Tag: male cancers

Categories : Cancer GenderTags :

Yes, Men can Get Breast Cancer

On By ModernMedia

Dr Salomine Theron, a radiologist at the SCP Radiology and Dr Lizanne Langenhoven, who specialises in the treatment of breast cancer, talk about breast cancer in men, how prevalent it is as well as the radiology behind the diagnosis, treatment and surveillance for recurrence.

‘It may come as a surprise that men can develop breast cancer,’ says Dr Langenhoven. ‘In fact, about 1% of all breast cancer cases are diagnosed in men. Unfortunately, men often present with more advanced disease, because they are not aware that they can develop breast cancer in the first place.’

Dr Theron says radiology plays a pivotal role in the diagnosis and treatment of breast cancer in both men and women. However, there is a difference in terms of radiology’s initial role in screening for breast cancer. ‘In women over 40, we recommend an annual mammography,’ she says. ‘In other words, looking for cancers which are asymptomatic. So even if there are no changes to your breast visibly or a lump, we still screen for anything that may develop into breast cancer or has already.

‘In men, that is not standard practice’ Here radiology is diagnostic and the referral is as a result of a lump in the breast, under the arm, there’s puckering or nipple pain. The mammogram differs too. It is a single mammogram image of each breast so that a comparison can be made.  In men, it will also include breast ultrasound and evaluation of the lymph nodes under the armpit.

Dr Theron says, ‘the imaging of a lump may also be incidental. For example, when we do any form of CT imaging on the chest in a male, even when creating images of the lungs, we always look at the soft tissue in the breast area. If we see an asymmetric nodule with an irregular shape (almost like a star) we alert the patient’s healthcare provider, even though that wasn’t the reason for the CT scan’.

Is a breast lump always in men always cancer?

‘No,’ says Dr Langenhoven, ‘About 50% of males develop small lumps in each of their breasts during puberty, usually behind the nipples which can be tender. This is called gynaecomastia – colloquially a ‘stony’ and it’s perfectly normal. It usually goes away as they finish puberty.

‘Breast cancer, on the other hand, usually presents as a firm nodule in one breast that is not tender. There are some men who present with inflammatory breast cancer, where the breast is red, swollen and tender. This is however, a rare but aggressive type of invasive breast cancer in which cancer cells block lymph vessels in the skin.’

She says, ‘the first message is one of awareness.  Men can develop breast cancer.  And that they should see their GP if they become aware of a lump in their breasts which feels firm and asymmetrical or if the breast becomes red, swollen and tender.’

The second message is one of precaution

Women and men can inherit the harmful BRCA1 or BRCA2 gene mutation that belong to a class of genes, known as tumour suppressors and have an increased risk of breast cancer.

Dr Langenhoven says, ‘I have a patient in my practice who presented with a hard lump on his left breast. Because he was aware of his family’s history of breast cancer, he went to his GP for an examination. A mammogram and biopsy confirmed the diagnosis of breast cancer.

She says men with these genes should always be assessed by a genetic counsellor. In addition, should you have a family member diagnosed with male breast cancer, prostate cancer below the age of fifty or ovarian cancer (women), you should seek the opinion of a genetic counsellor to discuss the possible genetic risk and the option of genetic testing. Prevention is better than cure.’

The role of radiology in diagnosis

‘A suspicious lump or mass can only be definitively diagnosed by a biopsy,’ says Dr Theron. She explains that there are three biopsy options:

  • Ultrasound guided core biopsies, where a sample of tissue or blood is taken for testing by a pathologist and a marker is left in the lesion or lump where the sample was taken
  • A fine needle aspiration (FNA) is a procedure to obtain a sample of cells from your body for testing by a cytologist for cancer cells usually of a lymph node or occasionally of a breast mass
  • A vacuum-assisted biopsy can produce slightly larger samples of tissues which is sent to the pathology lab
  • If there is no lump visible on ultrasound, only suspicious calcification on the mammogram, stereotactic guided vacuum biopsy will be done. Put simply, a mammogram will help us find the abnormality to biopsy
  • If the lump is very small or has a cystic component, an ultrasound guided vacuum assisted biopsy will be performed

Radiology at every stage of cancer care

‘Radiology is integral to breast cancer management beyond diagnosis, providing critical information that guides clinical decisions at every stage of care,’ says Dr Theron. ‘This includes staging of the disease, it allows for precise treatment planning, guiding surgical procedures, effective monitoring of treatment responses, early detection of recurrence, all of which are essential for improving patient outcomes.’

Male breast cancer treatment

Men with breast cancer are treated exactly as their female counterparts. Based on the type of breast cancer and the extent (stage), treatment options include chemotherapy, hormone withdrawal therapy, targeted therapies, immunotherapy, surgery and radiotherapy.

‘Even though only one in a hundred diagnosed cases of breast cancer is men,’ says Dr Theron, ‘we still urge men and of course women to check themselves regularly and to see a doctor if they feel or see any changes in their breasts.’

Early detection can save your life.

Categories : CancerTags :

Global Study Predicts Disparities, Increases in Men’s Cancer Cases and Deaths

On By ModernMedia

Results indicate the need for efforts to improve cancer outcomes equitably.

Credit: Darryl Leja National Human Genome Research Institute National Institutes Of Health

In an analysis of 30 cancer types among men, investigators uncovered substantial disparities in cancer cases and deaths by age and countries’ economic status – disparities that are projected to widen by 2050. The study is published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.

Men face higher rates of cancer and cancer-related deaths than women, likely due to various factors including lower participation in cancer prevention activities; underuse of screening and treatment options; increased exposure to cancer risk factors such as smoking, alcohol consumption, and occupational exposure to carcinogens; and biological differences.

To assess the burden of cancer in men of different ages and living in different regions of the world, investigators analyzed 2022 information from the Global Cancer Observatory, which encompasses national-level estimates for cancer cases and deaths for 185 countries/territories worldwide. The projected cancer cases and deaths in 2050 were derived through demographic projections: the researchers multiplied the 2022 age-specific rates with their corresponding population projections for 2050.

In 2022, poorer survival was observed among older men; for rare cancer types such as pancreatic cancer; and in countries with low human development index, which measures health, education, and standard of living.

Between 2022 and 2050, cancer cases are projected to increase from 10.3 million to 19 million, an 84% increase. Deaths are projected to increase from 5.4 million to 10.5 million, a 93% increase, with a greater than two-fold increase among men aged 65+ years and for countries/territories with low and medium human development index.

The research reveals an urgent need to address these trends and ensure equity in cancer prevention and care among men globally.

“A national and international collaboration, as well as a coordinated multisectoral approach, are essential to improve current cancer outcomes and to reverse the anticipated rise in cancer burden by 2050. Implementing and expanding universal health coverage and expanding health infrastructure and establishing publicly funded medical schools and scholarships for training medical and public health staff can improve cancer care and equity,” said lead author Habtamu Mellie Bizuayehu, PhD, of the University of Queensland, in Australia. “Emphasis should be placed on low and medium human development index countries with high unmet cancer service needs despite a significant cancer burden.

Dr Bizuayehu added that improving access to and use of cancer prevention, screening, diagnosis, and treatment options, especially for older men, could also improve cancer outcomes and equity.

Source: Wiley

Categories : Cancer GenderTags :

X Chromosome is Shut Down in Some Male Cancers

On By ModernMedia
Source: NIH

Researchers report in Cell Systems that they have discovered another difference between cancer cells and normal cells besides mutations: the X chromosome, typically only inactivated in XX female cells, can also be inactivated across different male-derived cancers.

“To balance the expression of genes between the sexes, in normal development, one copy of the female X chromosome is inactivated at random across the human body. We wanted to know if this process that occurs in normal development goes awry in genetically unstable male or female cancer cells,” says senior author Srinivas Viswanathan, a cancer geneticist and medical oncologist at the Dana-Farber Cancer Institute.

By using publicly available datasets comprising of thousands of DNA samples from cancer patients around the world, the team of researchers stumbled upon the high expression of XIST – the gene responsible for shutting down gene expression on the X chromosome – in about 4% of the male cancer samples analysed.

While XIST may be expressed in very early development in all sexes, X inactivation is thought to be a female-specific process later in development. It was previously shown that some female cancer cells may lose the ability to turn off one of the X chromosomes, leading to increased X-linked gene expression, but this ability of X inactivation had still only been studied primarily in female cells.

Within the 4% of anomalous male cancer samples identified, 74% were from reproductive cancers already shown to inactivate the X chromosome, but that left 26% of samples from other cancer types. These included liver, brain, skin, heart, lung, and thyroid cancers.

“We were very surprised by this result since XIST is a transcript typically used to classify female cancers, and so we wanted to ensure that this was not merely a result of mis-annotation. Yet, we do in fact see that some male cancers of diverse subtypes activate XIST and display features of X inactivation,” says Viswanathan.

“We have to be aware of the caveats of working with these types of datasets. These samples have been in many people’s hands, and there is more room for human error,” said co-corresponding author Cheng-Zhong Zhang, cancer biologist at the Dana-Farber Cancer Institute. “This is the biggest source of uncertainty for us; we have to be creative in how we look at the data and find controls.”

One possible explanation for why this phenomenon is occurring is genetic instability. Cancers often have multiple copies of chromosomes, and if two X chromosomes happen to be in one cell, then it may be necessary to inactivate one of them by activating XIST, regardless of whether that cell is in a female or male individual.

“Another possibility is there are some important genes on the X chromosome that, when silenced, enable the cancer to grow. We will investigate this in future studies,” says Viswanathan.

“In some ways, sex is the ultimate biomarker in that it subdivides the human population, but we often don’t think about how genetic differences between the sexes may inform cancer prognosis or response to therapy,” says Viswanathan.

Source: Cell Press