Men Have Breasts Too: My Dad's Pink-Hued Fight with Breast Cancer

Dad seemed to go through menopause as I went through puberty. While I complained about my rapidly growing breasts, menstrual cramps and the trappings of adolescence, my father suffered from hot flashes and night sweats; he frequently discussed his declining libido and inability to get it up. We shared a small apartment in Hell's Kitchen (his makeshift bedroom: a walk-in closet) and privacy was a luxury we couldn't afford. He grew irritable, his moods swung wildly, and he inexplicably began writing romantic poetry, wearing blue eyeshadow and draping his neck in floral scarves. This made it easier to imagine what it'd be like to grow up with a mom, but as is often the case with single-parent, single-child relationships, our roles and boundaries were already confused. My father's slow and eerie transformation to a menopausal man rendered everything even more perplexing.

This was all since Dad had begun hormone therapy, not because he was undergoing a gender transformation, but because he was diagnosed with breast cancer and all viable treatments were—and still are—designed exclusively for women.

During a routine doctor's visit in 2001, a hard cyst-like lump was detected in Dad's left breast. He was sent for a mammogram for safe measure—at a women's clinic—where the mandatory forms asked questions like "date of last menstrual cycle," his gynecologist's name, and if there was any chance he could be pregnant. The technician had never performed a mammogram on a male patient. "Just think of me as a flat-chested, hairy woman," Dad said. To ice his sore breast, my father was given a floral ice pack with instructions on bra insertion—standard protocol. "These are pecs," my father said to his oncologist at Mount Sinai Hospital, subconsciously flexing them.

"You have breast cancer" is not a phrase most men would ever expect to hear, but roughly 2,500 men in the US will be diagnosed with invasive breast cancer this year. Contrary to popular belief, everyone—male and female—is born with breast tissue and milk ducts. Dad joked, "Well, if I have breasts, why don't they turn me on?"

Dad was no rookie to hardship. In 1993, in one violent cataclysm: a jeep, a bus, screams, crunching bones, broken glass and twisted metal, every surface splattered in red. Our lives changed forever. My parents lay unconscious; my mother would never recover. I was unscathed. My father remained in a coma for weeks, sustained by a respirator. When he regained consciousness, he was agonized by a lost wife, snapped pelvis, seven broken ribs, and leg bones shattered like glass. After he healed in 1995, a rare melanoma was detected in his eye; it too was gouged out. Now Dad was diagnosed with breast cancer: deeper cuts and longer scars this time, and chemo.

My father, formerly so effervescent (a poet, activist and businessman), withered into a shade—pale, enervated, and hairless. We lost time as doctors mistakenly deemed him cancer-free when his cancer had actually leapt from Stage I to IV and had metastasized to his thigh. His leg had to be amputated. My one-eyed, one-breasted, one-legged father appeared almost mythic, as if an angry Zeus had split him in two, condemning him to spend his life in search of his own other half.

If he were a woman, Dad's breast cancer probably would've been more closely monitored by his doctors. Perhaps his leg would've been spared. Perhaps he'd even still be alive.

During Dad's breast cancer treatment, doctors handed him pamphlets about bras and wigs. "Welcome to my world," his female friends would say when he complained of hot flashes. "I don't want to be in your world," he'd respond. The searing hot flashes tormented, confused, and emasculated him as he struggled to stay afloat, to grasp any drop of manhood left.

Breast cancer has become so feminized and pinkified that it's often an embarrassing terrain for men. A study at the University of Colorado Denver found that 43 percent of men said they'd question their masculinity if they were diagnosed with breast cancer. 80 percent of those men said they were unaware they could even get breast cancer.

"When the doctor told me I had breast cancer, the words hung in the air. I couldn't wrap my head around them. Men don't get breast cancer. Do we?" author and breast cancer survivor Michael Kovarik, who underwent a double mastectomy, told me. "I was already grappling with coming out and being gay when I was diagnosed with breast cancer—a woman's disease. I had to face that whole question: Am I a man according to our society?"

The world of breast cancer may be awash in a sea of pink, but cancer doesn't discriminate. Though rare, the mortality rate of men with the disease is 25 percent higher than women. Early detection is uncommon because research, awareness and funding are scarce. Men tend to wait longer to go to the doctor after feeling a lump and fail to report family history of breast cancer since they think it doesn't pertain to them. By the time men are diagnosed, the cancer is often more advanced and may have metastasized, and another form of canceris blamed as the culprit.

Because we don't associate men with having breasts, the fundraising disrupts an existing cultural narrative. "The National Cancer Institute raises $600M annually for breast cancer research [including a $200M advocacy bump]. Only 0.05% of it is given to male research," reports Oliver Bogler, a cancer researcher at MD Anderson and breast cancer survivor, on his blog Entering a World of Pink. Bogler is currently working on a documentary with The Scar Project. "Males make up one to two percent of breast cancer patients. Allocating one percent of funding would represent a 20x increase," he writes, "Please consider it." Primary research is desperately needed. Fixing this funding discrepancy could change the fate of male breast cancer.

Breast cancer, unlike ovarian, testicular, uterine or prostate cancer, is actually not sex-specific—it just appears to be. "It's odd we call it ''male breast cancer.' We'd never say ''male lung cancer," says Lori M. Berlin of the Male Breast Cancer Coalition. The categorization of gender as binary is already a cultural misnomer. If we, as a society, are beginning to accept a more fluid definition of gender, then wouldn't it be logical for modern medicine to follow suit, to de-classify diseases as gender-specific, because evidence proves otherwise: men do get breast cancer. Khevin Barnes, breast cancer survivor, writes on the Male Breast Cancer Coalition website, "Breast cancer is no more a woman thing than being a commercial pilot, or senator or leader of a country is a man thing."

Do health clinics offering free mammograms for Breast Cancer Awareness Month extend the same courtesy to men? If 82 percent of male breast cancer is attributed to heightened estrogen signaling, then should men also steer clear of soy and other foods linked to breast cancer? Why has male breast cancer incidence risen by 26 percent since 1975? Why do black men have a higher chance of getting it, and why are younger black men 76 percent more likely to die from it than white men, even after receiving similar treatments? Are we likely to see a spike in transgender breast cancer?

Though a lot of questions remain unanswered, we know estrogen (specifically Estradiol or E2, the most potent and prevalent of estrogens) is a big culprit. Elevated estrogen levels promote breast cell growth, so risk factors include hormone therapy (like in gender transformations), eating hormonally-pumped food, obesity (which increases estrogen production), excessive alcohol consumption (resulting in the liver's inability to regulate blood estrogen levels), prostate cancer, Klinefelter's syndrome (males born with more than one copy of the X chromosome) and testicular disease. Other risk factors include old age, exposure to radiation and genetics.

Symptoms to watch for include a lump, dimpling, puckering or scaling of breast tissue, inward-turning nipple and discharge. Survivor Bret Miller designed a t-shirt for the Bret Miller 1T Foundation advocating men to do self-exams. The T-shirt reads: "Guys, don't be afraid to touch yourself." If you feel a lump, go get a man-o-gram.

Gene mutations like BRCA1 and BRCA2 also put you at a much greater lifetime risk—up to 85 percent likelihood—of developing not just breast cancer, but also melanoma, ovarian, prostate, colon and pancreatic cancers. If you have a parent with this gene variant, you have a 50-50 chance of inheriting the mutation—regardless of your gender. If you're of Ashkenazi Jewish descent, your chances of being BRCA-positive skyrockets to one in 40, compared to up to one in 800 in the general population. BRCA2 mutations are more common in male breast cancer, for reasons that remain unknown. Still, most men diagnosed with the illness have no family history of breast cancer, and only 5 to 10 percent of cases are hereditary. "If you're BRCA-positive, the odds are against you. If you're not, you're still not in the clear," says Lori M. Berlin, who is making a documentary Men Have Breasts Too.

I blamed my father's cancers on bad luck and never thought I needed genetic testing. Berlin "intervened with fate" by getting preventative surgery after she had a high risk diagnosis and genetic tests (spurred by a male relative diagnosed with metastatic breast cancer) confirmed she was BRCA2-positive, increasing her lifetime chance of developing breast cancer to ninety percent. Being BRCA-positive would be a game-changer but awareness is the best weapon I have, so I made an appointment. I'd rather avoid more unnecessary curveballs, and science is blessing me with the privilege of prevention. I've already witnessed the horrors of breast cancer firsthand; I don't want to have to experience it firsthand.

Treatment tends to involve a one-size-fits-all approach including surgery, chemo, hormone suppression therapy, and radiation. "My doctors admitted that they really didn't know how to treat me," Michael Kovarik tells me in an interview. The pathology appears similar in both sexes, but the biology of male breast cancer is not yet understood.

Like many dismayed by existing Western medical treatment and methodology, Kovarik now gravitates toward holistic approaches like Reiki, energy healing and homeopathy. "They listen to all of me, whereas traditional medicine just looks at the disease, not the person," he said. "And there's so much more to me than breast cancer."

My father felt similarly, and even persuaded me to take peyote with him at a shamanic healing ceremony in a last-ditch attempt to recover. I felt it kismet that Dad died on the anniversary of my parents' wedding—perhaps the universe's way of rejoining them, of mending my father's soul.

I wondered if Dad's mastectomy scar brought him shame. Some opt for surgical reconstruction or a tattooed nipple, while others wear their scars as badges of honor. My fingers would trace the vertical rope-like scar along my father's breast during his final days, when we'd huddle together watching nature programs on his hospital bed. His many scars looked to me more like beauty marks than battle wounds. I miss them the most. They seemed to map out every road we had traveled together. What other tangible proof did we have of all the terror and beauty we encountered?

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