When we talk about breast cancer, we always think of a woman and, on too many occasions, only positive messages are sent, when “breast cancer is very hard, we don’t have to sugarcoat it,” as Pilar once told this supplement. Fernández, patient and president of the Metastatic Breast Cancer Association.
It is the b side of breast cancer, and the one that also needs to be shown because men also suffer from breast cancer. And, yes, equally metastatic. A reality on which there is still no focus, and why many men today continue without undergoing examinations and without giving importance to a detected lump.
Hence the need for make visible, destigmatize and increase awareness of this cancer in mensince precisely for these reasons men are too often diagnosed late, in phase IV or metastatic, which is when some cells from the original tumor have spread and invaded new tissues.
And this despite the fact that today the situation is very different from that of 2018 when Màrius Soler created the Male Breast Cancer Association (INVI) to make it known and help others in the same situation. Make the invisible visible.
«I noticed a lump while I was in the shower, but I waited. It was August 2016 and I wasn’t diagnosed until January 2017. I let it go because I thought it was like the one in my head, and I didn’t go to the doctor until my rib started to hurt.», recalls Soler, founder and now outgoing president of INVI.
Had “breast cancer with bone metastases.” The doctors then gave him six months to live. Seven years have passed and Màrius continues to be the speaker of this cause. Because today people continue to talk about patients. And yes, they are the majority, but that makes men mistakenly believe that they cannot suffer from this tumor simply because they are men.
“After five months in hospital and three clinical deaths and 25 injuries, I am stabilized”
Soler has suffered a relapse. But, “after five months in the hospital, I am stabilized. I have had three clinical deaths. I have suffered a relapse. Now I have 25 lesions, not 22. I have a spot on my lung and liver and this has caused hypercalcemia. Luckily now I am at normal levels. But we have to wait and see,” he explains from the hospital.
Weeks later we call you again to see how you are and to complete the interview. «I am on my eighth opportunity and it was going to be the last because not in all communities or in all hospitals the compassionate use drug is given even though they are required by Royal Decree. But in my case the luck factor has played a role and in one week I have gone from having no more options, to having option b and c,” he says, remembering that until a few weeks ago “there were autonomous communities in which they were giving nine treatments for breast cancer.” and in others not. «And, what option do we have for patients? Die, and I say it just as it sounds, or change communities so that they give it to us.
And the same thing may happen in the future with other drugs. It is a shame, and I say it this way, that we are one of the pioneering countries in clinical trials and then it takes almost 900 days to authorize drugs. How many lives are lost in this time? Because a treatment can triple your survival or life, even remission or give you more time to see how your daughter makes communion,” he denounces.
«A drug can give you time and see your daughter’s communion. How do they take 900 days to approve it?
«Now I am hospitalized at home. Medical and nursing staff come to check on me, alternating. They do an analysis every day, as if I were in the hospital and we have a 24-hour service in case of emergency,” he highlights. “The home delivery service is impressive, how well everything is organized, I am impressed,” emphasizes Soler.
After having been “operated on three times and having had a lot of radiation, on Tuesday for the first time an adapted exercise oncology physiotherapist doing two exercises found that I have a hernia that has been bothering me for eight years.”
«For the first time in almost eight years, they tell me that I have to do these exercises every day. Oysters, Integrative Oncology please. Here in the center where I am they are doing it, they are having a transversal vision”, which they had not had to date…
It is good proof of this that the committee of experts he went to “was not on pain, when from 5 to 6 it goes up to 10 towards the evening, which is when hypercalcemia hurts the most,” thank goodness they were able to see that the treatment approved for him, the one they wanted to give him, “interacted with another medication I take for pain.” In short, transversality is needed and it cannot be that today, depending on the center where one is, the committee of experts is made up of some specialists or others.
Regarding treatment, Màrius explains that men receive treatment at the same time as other patients, but before, not so far in time, “we were not even entering clinical trials and thanks to us these protocols have been changed”he says proudly. No wonder, “it has cost us a lot to put a blue dot on a pink bow.” Of course, “it continues to work against us that we are a minority,” he says, referring to the fact that “it is a different subtype of breast cancer. Ours is due to estrogen and theirs is due to hormones.
Specifically, breast cancer is very rare in men. Suppose between 1.5 and 2% of diagnoses. Well, this tumor has “an important component related to hormones, mainly estrogens. That is why treatments with estrogen inhibitors are often used. However, in men (and this may be the reason why breast cancer has a more aggressive course) there is less hormonal dependence on this tumor,” explains Jorge Contreras, head of the Comprehensive Oncology Service at the Quirónsalud Málaga Hospital. . Despite this, the treatment is practically the same.
Another difference is that male breast cancer It is more hereditary than the female. 18% of male patients have a mutation in transmissible risk genes, compared to 5-10% of women, according to data extracted from the National Male Breast Cancer Registry, promoted by the Geicam Breast Cancer Research Group.
Therefore, if you have close relatives with breast cancer (several first and second degree relatives such as sisters, mothers or grandmothers who have had the disease or cases of male breast cancer in the family), it is possible that professionals recommend undergoing a relevant genetic study.
There are still no studies designed specifically for breast cancer in men. Hence, Geicam launched the aforementioned National Registry with clinical and biological data of some 800 male patients from 54 hospital centers that have revealed the high rate of mastectomies in men, which reaches between 94% and 96%, compared to the much more common conservative treatment in women, which is around 70%. This approach in men may need revision, considering the aesthetic and functional importance of the breast. Furthermore, the need for more conservative treatments is questioned depending on the individual case.
Regarding age, «The median age of diagnosis is slightly higher for men than for womenaround 60 years old,” they report on the INVI association website. When 56 years is the average age of patients with metastatic breast cancer.
Regarding the typical presentation of breast tumor in men, this is in the form of a unilateral painless palpable mass (in a single breast) located centrally, subareolar or eccentric to the areola-nipple complex with early involvement of the nipple.
The majority of cases (85-90%) of breast cancer in men correspond to infiltrating ductal carcinoma. About 65-90% of these tumors express estrogen and/or progesterone hormone receptors. And in most cases, when it is detected it is already in advanced stages. Thus, around 300-350 men are diagnosed each year in Spain, 80% in stage III or metastatic.
Prejudice and lack of information promote diagnosis in advanced stages, and this situation is worrying, since men are 49% more likely to be diagnosed in advanced stages than women. Furthermore, the low correlation between diagnosis and treatment effectiveness contributes to lower survival in men.
«People have no idea what cancer is, but also the consequences for the family.“Effective or effective prevention is not being done.”that’s why «Sir, man, man, if you notice a lump or if your breast hurts, don’t wait and go to the doctor», concludes Soler.
Catch it in time!
►The INVI Male Breast Cancer Association has launched the international campaign “Catch it on Time!”, which will take place until October 20 in Spain, Australia, Belgium, France, Italy, Japan, New Zealand, Portugal, United Kingdom, South Africa, Germany and the United States, within the framework of European Male Breast Cancer Day and international breast cancer awareness month. This initiative focuses on informing men about how important self-examination and medical consultation is in the event of any suspicious symptoms, since education is key to saving lives.
