FRIDAY, Nov. 15, 2002 (HealthDayNews) -- Michael Samuelson almost died from a disease he didn't even realize he could get -- breast cancer.
"A lot of men don't know they have breasts," says Samuelson, a 54-year-old health educator who lives in Ann Arbor, Mich. "They think they have 'pecs.' They think breast cancer is a woman's disease."
But men can and do get breast cancer. About 1,500 cases of breast cancer in males will be diagnosed in the United States this year, and 400 men will die of the disease, according to the American Cancer Society.
While death rates for women have dropped in the last 20 years, the death rate for men has remained steady.
A big part of the reason why is that breast cancer in men is often diagnosed at a later stage, after the disease has metastasized -- or spread -- to other parts of the body.
Women have greatly benefited from massive public education campaigns urging them to get regular breast screenings and mammographies after age 40, says Debbie Saslow, director of breast and cervical cancer for the American Cancer Society.
But men don't do breast self-exams, they don't get mammographies, and doctors don't routinely look for signs of breast cancer in men because it's so rare, Saslow says.
"Most people think of breast cancer as affecting only women," Saslow says. "It does affect diagnosis because men and [health-care] providers are less likely to be looking for symptoms. And for some men, embarrassment can be a factor."
Little research has been done into male breast cancer. Doctors do know, however, that nearly all male breast cancers begin in the breast ducts, while about 70 percent of breast cancer in women begins in the breast ducts.
Until puberty, both boys and girls have a small amount of breast tissue, consisting of a few ducts located near the nipple. At puberty, a girl's ovaries produce hormones that cause breast ducts to grow, and lobules, or milk glands, to form at the ends of the ducts. In boys, male hormones prevent further growth of breast tissue, but the ducts remain.
Samuelson very nearly discovered his breast cancer too late. He went for a meeting with his accountant and noticed the man looked pale and drawn.
Samuelson was shocked when he found out the accountant had been diagnosed with breast cancer.
Sitting in his car in the parking lot after his appointment, Samuelson felt his own nipples, just to be sure. He detected a hard lump under one nipple. He went home and had his wife feel it, too.
Within a few days, a biopsy confirmed the lump was cancer -- and it was growing rapidly.
He had a radical mastectomy. He was told by his doctor the cancer had spread to his pectoral muscles but hadn't reached his lymph nodes or other organs -- good news.
Since his breast cancer was successfully treated three years ago, Samuelson has been traveling to speaking engagements across the country. He's addressed men's and women's groups, trying to increase awareness about the health threat.
Other men with breast cancer have told him about their reluctance to tell anyone they had cancer of the breast.
"They think, if I'm a macho man, how can I have that?" says Samuelson.
"You take that along with the male psyche that says, 'I don't want to talk about these things. I don't want to admit anything is wrong,' and you have a lot of men who are very much alone."
Samuelson recently founded what could be the nation's only support group for men with breast cancer and their families, called "A Touch Of Blue."
"I founded it because when I was out there looking for information after my diagnosis, everything was directed to women," he says. "But men are frightened. They're angry. They simply want to find other men that they can talk to about issues from masculinity to being embarrassed about your mastectomy scar when you want to go to the gym."
Today, Samuelson is doing well. He's training for a marathon. He climbed to base camp on Mount Everest in Nepal and hiked across a glacier in Alaska.
"I did it to tell men that you can certainly survive breast cancer," he says. "And for guys who wonder about whether or not breast cancer has any relationship to a guy's ability to do 'guy' things, this was to let them know they still can."
The incidence of breast cancer in men is too low to recommend that they get screened with mammograms, Saslow says. While about 400 American men will die of breast cancer this year, 40,000 women will die, according to the cancer society.
"Men should be aware that breast cancer does occur in men even though it is very rare," Saslow says. "If they feel a lump in the shower or through other routine daily activity or notice any physical changes, such as the appearance or discharge from the nipple, they should bring it to their doctor's attention promptly."
Men who have close relatives with breast cancer should be aware that they may be at increased risk, Saslow adds.
What To Do
For more information about male breast cancer, visit the American Cancer Society.
Samuelson can be reached at the National Center for Health Promotion, which he founded.
