Frequently asked questions about breast cancer in men - risk factors, symptoms, self-diagnosis and more

October is observed as the Breast Cancer Awareness Month, all around the world. Breast cancer is one of the leading causes of death among women and is also the most common type of cancer that affects women. However, we often associate breast cancer only with women. In fact, some people are not even aware that breast cancer can also affect men. The fact is that men do have a small amount of breast tissue in their body. 

It is important to know and be aware of breast cancer in men. A medical expert answers some frequently asked questions about breast cancer in men.

How is breast cancer in men different from that in women? What causes breast cancer in men? 

 

Breast cancer in men is a rare type of cancer that forms inside the breast tissue. While every individual is born with a small amount of breast tissue, women begin developing more breast tissue during puberty as compared to men. Therefore, the occurrence of breast cancer is higher in women. According to a study titled ‘Male Breast Cancer in India: Series from a Cancer Research Centre’ out of 1,752 cases of breast cancer in the country, between 2005 to 2014, only 18 cases were identified to be among men. 

Types of breast cancer in men include: 1) Ductal carcinoma: This cancer begins in the milk ducts. Majority of all male breast cancer is ductal carcinoma.  2) Lobular carcinoma: This type of cancer is rare because men have few lobules (a gland in the breast that makes milk) in their breast tissue.

Other rare types of breast cancer that can occur in men include Paget's disease (a type of cancer with skin changes involving the nipple of the breast) and inflammatory breast cancer (a rare and very aggressive disease in which cancer cells block lymph vessels in the skin of the breast)

What are the early warning signs of breast cancer in men that one should look out for? 
Breast cancer does not produce symptoms when the tumour is small and most treatable, making it difficult to detect.
The warning signs include a painless lump or thickening in the breast tissue, changes to the skin covering the breast such as dimpling, puckering, redness or scaling. It can also be identified through changes to the nipple such as redness, scaling, nipple discharge or a nipple that begins to turn inward.

How can you do a self-examination of breasts?

To perform a self-examination, stand in front of a mirror, placing your arms on your hips. Look closely at your chest area for noting any changes to your nipples such as swelling or inversion. Then, raise your arms above your head and inspect the areas around your chest and armpits. The next step is to feel your chest for any potential lumps, which can be done by moving your fingertips in a circular motion around the breast area. Additionally, the nipple area needs to be checked for any discharge.

Who is at risk of breast cancer?

The most common risk factor for male breast cancer is old age. It is most often diagnosed in men who are in their 60s. Other risk factors include:

• Family history: Some men inherit abnormal genes from their parents that increase the risk of breast cancer
• Liver disease: Certain conditions such as cirrhosis of the liver (late stage of scarring of the liver caused by many forms of liver diseases such as hepatitis and chronic alcoholism), can reduce male hormones and increase female hormones which can lead to increased risk of breast cancer
• Exposure to estrogen: The risk tends to increase if one takes estrogen-related drugs such as those used for hormone replacement therapy for prostate cancer. High estrogen level can be a result of excess alcohol and tobacco consumption, inadequate physical activity and obesity.

How can breast cancer be diagnosed?

Apart from self-examination, mammogram, ultrasound and biopsy require identifying cancer cells in tissue specimens.
A mammogram is a process of using low-energy X-rays to examine the human breast for diagnosis and screening. Ultrasound is most often done to confirm if a lump found by a mammogram or physical exam is a cyst filled with fluid or a solid tumour. A biopsy is a test in which tissue or fluid from the suspicious area is extracted and examined under a microscope and further tested to check for the presence of breast cancer. 

What are the treatment options available?
Treatment depends on the stage of cancer, overall health and individual treatment preferences. It can be a combination of surgery, radiation and medical therapy. 

The aim of the surgery is to remove the tumour and surrounding breast tissue. Common surgical procedures include:

Mastectomy: This involves the removal of entire breast tissue, including the nipple and areola.
Sentinel lymph node biopsy: This involves identification of the lymph nodes where the cancer cells are likely to start spreading from. If cancer is found, additional lymph nodes are removed for testing. If no cancer cells are found here, then there is a good chance that breast cancer hasn't spread beyond the breast tissue. 

Apart from the surgical procedure, one can opt for radiation or systemic therapy. Radiation therapy is used to destroy cancer cells remaining in the breast, chest wall, or underarm area after surgery, or to reduce the size of a tumour before surgery. In systemic therapy, anti-cancer drugs are injected into a vein or given by mouth. It includes biologic therapy, chemotherapy, and hormone therapy.

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Athlete's foot

Athlete's foot is a common form of a fungal infection. It most commonly occurs between the toes and is medically known as tinea pedis. The most common cause are sweaty feet which when enclosed inside a tight-fitting shoe for a prolong time leads to this condition. The most common symptom of athlete's foot is a scaly rash which causes itching and burning on your foot. It is a contagious disease and is most commonly spread through towels or clothing of people who have that disease. It can also be spread through the floors which people with athlete's foot walk on. Here is everything you need to know about athlete's foot.
Causes:

1. Dirty wet socks inside covered shoes: As mentioned earlier, athlete's foot is a contagious disease which originates from wearing dirty wet socks inside covered shoes. 
2. Infection: You may also get it by coming into contact with an infected person or their towels and/or clothing. Even walking on the same floor as they walk on may cause an infection.

Symptoms:

1. Scaly red rash: There is usually a scaly red rash in between the toes when you have athlete's foot.
2. Itching: There will be severe itching throughout the persistence of this disease especially when you first take off your shoes.
3. Blisters and ulcers: This is not a very common symptom of athlete's foot. However, blisters and ulcers do occur on certain types of athlete's foot.
4. Chronic dryness and scaling: This occurs on the soles of the feet and then slowly starts spreading upwards. These symptoms only occur on the type of athlete's foot known as moccasin. Due to this, athlete's foot is often mistaken for eczema and sometimes even dry skin.
5. Spreading to the hand: Athlete's foot always starts in your legs and in some cases spread to your hands as well. The likelihood of athlete's foot spreading to your hand is increased if you scratch or pick at the areas of the foot infected.

Treatment:
There are three stages of treatment and these depend on the severity of the infection.

1. Over-the-counter medicines: In the first stage of treatment, the doctor will simply prescribe over-the-counter anti-fungal ointments, sprays or powders.
2. Prescription medications: In the next stage of treatment, prescription medications need to be applied to your feet.
3. Anti-fungal pills: If nothing else works, only then should anti-fungal pills be prescribed.                                                  this is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.   
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Some Dental Myths And Facts

Myth: Scaling is not good for teeth
Fact: Scaling removes tartar and keeps teeth and gums healthy. Scaling and deep cleaning of gums prevents bad breadth and bleeding gums. Thus, scaling is beneficial. One should get professional cleaning done by a dentist with a proper ultrasonic scaler. Extensive scaling done (more than required) is harmful.                        
                                                                          
Myth: Teeth whitening is harmful, as it damage enamel
Fact: Modern technique like Zoom Whitening works by exfoliating stains from one’s teeth to lighten them and bring back their natural colour. It is the simplest and safest procedure as a product is being used by dentists that is devoid of bleaching agents and chemicals.

 Myth: Only sugar causes cavities
Fact: It is one of the popular myths about dental cavities. Cavities occur when bacteria produces acids in the mouth. The process can begin by any carb that you consume. That includes sugar, fruits, vegetables, rice and bread. To reduce tooth decay, one should not only practice good dental care but also limit intake of acidic food.

Myth: Brushing your bleeding gums is bad
Fact: Brushing is not only good on teeth, but also on your gums and tongue. Brushing these areas help get rid of plaque which is what causes inflammation and gum disease. One should not brush too hard if they have sensitive gums. One should use a soft toothbrush for bleeding gums.           
                                      
Myth: Using sugarless chewing gum with Xylitol after meal can replace brushing
Fact: Nothing can replace proper brushing technique. And in case you want to use sugarless chewing gum, do not chew it for more than 10 minutes.

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.






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Actinic Cheilitis (Farmer's Lip)

This picture shows dry, scaly & cracked lips.
Actinic cheilitis is significantly more common in men, the elderly, and fair-skinned individuals. There is also a strong association with tobacco use.


Actinic cheilitis, sometimes known as "farmer's lip" or "sailor's lip," is a precancerous condition related to cumulative lifetime sun exposure. The lower lip is most often affected. Individuals with actinic cheilitis often complain of persistent dryness and cracking of the lips. They will frequently exhibit other effects of sun-damaged skin, such as precancerous lesions on the skin called actinic keratoses and extensive wrinkling.

A certain type of skin cancer (squamous cell carcinoma) develops in 6–10% of cases of actinic cheilitis. 

Signs and Symptoms

Actinic cheilitis is located on the lips, most often the lower lip. Persistent redness, scaliness, and chapping are among the symptoms noted. Erosions and cracks (fissures) may be present as well.

Preventive Tips

 Wearing  wide-brimmed hats and sunscreen-containing lip balms can aid in preventing actinic cheilitis. 

When to Get Medical Help

See a dermatologist when persistent scaling of the lips is noted. A biopsy of the lip may be needed to rule out squamous cell carcinoma.

Treatments 

In severe cases without evidence of malignancy, a lip shave procedure (vermilionectomy) may be performed. In less extreme cases, your doctor may recommend ablation of the damaged cells with a carbon dioxide (CO₂) laser.

Alternative treatments include the use of electric current to destroy the precancerous cells (electrodesiccation) and a facial sanding technique (dermabrasion). Topical therapy with a chemotherapeutic agent (fluorouracil) or a topical immunomodulator (imiquimod) may be prescribed.