When men develop breast cancer they are slower to seek help – and the most at risk

Recent figures indicate that around 1.7 million people will develop breast cancer each year, which means roughly 17,000 men could be affected annually. (Shutterstock)
Updated 22 October 2017

When men develop breast cancer they are slower to seek help – and the most at risk

DUBAI: Recent figures indicate that around 1.7 million people will develop breast cancer each year, which means roughly 17,000 men could be affected annually – enough to fill 19.5 Boeing A380 aircraft. However, those men face a higher mortality rate than women, because a lack of awareness often leads to a delay in seeking treatment.

Why? Because it is much harder to detect something when you are not looking for it – or you do not even consider it to be a possibility. The symptoms are revealed the same way, usually detected as a hard lump underneath the nipple and areola, but men are more likely to develop ‘significantly’ larger tumors due to the latecomer effect, and that is according to the largest gender-focused study on breast cancer ever conducted.

Men at risk
Breast cancer expert, Dr. Jon Greif, released his research in 2012, which compared the medical records of over 13,000 men who developed breast cancer, with those of more than 1.4 million women with the same plight Greif and his team found that the five-year survival rate for women overall was 83 percent, compared to 74 percent for men.

The study, presented at the American Society of Breast Surgeons (ASBrS) annual meeting, notes that the average male diagnosis occurred at 63, while women were 59, and that male breast cancer is “nearly always found as a lump,” while many instances in females are detected before a lump is felt, through screening.

“Regular mammographic screening might even benefit certain high risk men, although no research or controlled trials have been conducted on male screening as there have been for women,” said Greif. “Men at risk include those with certain genetic predispositions, a history of breast cancer in the family, significant exposure to radiation in the chest area and a history of breast cancer,” he added.

A first-hand account
“I noticed a change in appearance of the areola on my left breast and didn’t really think about it too much,” recalls one survivor. “My wife also had breast cancer and had a lumpectomy and radiation… So I am aware of what is involved with breast cancer and also was aware of male breast cancer, but I didn’t think it was what was going with me.”

The anonymous male was 56 when he happened to be visiting his doctor for a diabetes check-up, but was taken by surprise when his physician recommended a mammogram, which was scheduled immediately at a local women’s center. Within days a core biopsy (tissue test) confirmed the cancer was present, and the mastectomy removed all the breast tissue including the nipple.

“Male breast cancer is rare,” he added. “The one breast cancer specialist I saw said that I am the fourth case in six years that she has been a specialist in a large hospital. You should just be aware that it exists and to check yourself or have someone check you if you have any questions.” It turned out his specialist found cancer in several of the lymph nodes that they checked, which led to more surgery, chemo and radiation.

Where to turn?
If you discover a lump or experience any other worrying symptoms – such as discharge from the nipple – then you should see your physician immediately. But prevention is better than having to deal with a cure, and that is even more poignant considering the intensity of chemotherapy and other treatments.

For men and women alike, examining your pectoral area for lumps or other possible symptoms is incredibly simple. This useful guide from the UAE-based Pink Caravan organization breaks down a few simple steps, and recommends moving your hands in a consistent motion over your chest tissue, making it easier to detect any changes.

The test is particularly important for anyone who may be more at risk; men with previous breast pathology, men with gynecomastia, those with a history of testicular pathology, and anyone who has history of breast cancer within the family. What is also important is understanding that, despite its rarity and female associations, breast cancer does pose a risk to men – and it is up to all of us to encourage anyone with symptoms to seek medical help immediately.

Take a healthy approach to the issue of nutritional supplements

Updated 21 April 2018

Take a healthy approach to the issue of nutritional supplements

JEDDAH: There is a growing need for dietary supplements in Saudi Arabia, given the increasing popularity of junk food and the effective role supplements can play in treating diseases caused by mineral and vitamin deficiencies.

A recent study found that 22 percent of Saudi people take nutritional supplements. It is no surprise, then, that many Saudi businesses have forged partnerships with international dietary-supplement companies.

Dr. Rowaidah Idriss, a Saudi dietitian with a Ph.D. in nutrition, said dietary supplements can be defined as substances that provide the human body with a nutrient missing from a person’s regular diet. However, she stressed that they are not intended to replace healthy eating.

She also warned against taking them without first talking to a doctor or dietitian, as some products can have side effects, especially if taken before surgery or with other medicines. 

“They can also cause problems if someone has a history of certain health issues,” she added.

A blood test can determine which nutrients we are not getting enough of in our diet, and therefore which supplements might be beneficial. Nutritional supplements are also used to help treat certain health conditions. 

“Vitamin C, for example, is often used to reduce cold symptoms,” said Idriss. “Fish oil is taken to lower elevated blood triglycerides.”

She suggested four daily essentials that can bridge nutritional gaps in our diet: a multivitamin, vitamin D, calcium and omega-3 fatty acids. 

“I routinely recommend a daily multivitamin and mineral supplement to my clients after consulting with their doctors,” she said. 

“For menstruating women, who require 18 milligrams of iron each day, a daily supplement helps boost iron intake.”

She said people over the age of 50 are advised to take a multivitamin to ensure they are getting enough B12, which plays a key role in the functioning of the nervous system and the development of red blood cells. 

“Older adults are more vulnerable to B12 deficiency because they are more likely to have decreased production of stomach acid, which is needed to release B12 from the proteins in food.” said Idriss. 

“It is also a good idea to take a daily multivitamin if one is following a low-calorie diet.”

She also pointed out that a high intake of DHA and EPA, the two omega-3 fatty acids found in fish oil, are linked with a lower risk of heart disease and Type 2 diabetes. A deficiency of DHA might also increase the risk of Alzheimer’s. 

“A daily intake of 1,000 milligrams of both DHA and EPA is equivalent to eating 12 ounces of salmon a week,” said Idriss.

The dietitian believes that the Saudis who take food supplements often do so more to benefit their appearance than their health. 

“Saudi women consume more dietary supplements than other people in Saudi Arabia,” she said. 

“They do so either to lose weight or to care for their hair and nails. Bodybuilders also take large amounts of supplements.”

However, both groups, according to Idriss, tend to take supplements on the recommendation of friends and trainers, not doctors. 

She warned that commercials and social-media rumors can persuade people to buy supplements online that may not be approved as safe by the Saudi Food and Drug Authority, and advised people to get as much of their daily nutrient needs as possible from healthy eating.

Dr. Rowaidah Idriss

“Along with vitamins and minerals, a healthy diet provides fiber and hundreds of protective phytochemicals, something a supplement cannot do,” she said, adding that the body absorbs natural food more effectively than supplements.

In addition, combining supplements with medications can have dangerous, even life-threatening, effects. 

“Drugs for heart disease and depression, treatments for organ transplants, and birth-control pills are less effective when taken with herbal supplements,” she said.

“Taking an anticoagulant, aspirin, and a vitamin E supplement together may increase the potential for internal bleeding or even stroke.”


Natural sources

With the spread of fast-food restaurants and their alluring ads, the long-term health of the Saudi people is in danger, as children and young people snub natural sources of nutrients, such as fruit and vegetables. 

“This can lead to many deficiency diseases. Moreover, vegetarians can develop similar illnesses due to the absence of meat in their diet,” she said.
Dr. Ashraf Ameer, a family-medicine consultant, said the importance of nutritional supplements lies in treating mineral and vitamin deficiency, especially for pregnant women, growing children, diabetics, people with chronic diseases, and the elderly. 

“However, these products should come from reliable companies and meet Saudi food and drug requirements,”he added.

Mohammed Yaseen, who has a food supplements business, said his company works with a leading British health-care company to provide the Saudi market with high quality products.

“With this we hope we can contribute to the national transformation program by raising private-sector spending in health care from 25 percent to 35 percent, which in turn would lead to the sector’s financial sustainability and boost economic and social development in the Kingdom,” Yaseen said.


Vitamin Terms

DHA stands for docosahexaenoic acid. EPA stands for eicosapentaenoic acid.  Phytochemical is a biologically active compound found in plants.