Archives for 2021

Male Breast Cancer

Male Breast Cancer

Men absolutely get breast cancer. It happens here in Green Bay.

I’ve treated it. So it’s absolutely a thing.

But men get breast cancer about 100 times LESS often than women do, for a very simple reason:

Most breast cancers develop from abnormal cells in the ductwork of the breast. But men have less breast ductwork to begin with – so they get breast cancer less often. It’s kinda the same reason you see fewer cheesehead hats in Florida…there are fewer Packer fans in Florida to wear them.

Since cancer screening only works in a high-risk population, and the risk for breast cancer in most men is so low–screening for breast cancer with breast exams and mammograms and such isn’t usually recommended (or even a good idea) for most men.

The exception is men who carry mutations that increase the risk of cancer, such as the BRCA mutation (specifically, the BRCA2 mutation). There are other mutations that also increase breast cancer risk, but that’s the most relevant one for men. The association between BRCA mutations and male breast cancer is so strong that having a male relative with breast cancer is usually a good enough reason to consider getting tested for the mutation.

Having said all that, once a man gets breast cancer–the treatment for it is remarkably similar to the treatment for women. This is because these cancers, whether they appear in a man or a woman, are driven by similar biological mechanisms, tend to spread in similar ways, and tend to respond to the same kinds of drugs.

One caveat to that general rule of treatments being more alike than different for men and women is that most men need mastectomy (removal of the whole breast) rather than lumpectomy (removing only the affected part of the breast) – but this is simply due to the fact that men generally have less breast tissue to work with than women do.

Estrogen blockers (like tamoxifen and aromatase inhibitors like arimidex and letrozole) work in most male breast cancers as well as they do for most female breast cancers. That surprises people because we tend to think of estrogen as the female hormone and testosterone as the male hormone, and tend to forget that both men and women have lots of both. It’s just the relative mix of the two hormones that’s different between the sexes–and that mix changes as we age.

COVID-19 and Cancer

COVID-19 and Cancer

Does Cancer put me at higher risk for COVID-19?

If you have cancer currently, your body is probably more susceptible to COVID-19 infection and more likely to become seriously ill from COVID-19 if you get it. This appears to be true whether you’re currently receiving cancer treatment or not. Having a previous history of cancer that’s either in remission or cured doesn’t appear to carry the same risk.

How is COVID-19 transmitted?

If you have cancer currently, your body is probably more susceptible to COVID-19 infection and more likely to become seriously ill from COVID-19 if you get it. This appears to be true whether you’re currently receiving cancer treatment or not. Having a previous history of cancer that’s either in remission or cured doesn’t appear to carry the same risk.v

Are masks helpful?

Masks reduce (but do not completely eliminate) the number of droplets expelled by people when they breathe or speak. They also appear to reduce (but not completely eliminate) the number of droplets you inhale from others. The type of mask, how tightly it fits, and its condition affects how well (or poorly) it does all these things. Single-layer cloth masks provide the least protection, and professionally-fitted N95 masks provide the most protection.

Should I be wearing a mask?

If you live in an area with a high rate of active COVID infection, wearing a mask while indoors with other people is recommended whether you’re vaccinated or not. But if you’re vaccinated and the area you live in has a low rate of active COVID infections, then wearing a mask while indoors with others probably isn’t necessary.

Should I take the vaccine?


Should I still get the vaccine even if I’ve had COVID-19 before?


Is the vaccine dangerous?

There appear to be very few short-term risks. Though longer-term risks won’t be clear for some time, nothing in how the vaccine is made (or what it’s made from) is thought to pose significant long-term dangers to humans.

Should I prefer one vaccine manufacturer over another?

At present, all the provisionally-approved vaccines are reasonably effective and reasonably safe against COVID-19. There are some slight differences among them in the exact degree of protection and also in the potential side effect profile, but the differences seem very small. It’s unclear at this time if there are differences in the long-term protection provided by the different vaccines.

Can the vaccine make me sick?

Most people experience a few days of inflammatory symptoms (e.g. fatigue, fever, soreness) after any vaccine of any kind, and the COVID-19 vaccine is no exception. Though serious illness and death from the COVID-19 vaccine do occur (as they do with all vaccines), these severe bad effects are extremely rare.

Can I still get COVID-19 if I get the vaccine?

Yes, but the risk you’ll get it (or get seriously ill from it) will be much lower if you’re vaccinated.

Will the vaccine still work if I have cancer or am getting chemotherapy or radiation therapy?

If you’re on any medications that suppress your immune system (such as steroids, immune suppressants, and many cancer chemotherapies) then the vaccine may be less effective–but it still appears to offer significant protection, as post-vaccination infection rates in at-risk individuals are low, and vaccinated individuals who do get COVID anyway seem to have a much lower rate of severe illness resulting from the infection.

Should I be concerned about the Delta (and other) variants?

Every living thing is constantly growing and adapting and viruses are no exception. We have to remember that new variants (or entirely new viruses) might rewrite the rules at any time–just like COVID-19 did in 2020. So yes, new variants are a concern and could change the rules for what’s safe (and what isn’t). It isn’t yet clear how effective the current vaccines are against the DELTA variant, or whether previous COVID infection offers any protection from it.

Why do the recommendations keep changing? Why can’t the experts get it right?

There was a time in history when “the facts” were that the earth was the center of the galaxy. But as we learned more, we had to admit our initial impression was wrong and that the earth in fact orbits the sun. An honest expert who weighs new data as it comes in will very often have to admit that things aren’t as we initially thought. With COVID-19 for instance, airborne transmission wasn’t initially thought to be important so masks weren’t recommended – but a lot of unhelpful things like scrubbing public surfaces regularly were. We’ve learned more since then, and have had to change our thinking. Having to change our minds is often a sign that science is doing its job well, and providing new knowledge at a fast rate.

Should I be afraid?

Though we think it’s unwise to live without sensible precautions and without regard for a global pandemic that’s taken millions of lives, we also think it’s unwise to live paralyzed by fear. Humans should never expect permanent health or freedom from all illness, but we shouldn’t lose sight of how fortunate we are. Our world has significant hazards, but our society suffers less from premature illness and death than any humans in history ever have. Many of our most common ailments are the result of excess, rather than deprivation.