Research on Men with Breast Cancer

Scripture of the Day:

Lamentations 3:26

          The Lord is good to those whose hope is in the Him, to the one who seeks him

I want to thank the Cancer Research UK for this picture to help prove my point.

Men are not immune to breast cancer. 19% of  cases diagnosed with breast cancer are men based on some of the numbers that I have read about. The following is parts of several articles that I read about breast cancer in men. The link is provided for you if you want to go to the site itself.

What are the key statistics about breast cancer in men?

The American Cancer Society estimates for breast cancer in men in the United States for 2016 are:

• About 2,600 new cases of invasive breast cancer will be diagnosed
• About 440 men will die from breast cancer

Breast cancer is about 100 times less common among men than among women. For men, the lifetime risk of getting breast cancer is about 1 in 1,000. The number of breast cancer cases in men relative to the population has been fairly stable over the last 30 years.

Breast Cancer in Men

Signs and symptoms of breast cancer in men

Men need to know that breast cancer is not limited to only women. Possible symptoms of breast cancer to watch for include:

A lump or swelling, which is usually (but not always) painless

Skin dimpling or puckering

Nipple retraction (turning inward)

Redness or scaling of the nipple or breast skin

Discharge from the nipple

Sometimes a breast cancer can spread to lymph nodes under the arm or around the collar bone and cause a lump or swelling there, even before the original tumor in the breast tissue is large enough to be felt.

These changes aren't always caused by cancer. For example, most breast lumps in men are caused by gynecomastia (a harmless enlargement of breast tissue). Still, if you notice any breast changes, you should see your health care professional as soon as possible.

Symptoms in Men

How is breast cancer in men diagnosed?

Medical history and physical exam

If there is a chance you have breast cancer, your doctor will want to get a complete personal and family medical history. This may give some clues about the cause of any symptoms you are having and if you might be at increased risk for breast cancer.

A thorough clinical breast exam will be done to locate any lumps or suspicious areas and to feel their texture, size, and relationship to the skin and muscle tissue. The doctor may also examine the rest of your body to look for any evidence of possible spread, such as enlarged lymph nodes (especially under the arm) or an enlarged liver. Your general physical condition may also be evaluated.

Tests used to evaluate breast disease

If the history and physical exam results suggest breast cancer may be possible, several types of tests may be done.

Diagnostic mammography

A mammogram is an x-ray exam of the breast. It is called a diagnostic mammogram when it is done because problems are present.

For a mammogram, the breast is pressed between 2 plates to flatten and spread the tissue. This may be uncomfortable for a moment, but it is necessary to produce a good, readable mammogram. The compression only lasts a few seconds. This procedure produces a black and white image of the breast tissue either on a large sheet of film or as a digital computer image that is read, or interpreted, by a radiologist (a doctor trained to interpret images from x-rays and other imaging tests). In some cases, special images known as cone or spot views with magnificationare used to make a small area of abnormal breast tissue easier to evaluate.

The results of this test might suggest that a biopsy is needed to tell if the abnormal area is cancer. Mammography is often more accurate in men than women, since men do not have dense breasts or other common breast changes that might interfere with the test.

Breast ultrasound

Ultrasound, also known as sonography, uses high-frequency sound waves to outline a part of the body. Most often for this test, a small, microphone-like instrument called a transducer is placed on the skin (which is first lubricated with gel). It emits sound waves and picks up the echoes as they bounce off body tissues. The echoes are converted by a computer into a black and white image on a computer screen. A newer ultrasound machine that was designed to look at the breast uses a much larger transducer that can examine the entire breast at once.

This test is painless and does not expose you to radiation.

Breast ultrasound is often used to evaluate breast abnormalities that are found during mammography or a physical exam. It can be useful to see if a breast lump or mass is a cyst or a tumor. A cyst is a non-cancerous, fluid-filled sac that can feel the same as a tumor on a physical exam. A mass that is not a simple cyst will often need to be biopsied.

In someone with a breast tumor, ultrasound can also be used to look at the lymph nodes under the arm to see if they are enlarged. If they are, ultrasound can be used to guide a needle to take a sample (a biopsy) to look for cancer cells.

Magnetic resonance imaging (MRI) of the breast

MRI scans use radio waves and strong magnets instead of x-rays. The energy from the radio waves is absorbed and then released in a pattern formed by the type of body tissue and by certain diseases. A computer translates the pattern into a very detailed image of parts of the body. For breast MRI to look for cancer, a contrast liquid calledgadolinium is injected into a vein before or during the scan to show details better.

MRI scans can take a long time — often up to an hour. You have to lie inside a narrow tube, face down on a platform specially designed for the procedure. The platform has openings for each breast that allow them to be imaged without compression. The platform contains the sensors needed to capture the MRI image. It is important to remain very still throughout the exam. Lying in the tube can feel confining and might upset people with claustrophobia (a fear of enclosed spaces). The machine also makes loud buzzing and clicking noises that you may find disturbing. Some places will give you headphones with music to block this noise out. MRIs are also expensive, but insurance plans generally pay for them in some situations, such as once cancer is diagnosed.

MRI machines are quite common, but they need to be specially adapted to look at the breast. It's important that MRI scans of the breast be done on one of these specially adapted machines and that the MRI facility can also do a MRI-guided biopsy if it is needed.

MRI can be used to better examine suspicious areas found by a mammogram. MRI is also sometimes used in someone who has been diagnosed with breast cancer to better determine the actual size of the cancer and to look for any other cancers in the breast.

Nipple discharge exam

Fluid leaking from the nipple is called nipple discharge. If you have a nipple discharge, you should have it checked by your doctor. If there is blood in this fluid, you might need more tests. One test collects some of the fluid to look at under a microscope to see if cancer cells are present. This test is often not helpful, since a breast cancer can still be there even when no cancer cells are found in the nipple discharge. Other tests may be more helpful, such as a mammogram or breast ultrasound. If you have a breast mass, you will probably need a biopsy, even if the nipple discharge does not contain cancer cells or blood.

Biopsy

A biopsy removes a body tissue sample to be looked at under a microscope. A biopsy is the only way to tell if a breast abnormality is cancerous. Unless the doctor is sure the lump is not cancer, this should always be done. There are several types of biopsies. Your doctor will choose the type of biopsy based on your situation.

Fine needle aspiration biopsy: Fine needle aspiration (FNA) biopsy is the easiest and quickest biopsy technique. The doctor uses a very thin, hollow needle attached to a syringe to withdraw (aspirate) a small amount of tissue from a suspicious area. The doctor can guide the needle into the area of the breast abnormality while feeling the lump. A local anesthetic (numbing medicine) may or may not be used. Because such a thin needle is used for the biopsy, the process of getting the anesthetic might actually be more uncomfortable than the biopsy itself.

An FNA biopsy is the easiest type of biopsy to have, but it has some disadvantages. It can sometimes miss a cancer if the needle is not placed among the cancer cells. And even if cancer cells are found, it is usually not possible to determine if the cancer is invasive. In some cases there may not be enough cells to perform some of the other lab tests that are routinely done on breast cancer specimens. If the FNA biopsy does not provide a clear diagnosis, or your doctor is still suspicious, a second biopsy or a different type of biopsy should be done.

Core needle biopsy: For a core biopsy, the doctor removes a small cylinder of tissue from a breast abnormality to be looked at under a microscope. The needle used in this technique is larger than that used for FNA. The biopsy is done with local anesthesia and can be done in a clinic or doctor's office.

A core biopsy can be used to sample breast changes the doctor can feel, but it is also used to take samples from areas pinpointed by ultrasound, MRI, or mammogram. (When mammograms taken from different angles are used to pinpoint the biopsy site, this is known as a stereotactic core needle biopsy.)

Because it removes larger pieces of tissue, a core needle biopsy is more likely than an FNA to provide a clear diagnosis, although it might still miss some cancers.

Surgical (open) biopsy: Most breast cancer can be diagnosed with a needle biopsy. Rarely, though, surgery is needed to remove all or part of the lump to know for certain if cancer is present. Most often, the surgeon removes the entire mass or abnormal area, as well as a surrounding margin of normal-appearing breast tissue. This is called anexcisional biopsy. If the mass is too large to be removed easily, only part of it may be removed. This is called anincisional biopsy.

In rare cases, a surgical biopsy can be done in the doctor's office, but it is more commonly done in the hospital's outpatient department under local anesthesia (you are awake, but the area around the breast is numb), often with intravenous sedation (medicine given into a vein to make you drowsy).

A surgical biopsy is more involved than an FNA biopsy or a core needle biopsy, and it often requires several stitches and may leave a scar. Sometimes, though, this type of biopsy is needed to get an accurate diagnosis.

All biopsies can cause bleeding and can lead to swelling. This can make it seem like the breast (or the lump in the breast) is larger after the biopsy. This is generally nothing to worry about and the bleeding and bruising go away quickly in most cases.

Lymph node biopsy: Cancer in the breast can spread to lymph nodes under the arm and around the collar bone (clavicle). If any of these lymph nodes are enlarged, they may be biopsied. Often, this is done with a needle biopsy during the same procedure as the breast biopsy.

Lymph node dissection and sentinel lymph node biopsy: These procedures are done specifically to look for breast cancer spread to lymph nodes. They are described in more detail under "Types of breast surgery" in the “Surgery for breast cancer in men” section.

Diagnosis in Men

It would appear that the diagnosis in men is not that different than in women from the above article. I did not know that it is easier to see breast cancer in a mammogram for men than women because of the density of the breast. I found that interesting.  Please, if you have breast cancer in your family, pay attention to the condition of your breast. As in women, early detection is very important.  Do that monthly self-exam. No one has to know what you're doing and please have any lumps checked out. I would not wish this on any human being, male or female!

Please look at the prayer list page on the right side of the blog and add those people to your prayer list. I believe in the power of prayer and we can all use them

If you are making this journey as I am, may God bless you in your travels.

Reconstruction

Scripture of the Day:

Psalm 103: 1-5 (NLT)

Let all that I am praise the Lord; with all my whole heart I will praise His name. Let all that I am praise the Lord; may I never forget the good things that He does for me. He forgives all my sins and heals all my diseases. He redeems me from death and crowns me with love and tender mercies. He fills my life with good things. He renews my youth like the eagle’s.

The following is from a website that concerns recurrences. Sadly some people have to go through the process more than once. 

Recurrent breast cancer

Recurrent breast cancer means the disease has returned after treatment. Most recurrences appear within the first two or three years after treatment, but breast cancer can recur many years later. This type of breast cancer may come back in the breast, chest wall or in other parts of the body.

Breast cancer that returns locally (i.e., in the area of the surgery) is called a local recurrence. If the disease returns in another part of the body, it is called metastatic breast cancer. Women with recurrent breast cancer will receive treatment based on where the cancer returned.

The next thing after the mastectomy is choosing a form of reconstruction. I was given 4 choices. The first was to do nothing. 

I had a double mastectomy and for about 5 minutes I considered doing nothing. I hate wearing a bra. This would've solved that problem. 

The next is a prosthesis. 

These things are very spongy and I was surprised. They seemed pretty heavy to me. I hated the thought of readjusting those every time they fell out of place.

The third was implants.

There are two types of these...saline and silicone. I originally wanted the saline. The thought of silicone leaking into my body was an awful thought. But my plastic surgeon, whom I really like, convinced me to use the silicone. He said they would be more natural. Since I can't compare the choices, all I can say is these silicone implants are fine. You can feel that they are not real. So, if these are better, I really can't imagine how fake the saline ones would've looked.

The last is complete breast reconstruction. This I was told would take 12 hours of surgery and they would take material from my stomach and use it to make my  breasts. It involved breaking my ribs, I was told. Twelve hours and broken ribs did not appeal to me so I chose the implants. 

I found both of these articles on the internet. I just googled them. 

If you are making this journey as I am, may God bless you with His healing touch. I know he loves you.

Managing the Cost

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Scripture of the Day:

Jeremiah 29: 11

For I know I have plans for you, declares the Lord, plans to prosper you and not to harm you, plans to give you hope and a future.

Managing the Cost

I can tell you that cancer is costly like it states in the first sentence of the article. One chemo-therapy treatment is $30,000.00. If you don't have prescription insurance, the monthly prescription for the daily pill I had to take for 5 years is $712.00. I was so blessed with my insurance. The cost to me was very minimal. I also had cancer insurance that I bought in 1992. I bought it because I was a smoker. I fully expected to be diagnosed with lung cancer one day. It was a foresight that I am very thankful for. It paid cash directly to me, not my doctor. If you think you're at risk for some type of cancer and can afford that extra insurance, you may want to consider it.

God was definately watching over me when my diagnosis came along. I would have never believed how beneficial my insurances were and can't tell you why we maintained them even during the lean times. 

The link to the article is at the end. I hope this is helpful. Cancer patients don't need the extra stress of worrying about paying for the treatment.

Managing the Costs of Your Cancer Treatment

Cancer is costly. It can take a toll on your health, your emotions, your time, your relationships – and your wallet. There will be unexpected charges, and even the best health insurance won’t cover all your costs. Here are some tips on what costs you can expect and some ideas on how to plan for, ask about, and discuss treatment costs with your cancer care team. Don’t wait until you have financial problems to discuss cancer costs with your health care team.

You might feel as if you don’t have the energy to deal with cancer and talk about money, too. You might want to ask a friend or family member to keep track of costs for you. Ask this person to go with you to doctor visits and help with these discussions.

Planning for treatment

Learn as much as you can about cancer and your cancer treatment before it starts. This will help you know what to expect. It can also help you plan for and deal with the costs. Many people with cancer have medical expenses for things like:

• Provider visits
• Lab tests (blood tests, urine tests, and more, which are usually billed separately)
• Clinic visits for treatments
• Procedures (for diagnosis or treatment, which can include room charges, equipment, different doctors, and more)
• Imaging tests (like x-rays, CT scans, and MRIs, which may mean separate bills for radiologist fees, equipment, and any medicines used for the test)
• Radiation treatments (implants, external radiation, or both)
• Drug costs (inpatient, outpatient, prescription, non-prescription, and procedure-related)
• Hospital stays (which can include many types of costs such as drugs, tests, and procedures as well as nursing care, doctor visits, and consults with specialists)
• Surgery (surgeon, anesthesiologist, pathologist, operating room fees, equipment, medicines, and more)
• Home care (can include equipment, drugs, visits from specially trained nurses, and more)

What to ask about costs of cancer treatment

Talk with the people on your cancer team. They’ll usually know who can help you find answers. Here are some questions you can ask about costs. Choose the ones that relate to you and your treatment.

The overall treatment plan

Here are some ideas for ways to bring up the subject of cost as your treatment is planned:

• I’m worried about how much cancer treatment is going to cost me. Can we talk about it?
• Will my health insurance pay for this treatment? How much will I have to pay myself? (Discuss this for each treatment option.)
• I know this will be expensive. Where can I get an idea of the total cost of the treatment we’ve talked about?

Some related or follow-up questions you might want to ask:

• If I can’t afford this treatment are there others that might cost less, but will work as well?
• Is there any way I can get help to pay for this treatment?
• Does my health insurance company need to pre-approve or pre-certify any part of the treatment before I start?
• Where will I get treatment – in the hospital, your office, a clinic, or at home?

Prescription drugs

Oral chemotherapy

Today, more and more chemo drugs are taken by mouth. (This is often called oral chemo, and includes drugs known as targeted therapy.) In most cases, this means you get a prescription and take the drugs on your own, at home.

Chemo taken by mouth is as strong as the other forms and, when taken properly, works just as well. But oral chemo drugs cost a lot – sometimes many thousands of dollars each month. And most health insurance plans don’t pay for the oral drugs the same way they pay for the IV drugs (those put into a vein in the hospital, clinic, or office).

Oral chemo drugs are often treated like regular prescription drugs. You have to pay for them and, even if your insurance covers them, you might have a very high co-pay. For example, some insurance companies require a co-pay of 25% of the drug cost. This can be thousands of dollars. And this isn’t a bill that you can pay later – you have to pay when you pick up the drug at the pharmacy.

Make sure you know how much you’ll have to pay for each treatment. Many drug manufacturers have patient assistance plans to help people pay for their drugs. Ask your cancer care team about this.

Please see If You Have Problems Paying a Medical Bill or call us to learn more about this.

Other prescription drugs used with cancer treatment

Many kinds of drugs are used to treat cancer. These may be drugs to prevent nausea, treat pain, help with anxiety, or control diarrhea. Drug prices vary a lot. You (or a family member) may want to call different pharmacies to get an idea of where you can get the best price.

When your doctor prescribes medicines or outpatient care, here are some questions you may want to ask:

• If I get outpatient treatment, how much of it will my health insurance cover?
• How much will the chemo drug that I take by mouth cost me? What about the nausea medicines and other drugs that go along with it?
• How much will I have to pay for this drug? Will my insurance cover it? (Ask this about each prescription you are given.)
• Are there programs to help me get the drugs I need?
• Are there less expensive drugs or a generic form that work as well?
• Is there any other way I can get help paying for this drug?

Hospital, surgery, and clinic treatments

If you must have surgery, chemo, radiation, or will be in the hospital for part of your treatment, here are some questions you might want to ask:

• Do we need to get my insurance company’s approval (sometimes called pre-certification) before the test, surgery, treatment, home care, etc.?
• Is there a co-pay for each treatment? (The co-pay is the cost you will be charged each time you get outpatient treatments in an office or clinic. Your health insurance company sets the co-pay amount.)
• If I must go into the hospital, how much will it cost? How much will my insurance cover?
• Is there a way to know beforehand if the doctors who will see me in the hospital are in my health plan network?
• Counting all the charges (hospital, anesthesia, surgeon, pathologist, and more), how much will this surgery cost me? How much will my insurance cover?
• Should I plan for rehab, home care, or long-term care (such as nursing home or hospice care)?

Health insurance

Out-of-pocket costs are costs you have to pay because your health insurance doesn’t. They can add up quickly and may make it hard for you to pay for other things you need.

You’ll want to be sure that your health insurance company pays or reimburses the bulk of your medical expenses. This means you’ll need to

• Know the terms of your policy
• Be aware of preferred or network doctors, hospitals, or clinics
• Keep careful records

If any of your treatments might be done by out-of-network doctors or providers, find out about those costs, too. Even when you know the terms of your policy, getting payments can mean re-submitting claims, appealing denials, and much more.

Usually, doctors’ offices and clinics have someone who handles health insurance concerns and problems. Ask your doctor if that person can help you with claims and codes on the bills that are sent to the insurance company.

You can find out more about health insurance and other costs at Understanding Health Insurance.

Our health insurance experts are also available to answer your questions 24 hours a day, 7 days a week. You can reach one of them by calling 1-800-227-2345.

More information from your American Cancer Society

We have a lot more information that you might find helpful. Explore www.cancer.org or call our National Cancer Information Center toll-free number, 1-800-227-2345. We’re here to help you any time, day or night.

National organizations and websites*

American Society of Clinical Oncology (ASCO)
Web site: www.cancer.net

Has a special section for patients on the costs of cancer care at www.cancer.net/managingcostofcare. Also offers cancer and cancer-related information (including many in Spanish), on things like treatment, side effects, coping, and survivorship, as well as a database to help find an oncologist

Patient Access Network Foundation (PANF)
Toll-free number: 1-866-316-7263
Web site: www.panfoundation.org

Helps under-insured patients with certain cancer diagnoses cover out-of-pocket costs related to cancer care.

Patient Advocate Foundation (PAF)
Toll-free number: 1- 800-532-5274
Web site: www.patientadvocate.org

Works with the patient and their insurer to resolve insurance problems; also provides direct financial support to insured patients who are financially and medically qualified for drug treatments and/or prescription co-pays, co-insurance, and deductibles related to certain cancer diagnoses.

*Inclusion on this list does not imply endorsement by the American Cancer Society.

References

American Society of Clinical Oncology. Managing the Cost of Cancer Care. Accessed at www.cancersupportcommunity.org/MainMenu/About-Cancer/Understanding-Cancer/Coping-with-the-Cost-of-Care/Where-do-I-begin.html on October 30, 2015.

Bestvina CM, Zullig LL, Yousuf Zafar S. The implications of out-of-pocket cost of cancer treatment in the USA: a critical appraisal of the literature. Future Oncol. 2014;10(14):2189-2199.

Bullock AJ, Hofstatter EW, Yushak ML, Buss MK. Understanding patients’ attitudes toward communication about the cost of cancer care. J Oncol Pract. 2012;8(4):e50-58.

Cancer Support Community. Frankly Speaking About Cancer: Coping with the Cost of Care, 5th edition. Accessed at www.cancersupportcommunity.org/General-Documents-Category/Education/FSAC-Coping-with-the-Cost-of-Care.pdf on October 30, 2015.

Peppercorn J. The financial burden of cancer care: do patients in the US know what to expect? Expert Rev Pharmacoecon Outcomes Res. 2014;14(6):835-842.

Tangka FK, Trogdon JG, Richardson LC, et al. Cancer treatment cost in the United States: has the burden shifted over time? Cancer. 2010;116(14):3477-3484.

Ubel PA, Abernethy AP, Zafar SY. Full Disclosure – Out-of-Pocket Costs as Side Effects. N Engl J Med. 2013;369(16):1484-1486.

Last Medical Review: 11/15/2015

Last Revised: 11/15/2015

Cost of Cancer Treatment

Please go to my prayer list page and add these cancer patients to your prayer list. The power of prayer is amazing and I've seen it work.

If you are making this journey as I am, may God bless you with His healing touch. I know He loves you.

Paying for Treatment without Insrucance

Scripture of the Day:

James 1:2

            Count it all joy when you fall into trials, knowing that the +

testing of your faith produces patience

I was very fortunate that I had wonderful insurance and am a military dependent. My surgeries cost next to nothing and my civilian oncologist is covered as well, with a small co-pay. But so many women are not covered and have no where to turn. I've read some terrible horror stories. The following is a a short article about getting treatment without insurance. The link is at the bottom. If going to this link is not helpful. Then maybe you can find something better on your own. If there is a group out there that you can see your way clear to support with donations so that they can help these women, please give. I know that many are afraid to give because they are not sure the women are actually getting the money they need for treatment. It truly is a conundrum. 

Paying for Treatment Without Insurance

 
 

Question: I don't have health insurance. How will I pay for breast cancer treatment?

Answer: Several government and private organizations help people without medicalinsurance to pay for treatment:

• Begin by contacting the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237). They have information about how to get free mammograms, Pap smears, and treatment.
• Call your local Social Services Department. You may be eligible for Medicaid or other programs for low-income women.
• Call your local Public Health Department to find out about local health care programs.
• Many hospitals run free clinics where they provide medical care at no or low cost.
• Contact the Susan G. Komen Breast Cancer Foundation or the American Cancer Society.

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Last modified on May 15, 2015 at 10:34 AM

Paying for Treatment Without Insurance

If you are making this trip as I am, may God bless you with His healing touch. I know He loves you.