Breast cancer in men is a rare disease and accounts for around 1% of breast cancer cases in the western world. Although breast cancer is considered to be a women’s disease, incidence of male breast cancer seems to have increased in recent decades. In men, risk factors include hormonal and genetic factors and a family history of breast cancer including a first degree relative (either a mother or a sister).
Most of the breast cancer research carried out to date focuses on how this disease effects females. There is a social construct that associates breasts with femininity, motherhood and consequently associates breast cancer with pink and ‘Pink October’ and a female disease. This leaves men diagnosed with breast cancer feeling emasculated. Besides having to cope with having cancer and dealing with all the surgical and oncological treatments associated with this illness, males have to deal with the gender aspects of having breast cancer and any stigmatization associated with it.
Psychological impact of breast cancer in men
Altered body image
Men having breast cancer usually undergo mastectomy as part of their treatment. This usually involves removing the breast tissue and the nipple areola complex leaving the patient with a scar along one side of his chest. Research does indicate that male patients, post-mastectomy report body image disturbance. This can include a reluctance to bare their chest or even to wear clothes revealing the contour of the chest area after mastectomy. Body image difficulties in men are further exacerbated for those treated with tamoxifen. This drug blocks the growth-promoting action of oestrogen on cancer cells and is usually prescribed to men after surgery. However, about half the men who are on this drug report weight gain and sexual dysfunction. This at times prompts some of these patients to discontinue treatment.
Shame and masculinity
Shame and perceived stigma can cause anxiety and a fear of being marginalised when being diagnosed with this disease. The feelings of shame and guilt can be further increased if the man is a BRCA gene carrier and fears passing this gene to his children. Studies indicate that health in males is correlated with emotional and physical strength and breast cancer seems to challenge this concept.
Most published work on the psychological and emotional impact of breast cancer seems to focus on female patients. Coping with breast cancer diagnosis is correlated with the ability to recognize and express emotions and having a solid support network. Managing other life stressors beside the illness and its treatment and developing healthy coping strategies are also important aspects of facing this disease head on. Males can find it difficult to express emotions and show vulnerability. Therefore, it is important that men are offered a psychological service tailored to their needs because these needs might be different from their female counterparts.
References:
Kipling, M.; Ralph, J.E.M. & Callanan, K. (2014). Psychological Impact of Male Breast Disorders: Literature Review and Survey Results, Breast Care, 9(1), 29-33.
doi: 10.1159/000358751.
Midding E.; Halbach, S.M.; Kowalski, C.; Weber, R.; Würstlein, R. & Ernstmann, N.
(2018). Men With a “Woman’s Disease”: Stigmatization of Male Breast Cancer Patients -A Mixed Methods Analysis. American Journal of Men’s Health, 12 (6) 2194-2207. doi: 10.1177/1557988318799025.
Anna Catania is a counsellor with Willingness. She has had a special interest in working with clients facing intimacy and sexual difficulties and runs a service for families going through cancer and chronic illness. She can be contacted on anna@willingness.com.mt or call us on 79291817.