Mike Welsh has stood by his wife for 43 years, in sickness and in health. But unlike most sympathetic husbands of women battling breast cancer, he can truly relate.
Nine months after Barbara Welsh, 63, of Munro, Ohio, had a lump removed in her breast, her husband found one in his own.
"They sent him out for a mammogram, if you can imagine, and they looked at him like he's crazy," Barbara Welsh said.
Mike Welsh, 62, found his lump after buckling a seatbelt and feeling a pain in his right breast. After a visit to the family doctor he mentioned the pain and asked "can men get breast cancer too?"
They can, and he did. The American Cancer Society estimates that 1,910 men will be diagnosed with breast cancer and 440 men will die from the disease in 2009.
Mike Welsh was diagnosed with an advanced stage of breast cancer and shortly afterwards underwent a radical mastectomy on the right side. He will soon receive more treatment at the Atrium Medical Center in Middletown, Ohio.
His wife caught her lump at an early stage of cancer and so only needed a lumpectomy -- also on her right side.
"He said, this sharing has got to stop," she laughed. "It may not be nice, but we're having fun with it."
"For a mammogram, boy, I know what you girls go through now," he said.
But despite Mike Welsh's sympathy, the Welshes said they have been greeted with a less-than-supportive reaction from their community.
Barbara Welsh has been criticized in public for taking off her head scarves and showing her bald head from her current doses of chemotherapy. Mike Welsh's news has been met with disbelief.
"When he tells them he has it, they think he's lying," she said. "Mike feels embarrassed but I said, 'Mike, if you can save one man, then let people know.'"
When men do get breast cancer, it is more likely to involve the two known genetic mutations that put people at risk for breast cancer: BRCA1 and BRCA2. Both genes cause breast cancer in men, but BRCA2 is especially risky.
Dr. Jay Brooks, chief of hematology and oncology at Ochsner Health System in Baton Rouge, La., said there may be other genes associated breast cancer yet to be discovered.
But, "what we clearly know is that probably up to 50 percent of men who are diagnosed have one of the BRCA genes, where as in women who are diagnosed only have a 5-7 percent chance of having one of the genes," said Brooks.
Doctors say men's tendency to have a genetic link to cancer could actually save them and their children from delayed diagnosis.
"The BRCA gene doesn't skip a generation just because it's passed through the man," said Dr. Julia A. Smith, the director of the Lynne Cohen breast cancer preventive care program at New York University.
Both a mother and a father can pass down a BRCA gene, and daughters and sons have a 50 percent chance of inheriting the gene from an affected parent.
"It's extremely important for men who have any history of breast cancer in their family, or if they have breast cancer themselves, to get evaluated," said Smith.
Men who confirm they have the BRCA genes can not only alert their daughters of their increased risk, they may also catch signs of breast cancer earlier in themselves.
Dr. Swati Kulkarni, assistant professor of surgery at the Roswell Park Cancer Institute in Buffalo, said men often come into her clinic with much more advanced cases of breast cancer than women.
"The biggest issue for men is they're diagnosed later because they're not screened," said Kulkarni, who added that men with breast cancer are much more likely to get a mastectomy because they have less tissue to remove.
However, there are more similarities between men and women with breast cancer once the cancer is diagnosed. Doctors say the course of treatment for each type of cancer is typically the same, and once a man is diagnosed with a BRCA gene they typically need to be screened with mammograms and exams as frequently as women, according to Smith.
"If men get a mutated gene, then they really need to be aware of it because they have an increased risk of early prostate cancer," added Smith.
Although Mike Welsh had family members with breast cancer, the thought never crossed his mind that he might be at risk until his wife was diagnosed.
"You see the advertisements about women; men are never mentioned," he said.
Brooks, who typically treats two men with breast cancer a year, agreed about the lack of information.
"I think men are very ignorant of the fact that they could get male breast cancer. There's all sorts of stigma. ... There's all sorts of taboos," he said.
As for the Welshes, they decided to raise awareness in their own community and beyond.
"I'm not going to hide it under a bush. I have sweatshirts that say I'm a breast cancer survivor," said Barbara Welsh. "I told my husband, 'You need to get a shirt, too.'"
"If we don't deal with this with humor and upbeat, the depression will kill you," he said.
To learn more about male breast cancer, visit the American Cancer Society
The Hamilton Journal News first broke the story.