.c The Associated Press
By LAURAN NEERGAARD
WASHINGTON (AP) -- James Lowery was showering the first timehe felt a tiny lump in his chest. It didn't hurt, and it was``pinhole-sized,'' barelynoticeable under his left nipple. So he didn't give it much thought.
A year later, the lump was still there, only now the skin over it was a little rough. Eventually it oozed, like a scab over a healing sore.
Still, ``I didn't have any pain,'' Lowery insisted. ``So I didn't know I had a problem. ... I thought it would go away.''
It was a year and a half before Lowery saw a doctor. He was stunned by the diagnosis: breast cancer.
``I said, 'Men don't get breast cancer,''' Lowery said.
But men can indeed get breast cancer -- 1,300 American men will get it this year alone, and it will kill 400. For reasons that are unclear, the incidence is rising, up from about 800 cases annually a decade ago.
That's less than 1 percent of the nation's total breast cancer cases. The disease will strike 175,000 women this year, and kill 43,000. Women have fought back with activism: Survivors wear pink ribbons and march to raise research money and urge other women to get regular mammograms to detect tumors early.
Partly because male breast cancer is rare, men like Lowery simply never heard about it. Men don't discuss it.
``Men are kind of surprised they have it, and they certainly don't like to go public with it,'' said Dr. William Donegan of the Medical College of Wisconsin in Milwaukee. ``I think in men it may be a much more private thing.''
That lack of awareness means few men see a doctor before their breast cancer has advanced, so ``survival has not been as high as in women,'' said Donegan, the American Cancer Society's expert on male breast cancer.
And it meant that Lowery's family spent hours hunting for the scarce information available on male breast cancer. Even his surgeon had had only one male patient previously. As for support groups for men, Lowery couldn't find any.
``I did feel lonely a long, long time,'' said Lowery, 74, of Mayer, Ariz. Lowery, who told his story to raise awareness and support for male patients, added, ``My daughter and my wife have been my support group.''
The good news is that doctors do understand male breast cancer fairly well. They know that men are at increased risk if many women in their families have had breast cancer. Radiation exposure is another risk factor.
In men, tumors usually develop under the nipple, which then can become inverted, Donegan said.
Men get the same treatment as women.
For Lowery, that saga began when he mentioned a growth on his shoulder to his daughter. She thought it looked like skin cancer and insisted he see a doctor right away, even though he was visiting her home in Oregon. Lowery turned out to have melanoma, but during that visit the doctor also spotted the lump in his left breast and delivered the additional bad news.
Right away, they scheduled a mastectomy. Surgeons also removed 15 lymph nodes from under his left arm that, fortunately, were cancer-free.
Then began three months of chemotherapy to target any cancer that might be roaming through his body. Like female patients, Lowery suffered nausea from the treatment and lost all his body hair, but last week he was declared in remission.
Much breast cancer growth is spurred by estrogen, even in men. So just like women whose tumors are ``estrogen receptor positive,'' he's about to take the drug tamoxifen for the next five years in hopes of preventing a recurrence.
And just like 30 percent of women with breast cancer, Lowery said he was diagnosed with too many copies of a gene called HER2, which can make breast cancer more aggressive. A new drug helps women who are HER2-positive, but Donegan said he's not aware of it being tried yet in men.
Lowery now offers advice: ``Men ought to do like women and check themselves.''
And if they feel ``a lump in the breast or any change in the nipple or anything that doesn't look right,'' see a doctor immediately, Donegan concluded.
EDITOR'S NOTE -- Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
AP-NY-05-07-99 0209EDT
Copyright 1998 The Associated Press.