But something that’s there for months and is not going away, is getting bigger or is causing pain, that’s not normal.
“A lot of the breast cancers in men are silent. There’s just a little lump there that doesn’t hurt. They just kind of sit there and can slowly get bigger, just like in a woman.”
Family history is one of the risk factors for breast cancer in men, Dr, Hopewood said.
“If you have first-degree relatives with breast cancer, for example a brother, a sister, a parent or a child, then your risk is increased,” he said. “That goes for men and women.”
Aging, obesity and radiation exposure, such as treatment for Hodgkin's disease, are among the other risk factors.
The presentation of male breast cancer is typically different than female breast cancer, he said.
“When a man has a cancer in the breast, it doesn’t feel like this rubbery thing right behind the nipple,” he said. “It’s usually off center, it’s hard, and it feels completely different. It feels like a bump that doesn't belong there.
“A lot of times, men don’t think they can get breast cancer, so they sit on it longer. They leave it alone, even though they're feeling something, so they get diagnosed a little later than a woman.”
About a year after his cancer surgery, Norlach participated in the American Cancer Society’s Relay for Life in Yarmouth. He and Shirley then chaired the relay’s survivors’ event for 10 years. He went on to become part of a national ACS team that trained people to run successful relays. Locally, he helped launch the annual Making Strides Against Breast Cancer on Cape Cod walkathon.
“It’s been a very heart-warming opportunity to give back,” he said. “All the people I’ve talked to about cancer, I don’t have any idea what impact it’s had, but maybe I helped save somebody’s life by something I said somewhere.”