A Whisper
After He Said Cancer | A Memoir
“The fact is, by the time most men are diagnosed, it is already a death sentence,” Pat said, her tone urgent and pressing.
Her son, Matthew Bowman, died of male breast cancer at the age of 49. He was a nurse and a pillar of his community, a lieutenant for his town’s volunteer fire department. Many women in Pat’s family had breast cancer, but the genetic testing hadn’t identified a high-risk gene. It hadn’t occurred to them to have male members of their family screened for breast cancer, much less to have them screened in their forties.
Our phone call was long overdue. We had a lot in common as two women who loved men diagnosed with male breast cancer. She was intent on making a difference to help men avoid an untimely death from the disease. I was focused on helping my husband stay alive long enough for our children to graduate from high school. Neither she nor I had a choice as to whether we wanted male breast cancer to enter our lives and how to end the stigma that kept the disease in the shadows.
No one wanted to talk about it. Not the men with breast cancer having their first mammogram to check a breast lump. Not even the caregivers who were too busy taking care of their sons, husbands, or partners to think about advocacy. At first, not even I wanted to talk about it, and when I told people, the words “male breast cancer” came out in a whisper. There is something that felt wrong about divulging that my husband had a woman’s cancer.
But it wasn’t a woman’s cancer. It was simply cancer. I knew this so deeply, it could have leached out of my bones, and even I had difficulty saying it aloud. I should be able to shout it from the street corner. But I couldn’t or wouldn’t. Something held me back. I was thankful that Matt had been a strong advocate when he was alive, and Pat had taken up the torch. An uncommon disease needed strong voices, and my own felt weak.
Our conversation turned to the next step and how we might work together. I was fixated on determining which treatments might work better in men than women. This might help my husband, who would be at high risk for a cancer recurrence after chemotherapy and radiation.
“I am going to be sick if I hear one more time that they don’t know which breast cancer treatments will work the best in men, so they are going to use the regimens tested in women,” I said, feeling my stomach churning. Every time I heard these words, my intestines began to revolt, and a wave of nausea came over me.
“Sure, we could spend our time figuring out whether men might benefit from a different treatment than women, but more lives could be saved if we get more men screened for breast cancer,” she replied quickly. “This is where we need to focus.” Pat had spent more time than I thinking about what it would take to make a dent in this disease.
She was right. Screening was the right thing to do to catch more cases in the early stages. Once breast cancer spreads beyond the breast and the lymph nodes, the chance that a man would live more than 5 years is only 20%. Why men’s survival isn’t as good as women’s, even when matched for the same cancer stage, wasn’t clear.
Before his death, Matt appeared on television and talked with journalists to spread the message that men could get breast cancer. I found an article featuring a quote from him.
“I believe education is the key,” he said. “This disease is treatable, if it is not found too late. Because of the lack of education out there, for every effort that is given to breast cancer in women, we need to spend four times that on male breast cancer to catch up with the rest of the breast cancer world.”
In recent years, the U.S. National Institutes of Health allocated more than 800 million dollars to breast cancer research out of a total of 8 billion dollars for cancer research. If we allocated only 1% of the breast cancer budget to the disease in men, this could fund two large grants to improve men’s survival. If nothing else, this approach seemed fair. One percent of breast cancer diagnoses were in men. Why shouldn’t 1% of the U.S. research dollars in this area benefit men’s health?
Matt lived for four years after his diagnosis. My heart ached for Pat, me, and my daughters. My physician brain kept playing out scenarios of how the cancer might progress, or go away, only to return within a year. I had seen so many patients in these situations that it wasn’t hard to overlay my husband’s image onto a memory of someone who died too young. More than anything, I wanted more time with him. When we were in our 80s, I wanted to hold hands with him and think back to decades of life together.
“The sad thing is that Matt had so many dreams that would never be fulfilled,” she said wistfully.
A heavy silence came over us that wasn’t broken for a long time.
If you would like to read other posts, here are a few:
How It Began. This story is the origins of my Substack and tells the story of the first moment when we learned of my husband’s breast cancer diagnosis. https://www.afterhesaidcancer.com/p/how-it-began
Extremes. The extremes of poverty give me perspective on my grief.
That Ribbon. https://www.afterhesaidcancer.com/p/that-ribbon
The Day He Nearly Died. https://www.afterhesaidcancer.com/p/the-day-he-nearly-died
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I’m glad you talked with Pat and heard Matt’s story. I did not have the pleasure of meeting Matt, but have been blessed to spend time with Pat on several occasions. I agree with him in that we need to implement screening for our men so we can stop, or at least slow down, this trend of diagnosing breast cancer in men at too late of a stage. Thank you again for this post.