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“To date, there have been a few men I have helped guide through this long process. I am motivated to support any male that requests assistance during their difficult time following a metastatic breast cancer diagnosis.”

Husband and advocate for male breast cancer awareness-guided by his loyal terrier

ABOUT JEFF, IN HIS OWN WORDS:

• Discovery led by my terrier, Kilts, my battle with breast cancer began.
• My fight with cancer taught me the power of self-advocacy and the importance of support.
• I now educate and support other men, turning my diagnosis into a mission to raise awareness and dismantle stigmas.

A Loving Dog’s Unlikely Clue

Usually, a guide dog helps people who are blind, but in my case, it was my little blind West Highland Terrier, Kilts, who guided me to my breast cancer diagnosis. It started for me when I found my own swelling and realized I had some pain too. I was carrying Kilts outside to do his business, as usual. The day I picked him up and he bumped into my left breast I felt a little pain and saw a bit of swelling. However, like many males, I ignored the symptoms. I assumed it was a swollen gland or a cryst that I would have checked if it got worse. I had never known of a male with breast cancer or heard of breast cancer in men.

From Discovery to Diagnosis

Six months later, while on vacation, I was changing for a day at the beach. My wife, Maureen, noticed that my left nipple was inverting and said, “You are going to the doctor as soon as we get home.”

When we returned home, I tried to make an appointment with a breast surgeon. The surgeon wanted me to visit my primary care physician first and have a breast MRI prior to meeting.

When meeting with my PCP, he poked at my chest and said “This is more than likely nothing.” He wrote a prescription for a mammogram instead of an MRI. Maureen reported this to the surgeon, who scheduled me an appointment right away. A few days later, a needle biopsy was performed. The surgeon reassured me, "99% this is probably nothing to worry about.” However, 1% was still concerning. I was obviously confused and concerned.

Three days later I received the dreaded phone call from the surgeon: My biopsy was positive for breast cancer. As anyone who has gotten this phone call knows, everything changed instantly. I had so many questions: What about my family? Will I survive this? And what about my job? How will I support my family? How will I tell my children and my 81-year-old mother? It was a very emotional time for me.

The next few weeks were a blur: meetings with the breast surgeon, an MRI, and then a mastectomy on my left breast. I was told that during my surgery two sentinel lymph nodes would be tested and if they proved to be cancerous, they would surgically removes as many as were reachable. They indeed tested positive for cancer. Of the thirty-five lymph nodes removed from my left breast, left underarm, and into the left portion of my back, thirty-four were found to be cancerous.

My diagnosis was invasive ductal carcinoma, stage III locally advanced breast cancer, estrogen receptor positive, HER2-negative. I was 59.

Career Shifts and Personal Battles

At the time of my diagnosis, I was a customer service senior director for a large computer company. My job literally required 24/7–365 availability. At times, I had been woken at any hour of the night to deal with emergencies and escalations. I loved my work, but there were high levels of stress and around-the-clock conference calls.

Once I was told that my cancer therapy would be chemotherapy and seven weeks of radiation, I knew I had to go on disability, as I could not perform my duties effectively after surgery, and on the days of and the subsequent days after chemotherapy. I went from being a senior director to trying to survive cancer. My life literally changed overnight.

As you can imagine, this kind of change was not easy! I was very busy with my work. There was a tremendous amount of boredom, fear, and digesting the changes that were occurring in my life. I was quite lucky that I had an amazingly supportive boss. He gave me whatever time I needed to recover from the cancer. I received gifts, emails, cards, and phone calls daily from my peers at both the corporate and local levels. The support was wonderful. My family was at my side from the day of surgery until I returned to work.

Bridging Health and Self Perception

I was initially embarrassed to tell anyone that I had male breast cancer, but after spending days on the internet reading other men’s stories and connecting with a surgeon-recommended survivor, I was determined to tell everyone. I wanted to educate other men. My advice has been to be proactive with breast-checking and taking action if anything is out of the ordinary.

After the mastectomy and healing, chemotherapy, and radiation, I had a hard time looking at myself with my shirt off in the mirror. I decided that I wanted to have reconstructive surgery, so I spoke with my doctors. Each of them discouraged another surgery. I was told, “Look at it like a battle scar,” or “have liposuction on your other breast to have both of them flat.” I wonder if this would have been the advice if I were female.

As a volunteer for male breast cancer support, some men that I have supported would never speak publicly about their diagnosis. Others were proud to show their mastectomy scar and lack of a nipple. I would have never removed my shirt at the beach or pool as I was extremely embarrassed with the way I looked. But part of this journey for me has been about listening to my gut and advocating for myself.

I decided reconstruction was important to me, so I had the surgery. I’m quite happy I did. Although it will never look perfect, it looks more normal to me, and I am nowhere near as self-conscious with my shirt off at the beach or pool.

I returned to work 10 months after my initial diagnosis. Completely bald, pale, and still undergoing radiation therapy, I was happy to be back to work and out of my home after all that time. Once the initial treatment ended, I still planned with my doctor to be on 10 years of daily maintenance medication plus regular checkups with the oncologist.

I didn’t spend 10 years on maintenance medication because a few years after my initial treatment, during a routine checkup with my oncologist, a lump was found above the original surgical area. The lump was small and near the area of my left collarbone. After another biopsy of this lymph node, it was found to be the same breast cancer as my original diagnosis. My oncologist raised my cancer diagnosis to stage IV metastatic breast cancer.

A New Path Forward with IBRANCE

My oncologist said that this lymph node was inoperable due to its location but there was an option for me to try called IBRANCE. I learned that IBRANCE was an oral therapy for patients with HR+ or HER2- mBC that I’d take in combination with fulvestrant. Before prescribing IBRANCE, my doctor told me about the benefits and the risks, including the serious and common side effects.

Since breast cancer is often more associated with women, my insurance company initially denied covering IBRANCE. During an already stressful time, my oncologist helped me do the work to get the approval, but I still remember how stressful it was while going through the process. I realize things have changed since then, and I know that men are even mentioned in IBRANCE TV commercials now.

As for my experience on IBRANCE, I’ve had multiple PET scans since starting on treatment and I can say my oncologist and I are pleased with the results. The medicine has caused some fatigue for me, but I try to stay active to combat it. It has also caused my hair to thin a bit. Please remember this is all just my experience, and yours could be different. Other patients may experience serious or common side effects including low white blood cell counts, lung problems, low red blood cell counts, low platelet counts, and loss of appetite.

The return of breast cancer changed my life again. My company offered an early retirement package. I decided it was the right time for me to retire.

Reflections on Life, Advocacy, and Moving Forward

As some of you may know, male breast cancer is very rare. Many men are unaware of the fact that men can get breast cancer, too. And often doctors don’t perform a simple breast examination during annual physicals on men. My advice is that men should check their breasts regularly and have their internist or primary care physician check for lumps during their annual physical exams.

Having a diagnosis of breast cancer can feel very isolating; possibly even more so for men diagnosed with breast cancer. I feel so grateful that I was able to connect with a male support group and speak with others who were dealing with similar experiences. I joined the group and collectively we created a brochure for men to check themselves and get checked during annual physicals. Many men feel shame about having a “woman’s disease,” but breast cancer doesn’t discriminate if you are male or female.

I decided that I would help other males afflicted by this horrible disease. To date, there have been a few men I have helped guide through this long process. I am motivated to support any male that requests assistance during their difficult time, who, like myself, has many questions. When you receive this diagnosis and have to learn how to live and cope with it, your mind begs the question: How did I get this cancer? I had always been healthy. I searched through my family history and found no one with breast cancer—male or female. I did genetic testing searching for the BRCA gene as a source of this cancer, which came back negative also. Solving the how and why is fairly philosophical but also somewhat futile.

But I know one thing for certain: I am grateful for the amazing care that I received and for my incredible family. The availability of the IBRANCE and fulvestrant regimen has helped me. I want to encourage men to be proactive about their own testing and know this is not just a disease for women.

Since my retirement, my daughter has given us two amazing grandchildren, and I enjoy every moment with family. Kilts may no longer be with us, but I know how therapeutic an animal can be. After all that I have been through, I decided to get another dog. I wanted a companion who would keep me busy and force me to get off the couch. And so I now have Ginger, a yellow English Labrador. We have walked a lot of miles together. Once her puppy years were over, I had no doubt in my mind it was a great decision to get her!

_{Ambassadors were asked to share their personal stories about IBRANCE and compensated by Pfizer for doing so. All content was accurate at the time of publication and may have since changed.}

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