In the Suburbs: Of BRCA genes and breast cancer in men
As Breast Cancer Awareness Month winds down, I couldn’t help recalling some 20 years ago when my folks joined us for their annual Passover visit in Fairfield. My late mom was to undergo a second mastectomy and my late father surprised me by pulling me aside and asking whether I had ever considered being tested for the BRCA gene. It was probably one of the most frank discussions I’d had with my father, who was clearly worried about my mom but about my brothers and me also.
I looked at dad like a deer in headlights at first. I hadn’t heard about this gene, which can be hereditary and could be a sign of cancer in the future. But since my grandmother, my mom and my aunt were breast cancer survivors through mastectomies, my dad wanted to suggest the possibility that I could carry the gene and could potentially be a target for breast cancer or other types of cancer.
Dad didn’t insist that I be tested, but he planted the seed, especially since we had a family history of breast cancer and two daughters. While I never had the genetic testing for BRCA, I definitely wanted to know more about it.
Thankfully Mom came through her surgery very well and lived a very comfortable life until lung cancer took her from us at age 90. And she used Tamoxifen, considered an excellent drug at the time.
Soon after my folks’ visit and mom’s surgery, my wife suggested that we attend a presentation she’d learned about at a Westport synagogue concerning current findings about the BRCA gene. The presentation was extremely enlightening and explained a lot about what genetic testing can show and the potential for who will actually develop cancer.
After that session I found a lot of information about the BRCA gene from many cancer organizations. Among the most interesting data was that in women, a BRCA mutation may cause a higher risk for breast and ovarian cancers.
According to several drug companies, the Mayo Clinic and the American Cancer Society, many men can carry the BRCA mutation, too. While men with a BRCA mutation have a lower overall chance of developing cancer than do women with a mutation, their chances of breast, prostate and skin cancers are increased. In some men, BRCA2 gene mutations have been associated with an increased risk of lymphoma and cancers of the pancreas, gallbladder, bile duct and stomach. This data was supported by virtually all cancer resources I checked.
Another thing I learned was that various cancers are more likely to develop at a younger age in men with a BRCA mutation. .If someone has a BRCA gene mutation, there is a 50 percent chance that the person will pass it on to each child in his or her family. There is also a 50 percent chance that they’ll pass on the gene without the mutation. All resources warned that knowing one’s BRCA status can be important for your children and other family members.
Until I explored information on the BRCA gene, I honestly had no idea that men could develop breast cancer, but according to statistics I found from the American Cancer Society just from this year, nearly 2,800 men in Connecticut have had breast cancer in the past year. Nationally, well-known male celebrities like drummer Tom Kriss of the band KISS developed breast cancer. And Matthew Knowles, father of superstar Beyonce, learned he had breast cancer this past July and urged both of his daughters to undergo genetic testing.
In addition to exploring genetic testing for the BRCA gene mutation, The Mayo Clinic reported that men who could be at risk for breast cancer should look for the following symtoms
• Older Age. Male breast cancer is most often diagnosed in men in their 60s
• Exposure to estrogen. If you take estrogen-related drugs, such as those used for hormone therapy for prostate cancer, your risk of breast cancer is increased.
• Family history of breast cancer. If you have a close family member with breast cancer, you have a greater chance of developing the disease.
• Klinefelter's Syndrome. This genetic syndrome occurs when boys are born with more than one copy of the X chromosome. Klinefelter's Syndrome causes abnormal development of the testicles. As a result, men with this syndrome produce lower levels of certain male hormones (androgens) and more female hormones (estrogens).
• Liver disease. Certain conditions, such as cirrhosis of the liver, can reduce male hormones and increase female hormones, increasing your risk of breast cancer.
• Obesity. Obesity is associated with higher levels of estrogen in the body, which increases the risk of male breast cancer.
• Testicle disease or surgery. Having inflamed testicles (orchitis) or surgery to remove a testicle (orchiectomy) can increase your risk of male breast cancer.
I have said over the years that Breast Cancer awareness should go on throughout the year, and the information I have found concerning breast cancer in men convinces me even more that no one is immune to this deadly disease. Even with the millions of dollars contributed to research every year, we are still fighting an uphill battle.
I hope that the younger men who may read this column will focus on their own possible predisposition to breast cancer and other cancers and consider genetic testing for the BRCA gene. That decision could go a long way toward protecting the men who choose the test and their families.
Steven Gaynes is a Fairfield writer, and his “In the Suburbs” appears each Friday. He can be reached at firstname.lastname@example.org.