Real men wear PINK

Men are gen­er­ally un­aware that they can de­velop breast can­cer, and while the life­time risk for women of de­vel­op­ing breast can­cer is one in eight com­pared to one in 1,000 for men, male suf­fer­ers tend to be for­got­ten amidst the flurry of pink sur­round­ing Oc

Malta Independent - - INTERVIEW -

How did you first dis­cover you had breast can­cer?

The first in­di­ca­tion was some blood on my shirt which I thought was a pim­ple that had burst and which I chose to ig­nore. Once I had blood the sec­ond day, I had a look and sure enough there was a growth.

What was the first thing that went through your mind?

I pan­icked but truth be told the idea that it could have been breast can­cer didn’t even pass through my mind. I im­me­di­ately met with the doc­tor and on closer ex­am­i­na­tion he said it could have been one of two things – ei­ther breast can­cer which is re­mov­able, or some­thing else a lot graver.

How did you re­act to the news?

The first thing that went through my mind was shock. Till then, all I had heard was that men could not suf­fer from breast can­cer. Then, which I think is the stan­dard ques­tion everyone asks them­selves is ‘Why me?’ I had just re­tired from the diplo­matic corps; I was un­der the im­pres­sion that I would live a happy life at a slow pace.

Once the news came in I was un­der se­vere stress; un­til the op­er­a­tion takes place, you don’t know the grav­ity of the can­cer. Once the op­er­a­tion was done, I found my­self un­der even more stress till I was told that ev­ery­thing was suc­cess­ful. If there is one pos­i­tive about breast can­cer, if there even is a plus, is that breast can­cer is a growth out­side you body, that is to say it does not touch the in­ter­nal or­gans of your body, so if it is caught in time, and that is why I stress check­ing your­self re­gard­less of gen­der, it is treat­able and can pre­vent the can­cer from spread­ing.

How did peo­ple close to you re­act to the news?

The first re­ac­tion was dis­be­lief that I had breast can­cer, be­cause in Malta it’s only three or four di­ag­noses per year, and nat­u­rally peo­ple don’t un­der­stand how a man could get it. I re­mem­ber meet­ing doc­tors who had been prac­tis­ing medicine for 30 odd years who had never seen a case of breast can­cer in men.

What is the process like?

The process you fol­low is ex­actly the same as women, so you be­gin with a mam­mo­gram, which for men is ex­tremely dif­fi­cult and quite painful, they then saw the growth, and af­ter con­duct­ing a biopsy, they con­firmed that it was a can­cer­ous growth that needed to be re­moved.

Well, first I did the op­er­a­tion, and since my case was not so se­vere, I did not re­quire chemo­ther­apy. In­stead, I was placed on ra­dium for about five weeks and then that was the end of it, but like women, I still have to take a pre­ven­ta­tive pill which some doc­tors say you have to take for a min­i­mum of five years.

Two and half years later I had a strain all along my right arm, I was a sporty per­son and thought noth­ing of it; un­for­tu­nately the same can­cer showed up in one of my lymph nodes un­der my arm, it was an out­growth, and the ra­dium did not clean enough the area of can­cer that there was. I was op­er­ated on again and it was re­moved.

And how did that feel?

Well, its start­ing all over again I guess, but you just have to em­brace it. It isn’t some­thing you’ve caused to your­self, maybe diet has some­thing to do with it, but it isn’t truly some­thing you’ve in­flicted di­rectly upon your­self. Ul­ti­mately, there’s noth­ing else to do but fight it as hard as you can. Here in Malta we’re ex­tremely lucky that we have some of the best doc­tors on the ground. Both my sur­geon, Mr Gor­don Caru­ana Dingli, and on­col­o­gist, Stephen Brin­cat, are some of the best doc­tors in the world. We’re also pretty lucky that we have the best med­i­ca­tion over here.

The only thing that re­mains liv­ing with you is that you’ve been touched. Your body, twice, has had a can­cer­ous growth, that ob­vi­ously puts a shadow on your life; it happened twice, it could hap­pen a third time or even a fourth time. Un­for­tu­nately, that shadow re­mains with you men­tally, ev­ery time I hear a story about a per­son with can­cer, it opens up that thought again, that the prob­lem could come back.

The first re­ac­tion was dis­be­lief that I had breast can­cer, be­cause in Malta it’s only 3 or 4 di­ag­noses per year, and nat­u­rally peo­ple don’t un­der­stand ow a man could get it"

Did any of this change your life­style in some way?

It didn’t re­ally. The only way I think I have changed my life­style is that I now con­sider ev­ery day a new day, and what­ever I can do on that day I don’t put off for the next, be­cause you never re­ally know where to­mor­row will take you.

Why do you think men are em­bar­rassed by breast can­cer?

I sup­pose men who are very mas­cu­line as­so­ciate breast can­cer with women, there­fore they prob­a­bly feel that if they were to speak up, it would lessen their man­hood one way or another, which I think is quite stupid, be­cause at the end of the day health comes be­fore any pub­lic im­age they have of them­selves. Ul­ti­mately, you have a choice, you could ei­ther keep it in and refuse to dis­cuss it un­til it spreads, or do what you have to do for your­self so you could have a life for years to come.

Do you think men strug­gle to share their ex­pe­ri­ence?

No doubt about it. The truth is, if some­one were to ask me if I knew of any other men who have suf­fered from breast can­cer, I would say no, it’s such a mi­nor­ity. How­ever, I know count­less women who have been vic­tims. It seems to me that men are less forth­com­ing about. I think it’s wrong, and the more we come to­gether and as a cho­rus sing the same song, we could have a real im­pact on the fu­ture. If we re­main an iso­lated voice, and only speak when we’re asked to, it just won’t work. This is why I am ap­peal­ing to any man who has suf­fered from breast can­cer, to come for­ward an speak pub­li­cally, and if they think we could come to­gether, form a group, do some­thing to­gether, we can raise aware­ness, and I am more than will­ing to join in an ex­er­cise.

How would you en­cour­age men who are cur­rently go­ing through it to come for­ward?

Again, this is very im­por­tant, I want to make my­self avail­able to any­one go­ing through the process, so I could give them my ad­vice, share with them my ex­pe­ri­ences, so they won’t feel lonely when con­fronting this dis­ease. The thing is, be­cause it’s so rare, there isn’t the com­fort in find­ing another per­son who went through it, so you’re bound to feel alone, as I was alone since I had no ref­er­ences of peo­ple who had suf­fered from breast can­cer.

Do you think that ‘Pink’ tag as­so­ci­ated to breast can­cer al­most stereo­types the can­cer?

Well, if you no­tice all the pub­lic cam­paign­ing or pro­pa­ganda that is dished out in Oc­to­ber, it’s solely di­rected to women. All the as­so­ci­a­tions fo­cus on the colour pink, which is purely as­so­ci­ated with women. Men who cher­ish their man­hood might al­most be em­bar­rassed to be as­so­ci­ated with that colour. I mean, I do un­der­stand that its pink for a rea­son, a ma­jor­ity of the suf­fer­ers are women so that is who they seek to at­tract. It makes 100% sense, but it does in­di­rectly ex­clude from its um­brella me. Then again, this is all cos­metic, the most im­por­tant thing is al­ways mak­ing sure to check your­self and do­ing what is right for you.

Do you feel that breast can­cer NGOs like Pink Oc­to­ber or Europa Donna un­in­ten­tion­ally marginal­ize male breast can­cer vic­tims?

With­out a doubt, but truth be told, men with breast can­cer are such a tiny mi­nor­ity, so they fo­cus all their en­ergy in alert­ing women, that’s why the tiny mi­nor­ity tends to get over looked. Un­less we raise our hands and be counted, and con­stantly re­mind peo­ple that this is a male is­sue too. In fact, I form part of the com­mit­tee for ac­tion against breast can­cer, and there­fore I see to it in that each and ev­ery ac­tiv­ity we do as an as­so­ci­a­tion, we make sure to high­light the male re­al­ity too.

What would you en­cour­age peo­ple to do to raise aware­ness of this is­sue?

I would sug­gest that peo­ple, who are ei­ther vic­tims of breast can­cer or peo­ple who just want to help shed light on this is­sue, should give pub­lic lec­tures on it, even go to places where there are men. You could speak ei­ther as a lucky vic­tim or some­body who is just aware of the is­sue. I also think there should be some videos which are di­rected solely to men and be made use of; ei­ther through pub­lic tele­vi­sion or pri­vate tele­vi­sion which is di­rected at a male au­di­ence.

What should the gov­ern­ment do to cre­ate more sup­port and aware­ness in male breast can­cer?

I think that wher­ever the gov­ern­ment is present in mak­ing women un­der­stand what they need to do, they should use that same en­thu­si­asm and pres­ence when talk­ing to men. Even if they don’t waste a whole cam­paign on men, even just men­tion­ing that even men can suf­fer from it will be im­por­tant, and what I im­plore the cur­rent gov­ern­ment to do is to cre­ate a page, di­rected solely at men, and what­ever is on that page ap­plies di­rectly to you. It has to be specif­i­cally di­rected at me, not as a sub note in a whole group of ma­te­rial. It has to be on its own with a male graphic rep­re­sen­ta­tion.

Do you think that the medical com­mu­nity can do more

The only thing is there are so few doc­tors know about it. For ex­am­ple, the pills I take ev­ery day are specif­i­cally de­signed for women, no one ever tells you what side-ef­fects these pills could have on, we are ob­vi­ously bi­o­log­i­cally dif­fer­ent to women. Luck­ily, for me there haven’t been ef­fects like there have been for others – some lose their hair and some get prob­lems with their stom­ach, for ex­am­ple. Un­for­tu­nately, there are only pills for women, not for men.

This is be­cause it is so rare in men, peo­ple don’t re­ally spend as much on in­ves­ti­gat­ing breast can­cer in men, and they do ev­ery­thing they can to help women, which I sort of un­der­stand be­cause women are more prone to the dis­ease.

That’s why it so im­por­tant for peo­ple like me to speak up and say ‘Look guys, it’s not just a women’s prob­lem’. The ma­jor­ity are women, but there is a mi­nor­ity of men who suf­fer from it, and there­fore other men shouldn’t think it’s ridicu­lous when some­body like me tells you to ‘check your­self’ in the same way women check them­selves.

Ul­ti­mately, it doesn’t make a dif­fer­ence if you’re a man or a woman, if you’ve got breasts or not, even if you’re flat-chested; un­der­neath your nip­ple, that’s a breast. So you have to check from time to time, and the mo­ment you feel some­thing like a growth go straight to the doc­tor.

Dr Noel But­tigieg Sci­cluna

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