Friday, November 25, 2005

(CNN) -- Bob Riter speaks to breast cancer patients, usually women, about something they can relate to -- his own experience with the disease.After a 1996 diagnosis, and treatment, Riter, 49, is in remission and working at the Ithaca Breast Cancer Alliance in Ithaca, New York, as the associate director."Lots of people have heard talks and things about breast cancer over the last decade, and sometimes by being a guy with breast cancer, it's a different twist that catches their attention," Riter says. "It makes them, I think, more receptive to the whole conversation."Arguably, little attention is paid to breast cancer among men, partly because of the low incidence in the population coupled with the assumption that it's not a male disease.The American Cancer Society estimates that in 2005, 1,690 men in the United States will be diagnosed with breast cancer (compared to 211,240 women likely to be diagnosed). Of those, roughly 460 will die from the disease.But while the rates may differ, breast cancers among men and women are nearly identical, including in terms of detection and treatment."It turns out that breast cancer is really the same disease in men and women," says Riter. "Under the microscope, you can't tell the difference."Diagnosis and treatmentBreast cancer in men usually presents itself as a lump in the chest, dimpling of the skin or changes in the nipple. From there, doctors can conduct a breast exam, mammography and biopsy to determine if the abnormalities are in fact breast cancer. In some cases, discharge from the nipple can be tested for cancer cells.Men are most often diagnosed anywhere from five to 10 years later than women -- with the disease most likely to strike those between the ages of 60 and 70.When the cancer is diagnosed in men and women at the same stage, the survival rate is similar, says Debbie Saslow, director of breast and gynecological cancer at the American Cancer Society. Treatment for men with breast cancer, as in women, depends on the stage and type of tumor, she adds.Based on those factors, a male patient's treatment can start with a mastectomy to remove the tumor and, in some cases, the surrounding lymph nodes. It might also include chemotherapy, radiation or hormone therapy."The treatment very much parallels what we do with women," says Dr. Eric Winer, director of the Dana-Farber Cancer Institute's Breast Oncology Center and associate professor at Harvard Medical School. "It seems to work about as well."Not just a women's diseaseRiter says he didn't think too much about the lump he felt under his right nipple one night as he was scratching his chest. But a few weeks later, when he began to bleed, he headed to the doctor, who in turn, sent him to a surgeon. To Riter's surprise, he was diagnosed with breast cancer.Among men with breast cancer-like symptoms, Riter is an exception. Often, men ignore some symptoms of the disease, because breast cancer doesn't come to mind as a potential ailment."One of the big problems for males is that men tend not to think about breast cancer. When they develop a sign or a symptom, unlike a woman, men tend not ... to go to the physician as quickly," says Dr. Lawrence Solin of the University of Pennsylvania Medical Center.That can result in a more advanced state of breast cancer when it's finally diagnosed, says Solin, which can affect a patient's survival rate. In 2005, the American Cancer Society estimates the survival rate for male breast cancer sufferers will be 73 percent, compared to 81 percent for women."The delay to diagnoses is substantially longer in men than in women," he says, noting that the successful public awareness efforts reminding women to examine themselves for lumps have been lost on many men.Awareness aside, experts acknowledge that while it is unnecessary all men (like women) should have regular mammograms, they do believe men should use good judgment."The biggest message is not so much that all men should do self-exams, but more that if a man feels lump, he should act on it. A woman who feels a lump should definitely get it checked out," Winer says.Combating assumptionsApart from the challenges of physically overcoming breast cancer, some male patients struggle with the disease's psychological baggage."A lot of guys with breast cancer go underground. They think of it as a women's disease and they're embarrassed about it, or they're ashamed of it," Riter says.But with a glint of hope, he adds that more men willingly talking about it.And Riter is doing his part, putting the disease in the spotlight for men and women alike."I really like to go to national breast cancer meetings," he says, "because a lot of people know that men get breast cancer in theory, but until you have a face to associate with it, it's fairly abstract. And so I'm sort of that face."CNN's Lauren Gracco and Greg Botelho contributed to this report.

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