The Docs: Breast cancer in men is rare but often deadly


Q: I was shocked to be diagnosed with stage one breast cancer. Fortunately my doc says they caught it early so my chances are very good that I’ll be able put this behind me. How freakish is this? -- Ernie K., Toledo, Ohio

A: The American Cancer Society estimates that 2,670 new cases of invasive breast cancer will be diagnosed in men in 2019, and about 500 of those men will die from it. Fatalities most often happen because men miss the signs that they have a breast tumor, thinking a lump there must be from something else. So you were smart and lucky that it was detected early.

It’s not common, but it certainly isn’t freakish; in fact, you’re in good company. Ernie Green, a fullback for the Cleveland Browns (1962-1966) was diagnosed in 2006. He survived, but unfortunately two of his sisters developed breast cancer and only one survived. Then there’s Peter Criss, the drummer for KISS, who was diagnosed in 2007 and survived to be inducted into Cleveland’s Rock & Roll Hall of Fame in 2014. Stand-out football player Paul Dombroski (Kansas City Chiefs, New England Patriots and Tampa Bay Buccaneers in the 1980s) also survived. All are outspoken advocates for male breast cancer awareness.

If your oncologist recommends getting tested for the BRCA1 and BRCA2 genes, that’s not a bad idea. Although those genetic markers are mostly associated with breast cancer and ovarian cancer risk in women, men can have them too, and they signal an increased risk of not just breast cancer, but prostate cancer.

So join the ranks of Ernie, Peter and Paul, and advocate for male breast cancer awareness. If men are tested for genetic risk and are hip to the warning signs for both breast and prostate cancers, they can expect to have as positive outcomes as women do these days (there’s a 99% five-year survival rate for localized breast cancer).

Q: My 4-year old niece had a bad cough and her mom gave her something that she (a 32-year-old) had been prescribed for a cough last spring. I was worried that it wasn’t good for a kid that age to take, but it cleared up her symptoms pretty effectively. How do you know if it’s OK or not? -- Denise Q., Madison, Wisconsin

A: Great question, and the answer isn’t always easy to figure out. In part, that’s because doctors often prescribe drugs to kids that have not been specifically approved by the Food and Drug Administration for them. That’s called an off-label prescription, and while it is legal, it can be problematic, especially for children, the very elderly and pregnant women.

According to the Agency for Healthcare Research (part of the Department of Health and Human Services), about one in five prescriptions written today is off-label, for both adults and kids. According to a recent study from the Robert Wood Johnson Medical School, an astounding 47% of prescriptions written for kids after a doctor’s appointment are off-label! This happens in part because medical science hasn’t done a lot of research on drugs’ effects on children, so many meds aren’t approved for kids. Unfortunately, that means we don’t actually know if they’re risky.

Where does that leave parents? When it comes to cold and cough meds, that’s one area where warnings are loud and clear: The FDA doesn’t recommend over-the-counter medicines for cough and cold symptoms in children younger than 2. Prescription cough medicines containing codeine or hydrocodone are not indicated for use by anyone younger than 18.

Concerning other meds, whenever your child of any age is given a prescription, ask the doc if it is an off-label use. If it is, ask why the doctor thinks it’s OK for your child to take and what any risks might be. Also ask how long it’s been on the market and been used off-label for kids. See if a kid-approved alternative treatment is available.

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