Ce que c'est d'avoir un cancer du sein quand on est un homme

In August 2010, Tony Herbert was on a safari holiday in Namibia when he felt a soreness in his nipple. Putting it down to a chafing seatbelt, he didn't think anything of it, but the pain persisted when he got home. By October, there was a lump under his nipple, which grew to be around an inch in diameter.

"I could feel it easily but I didn't do anything about it," he recalls. "In January 2011, I was sitting on the settee when my wife prodded me in the chest. She said I should go to the doctor and get it looked at. So essentially I spent five months without doing anything, assuming it must be a cyst."

While his GP agreed it was probably nothing serious, he referred Herbert to a breast clinic as a precaution. This decision could well have saved Herbert's life.

"Lorsque le médecin généraliste de la clinique du sein m'a examiné, j'ai pu voir à son visage que c'était cancer du sein," says Herbert. "I was referred for a biopsy and we got the results on the Tuesday. The surgeon operated on the Friday."

What breast cancer looks like in men

While breast cancer is often considered a women's disease, men can develop the condition too. And while the prevalence is much lower - 370 men are diagnosed each year in the UK, compared to around 62,000 women - it's just as important for men to be aware of any changes in their body.

En tant que Catherine Priestley, infirmière clinicienne spécialisée chez Soin du Cancer du Sein, explains, the symptoms in men tend to resemble the symptoms in women. The only caveat is that, since men have less breast tissue, any lumps will likely be centred behind the nipple.

"They might find some discharge, the nipple might become rather tender and inverted, there might be some ulceration or soreness, or just a swelling of the breast or chest area," she says. "Although some men might find a lump under their arm or towards their collarbone, more often than not it's a lump around the nipple area that's the first thing that's brought to their attention."

Chez les hommes, comme chez les femmes, les causes du cancer du sein ne sont pas entièrement comprises. Cependant, certains facteurs de risque peuvent rendre un diagnostic plus probable. Ceux-ci incluent être âgé de plus de 60 ans, avoir subi une radiothérapie antérieure à la poitrine, ou des niveaux d'œstrogènes inhabituellement élevés (qui peuvent être causés par une exposition prolongée liver damage ou l'obésité).

Genetic risk factors

Un autre facteur majeur est l'historique familial. Si plusieurs de vos proches ont été confrontés au cancer du sein, vous pourriez avoir hérité d'une mutation génétique (par exemple dans le gène BRCA1 ou BRCA2) qui augmente également votre propre risque. (Il convient de mentionner qu'un homme avec un BRCA mutation est encore moins susceptible de développer un cancer du sein que la femme moyenne, mais leur risque est environ dix fois plus élevé que celui de l'homme moyen.)

"Sometimes you'll find that men have daughters who've had breast cancer," says Priestley. "So if there have been multiple people in the family diagnosed, especially other men or younger women, that can come into play as well."

Dans le cas de Herbert, sa sœur avait été diagnostiquée en 2008, et des tests génétiques ont confirmé qu'ils ont tous deux une altération du gène BRCA2. Herbert dit que cela a provoqué beaucoup de chagrin, surtout puisque ses deux enfants ont un risque de 50 % de porter la même anomalie génétique. Malheureusement, cela aussi increases the risk d'agressif cancer de la prostate chez les hommes, et Herbert a également dû faire face à un cancer de la prostate par la suite.

"C'est quelque chose auquel il faut vraiment faire face, mais le plus important est d'être diagnostiqué tôt", dit-il. "Les hommes avec le gène BRCA2 altéré doivent obtenir le Test PSA aussi souvent qu'ils le peuvent."

The psychological implications

Herbert's breast cancer treatment involved a mastectomy, followed by 18 weeks of chemotherapy, a lymph node clearance and three weeks of radiotherapy. Medically speaking, there is little difference between what men and women go through here, but he thinks the psychological burden is slightly different.

"The mastectomy is a big thing for a lady because it changes her body shape, but as a man the only time anyone would notice is when you go swimming," he says. "And then with the chemotherapy, hair loss is a big thing with ladies but I haven't got much hair anyway. The other bonus is I didn't have to shave."

While Herbert is good-humoured about the body image aspect (which, of course, affects everybody differently), he did struggle with the sense of isolation.

"When I had the mastectomy, I was in a room of my own because all the others were ladies," he says. "My sister is still friends with most of the people who were having a mastectomy at the same time as her, but I never spoke to anyone about it."

Compounding the issue, he found that every time he turned up for an appointment, the health services would assume it was his wife who was getting treated. Then there were other irritants, like the invitations to mammograms that encouraged him to wear a blouse.

It wasn't until 2014, taking part in the Breast Cancer Care fashion show, that he met another man in the same situation.

"There were two men taking part, Clive and myself, and Clive was the first man I'd spoken to who had breast cancer," he says. "It's helpful speaking to a lady but it's not the same as speaking to another guy."

Where to find support

C'est pour cette raison qu'Herbert a décidé de faire du bénévolat pour Breast Cancer Care et Breast Cancer Now’s Someone Like Me service, qui met en relation des bénévoles avec des personnes en quête de soutien. Grâce à ce service, il a parlé à plusieurs hommes atteints de cancer du sein, qui pourraient autrement se sentir très seuls.

Priestley points out that all of Breast Cancer Care's services are open to men as well as women, and that anybody affected by breast cancer can call the helpline free on 0808 800 6000 for information and support.

"Nous recevons des appels d'hommes qui posent des questions sur leur santé mammaire, donc nous sommes toujours là pour quiconque souhaite poser des questions et discuter de ses préoccupations," dit-elle. "Nous avons quelques information spécifiquement conçu pour les hommes sur notre site, et nous avons également moving forward services pour les personnes qui ont terminé leur traitement - Je sais que des hommes y ont participé par le passé. Aucun de nos services n'est exclusivement réservé aux femmes."

Today, Herbert is fit and healthy. And as well as helping other men with breast cancer, he's looking to raise more awareness around the disease.

"Men don't like to go to the doctor anyway, but there's an added problem with something like this because they see it as a ladies' disease," he says. "I would say to all men that they should feel their breasts and make sure they haven't got any lumps or soreness, and if they do find anything then go to the doctor. And I think when people are talking about breast cancer they could say men and women with breast cancer, not just women, because men can get it too."