When Richard Roundtree was diagnosed with cancer in 1993, he was bowled over.
"The doctor told me, 'You have breast cancer,'" recalls Roundtree, who played John Shaft in the iconic 1971 film "Shaft." I heard the cancer part first -- it was only later that I heard the breast part. I couldn't believe it."
Roundtree found the lump while filming a movie in Costa Rica.
"It just didn't feel right," he says. "I'm a bit of a hypochondriac, so I decided to get it checked out when I was back in L.A."
For years after his diagnosis and treatment for breast cancer, Roundtree kept quiet about his status as a cancer survivor.
"I was in the closet, so to speak, until after the fifth year when I was cancer free," he says.
While at a celebrity golf tournament to raise money for a mobile breast cancer diagnostic unit, Roundtree decided to spill the beans. "I just got up and told everybody that I was a breast cancer survivor. The room was totally silent," he says, laughing. "I think it dawned on people that men can be affected by this, too."
Male breast cancer comprises only 1 percent of all breast cancer cases -- not a surprising figure, since men's bodies contain only about 1 percent of the breast tissue found in women.
In 2007, there will be about 2,000 men diagnosed with breast cancer, compared with 178,000 women identified with the disease. Breast cancer in men most commonly appears as a lump, like the one Roundtree found in his left breast.
Talking about his status as a cancer survivor has prepared Roundtree, now 65, for a new role: awareness advocate for male breast cancer. He now spends part of his time traveling around the country and speaking to different groups about his experience.
"Not talking about my cancer was really tough," he says. "And now that I do talk about it all the time, it's really become a backhanded blessing. I was getting on a plane recently and a flight attendant ran up to me and said 'You saved my husband's life.'" Her husband had a lump in his chest and only agreed to get it checked out after she showed him an article about Roundtree.
"Her husband had caught it early, which probably did save his life," says Roundtree.
For many men, talking about breast cancer can be as difficult as it is important. A study presented last week at the San Antonio Breast Cancer Symposium showed that men whose female relatives test positive for cancer-causing gene mutations are at higher risk for cancer, but often don't know it.
The researchers interviewed 24 men, each with a female relative who had cancer-causing BRCA1 or BRCA2 gene mutations. The women all reported telling their male relatives the results of the genetic test, but only 18 of the men remember receiving the results.
"We're not entirely sure where the communication is breaking down," said study author Dr. Mary Daly, senior vice president for population science at the Fox Chase Cancer Center.
"Perhaps some of the women who were sharing their test results were reluctant to tell the significance, or the men weren't paying attention. But the message wasn't getting through," says Daly.
Family history is important to share, she continues, because people with a higher genetic risk for developing breast and other cancers should be more vigilant about breast self exams and getting regular mammograms. The BRCA1 and BRCA2 gene mutations put family members at a higher risk of breast cancer in men and women, in addition to pancreatic and prostate cancer.
"I think it's also up to the primary care physician to do a better job," says Daly. "They need to be more aware of family history in male patients, which will also encourage that conversation between men and their families."
As for Roundtree, he has overcome his reticence.
"I don't know if it's a racial thing or not, but it's hard for the Roundtrees to talk about health issues. People have to get over all that stuff," he says.
"Think about your kids," he advises. "Sit down with your family and talk about history, about all this stuff because it can save your life. You got to be vigilant."