The New Times (Kigali)

Rwanda: The Untold Truth About Male Breast Cancer

SINCE 1997 a top medical doctor has registered three cases of male breast cancer in Rwanda. All the three received the news with shock, as many have always linked breast cancer to only females. Although statistics about male breast cancer in Rwanda are scanty, the three examples are an indicator that men in Rwanda are equally at risk of getting breast cancer. Worldwide, one out of every 100 cases of breast cancer is in male.

According to Dr Emmanuel Kayibanda of King Faisal Hospital, Rwanda, males are prone to breast cancer just like females because they also have breast tissue.

"Breast cancer is not common among males. But I have personally registered three cases," reveals Dr Kayibanda.

Dr Kayibanda says the first case was of a man in his late 30s. This man is still undergoing treatment. The second case was 10 years ago. The third and very recent case is of a 78-year-old man who was diagnosed with breast cancer. He is in the process of starting his treatment.

The New Times contacted the three patients but they declined to talk about their case.

A senior counsellor, however, said is an indicator that many cancer patients still feel they will be stigmatised when they go public about their condition. Perhaps opening up could be a starting point to raise awareness about breast cancer in men and the beginning of aweareness about preventive measures and early treatment of breast cancer.

Medical experts warn that there are some signs which a man should not ignore once they see them.

"Any one who gets a small mass (tumour) in the breast should immediately consult a doctor. Breast cancer is among the cancers that are curable provided they are detected early enough," Dr Kayibanda advises.

Even though men don't have breasts like women, they do have a small amount of breast tissue. In fact, the "breasts" of an adult man are similar to the breasts of a girl before puberty, and consist of a few ducts surrounded by breast and other tissue. In girls, this tissue grows and develops in response to female hormones, but in men -- who do not secrete the same amounts of these hormones -- this tissue doesn't develop.

However, because it is still breast tissue, men can develop breast cancer. In fact, men get the same types of breast cancers that women do, although cancers involving the milk producing and storing regions of the breast are rare.

Global trend:

It is estimated that about 2,140 new cancer cases are diagnosed annually in the US and about 300 in the UK, and the number of annual deaths is about 450 in the US. In a study from India, eight out of 1,200 (0.7per cent) male cancer diagnoses in a pathology review represented breast cancer.

Incidences of male breast cancer have been increasing. The American Cancer Society reported that this year, there will be 2,190 new cases of inversive breast cancer among men and about 410 men will die from it.

Discovering too late:

Medical reports and research show that most cancer patients discover that they are suffering from cancer when the disease is in its advanced stages. Once the disease is discovered late, treatment is normally for pain relief and probably to prolong life. Even those who can afford to go abroad don't necessarily survive as it is normally too late for health complications such as cancer because of late diagnosis. It is estimated that palliative care services in Rwanda are still only reaching just fewer of those in need. Statistics show that Cancer drugs are in short supply in all African countries generally.

For instance in neighbouring Uganda, according to records from the radiotherapy department at the Mulago National Referral Hospital in Kampala, five to six new cases of male breast cancer are registered every year.

While men are less at risk than women, their chances of surviving the ailment are lower because the male breast tissue is smaller than that of women and therefore quickly ravaged by the cancer.

"If detected in the first year there is an 88% chance of survival making it important for regular checkups in order to save the lives of men and women alike," noted a senior counselor in Integrated Counseling and Testing Services.

Although breast cancer is not directly linked to HIV, the rates of all cancers have doubled with the advent of HIV. According to experts, HIV has increased incidence and prevalence of cancer.

Typically, self-examination leads to the detection of a lump in the breast which requires further investigation. Other less common symptoms include nipple discharge, nipple retraction. Swelling of the breast, or a skin lesion such as an ulcer.

Lesions are easier to find in men due to the smaller breast size; however, lack of awareness may postpone seeking medical attention.

More so, the symptoms of breast cancer in men are very similar to those in women. Most male breast cancers are diagnosed when a man discovers a lump on his chest. However, unlike women, men tend to go to the doctor with more severe symptoms that may include bleeding from the nipple and abnormalities in the skin above the cancer. At that point the cancer may have already spread to the lymph nodes.

The one major difference is that men with breast cancer respond much better to hormone treatments than women do. About 77 per cent of male breast cancers have hormone receptors, that is, they have specific sites on the cancer cells where specific hormones can act.

It is rare for a man under the age 35 to get breast cancer. The likelihood of a man developing breast cancer increases with age. Most male breast cancers are detected between the ages of 60 to 70 years.

Preventive and early detection measures against cancer:

Get regular cancer screening tests:

Regular screening tests can catch some cancers early, when they're more treatable. With a few cancers, these tests can even prevent cancer from developing in the first place. Talk with your doctor about the tests for colon, lung, prostate, breast, and cervical cancers.

Control your weight:

Being overweight or obese is a risk factor for many cancers, including breast, colon, uterine, esophageal, and kidney cancer. You can control your weight by exercising regularly and eating healthy.

Exercise regularly:

Have regular exercise even if you have normal weight. Physical activity lowers the risk of several types of cancer. It also reduces the risk of diabetes and heart disease. It's recommend adults to get at least 150 minutes of moderate-intensity or 75 minutes of vigorous activity each week.

Eat healthy:

Eat at least 2 ½ cups of vegetables and fruits daily. Choose whole-grain breads and cereals over those made from refined grains. Eat less processed meat such as bacon, sausage and hot dogs. Substitute fish, poultry, or beans for red meat (beef, pork, and lamb).

Stop smoking:

Smoking damages nearly every organ in the body, is linked to at least 15 different cancers, and accounts for some 30 per cent of cancer deaths. Quitting smoking is one of the best things you can do for yourself and your loved ones.

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