Now, he is taking tamoxifen, a drug that interferes with the estrogen that fed his breast tumor. Tamoxifen is used to shrink existing tumors and to prevent them from coming back. He will be on the drug for the next five years. It does have side effects.
"How I got a women's disease from the start I don't know," Nelsen said. But because of the tamoxifen, "I get flushed from time to time. As my female friends say, 'Now you know what it's like to have hot flashes.' "
While there is data that tamoxifen can shrink tumors in men with breast cancer, Giordano said little is known about whether it has prevention properties in men, or what the side effects - which include blood clots, increased risk of uterine cancer and vaginal dryness in women - are in men.
Nelsen doesn't know for sure if he inherited his disease. But knows his mother had breast cancer while in her 40s, melanoma in her 50s and died of ovarian cancer at 63. And that an aunt had ovarian cancer, too. His daughter, 23-year-old Megan, plans to start getting routine mammograms when she is 25, much earlier than the average for women.
For now, Nelsen spends his good days at work - and they are mostly good days. He plays golf. He works in the yard at his Parkton home. He plays with Mikayla, the 2-year-old he and his wife adopted from Guatemala. And he will throw out the ceremonial first pitch at the June 14 Orioles game as part of an annual Cancer Survivors Day sponsored by St. Joseph.
It is not Nelsen's way to fret about his health. He's worrying more these days about whether he'll get the ball over the plate than if there is more cancer is in his future.
"I try to take everything in stride. You run into issues your whole life. Instead of feeling sorry for yourself, you just have to go on. I don't know how else to do it," he said.
"I'm not very good at sitting still."
