"The whole trend in cancer treatment in general and breast cancer in particular is trying to individualize therapy for the individual patient's cancer - targeted therapy," said Dr. Monica Morrow, chief of the breast service at Memorial Sloan-Kettering Cancer Center in New York. And little is known about how to do that for men. "There is something fundamentally different about the hormonal environment in men."
Dr. Sharon H. Giordano, an oncologist at the University of Texas M.D. Anderson Cancer Center in Houston, said a clinical trial was opened to study a hormonal breast cancer treatment in men. But without enough cases of the disease to enroll enough men in the trial, the trial was canceled.
Mike Nelsen, a healthy, vigorous guy, felt the lump underneath his right nipple last fall as he lay on his stomach in bed. "It felt tender," he recalled. "I thought, 'That doesn't seem right.' "
Nelsen procrastinated a bit about going to the doctor. He didn't have one. Within a month, though, he had an appointment. It was a good choice, he figured, when, a few days before his scheduled visit, he took off his T-shirt and found a wisp of blood on it.
His doctor sent him to Schultz, who ordered a mammogram and diagnosed the cancer. On Dec. 17, Mike Nelsen had a mastectomy. Schultz removed the breast tissue on Nelsen's right side and 14 of his lymph nodes. His nipple is gone, but he has decided against reconstructive surgery: "I'm not a surfer dude."
Nelsen spends a lot of time on the road, selling spices for McCormick & Co. in Hunt Valley, where he is director of sales. So he was back at it in no time, flying across the country still fixed with drains used to draw lymphatic fluid from his wound. There was work to be done.
He started chemotherapy in early February and was told that seven days later he would likely feel the worst. But he had a meeting in Chicago and then plans to entertain clients in Breckenridge, Colo. He just figured he wouldn't ski as hard as usual. He ended up in intensive care in a Chicago hospital for days, the chemo had so damaged his large intestine.
It would be his last round of chemotherapy. He was concerned he wasn't doing enough to keep the cancer from coming back, but genetic testing of his tumor indicated it was unlikely to return.
"I could get hit by a bus just as easily as I could die from cancer, based on this report," he said, his Midwestern accent giving away his Chicago roots.
