James McCabe was only 43 when his doctor delivered some surprising news: He had cancer, and it would hit him twice.
"I had a lump on my right side," said the telecommunications manager from Taunton, Mass. "I didn't think anything of it, but after six months, I went for my annual physical and mentioned it to my physician."
A mammogram and a biopsy revealed breast cancer, a rare disease in men and one McCabe says that they hardly think about.
Breast cancer is about 100 times less common among men than among women, according to the American Cancer Society. For men, the lifetime risk is about 1 in 1,000 and, unlike the disease in women, has remained stable over the last three decades.
About 2,240 new cases of invasive breast cancer will be diagnosed in men this year, and about 410 will die from breast cancer.
"When I first found out, I never thought men got breast cancer," said McCabe, who is now 48. "I am the only male in a women's facility -- it's kind of awkward. But over time I got used to it."
Genetic tests showed there was no family history of the disease. With six siblings, including four sisters, no one had ever been diagnosed with breast cancer, according to McCabe.
In 2008, he underwent a mastectomy followed by four courses of chemotherapy every two weeks, then 35 rounds of radiation. "The chemo was the worse -- it's pretty strong stuff," he said. "I pretty much had to wear a hazmat suit."
Then last year, the cancer came back, this time in his lymph nodes and McCabe had 16 more rounds of chemotherapy and 30 more radiation treatments.
But McCabe, an avid runner, found strength in competition. Not only did he survive his cancer, but in September, he beat his doctor in the Rock 'n' Roll Providence Half Marathon in Rhode Island. McCabe's winning time was 1:39 -- "not bad for an old guy," he quipped.
Dr. Steven Lane, his radiation oncologist, said he finished at 1:53. "It shows you can't let anything limit what you can do if you set a goal and go for it."
"I see him as an inspiration not only to other cancer patients, but to everybody," said Lane, who is chief of the oncology department at the Radiation Therapy Center at Signature Healthcare in Brockton. "He's been through this twice and maintained upbeat and keeping up on things. He is invested in long-distance running and through the course of treatment kept it up."
Lane said though breast cancer in men is rare, "most men deal with it quite well from a psychological standpoint."
McCabe's enthusiasm for running started when his brother encouraged him to do a 5K race just after his first cancer diagnosis in 2008.
"Last year I was doing 5 Ks and five miles," he said. "I try to do five miles before 5 a.m. -- three times a week. I was inspired by a few friends. I got hooked on it."
On Aug. 20, 2012, just the day before undergoing a second surgery, McCabe ran a half-marathon.
On Sunday, McCabe will run the Bay State Marathon, his first big one. Next year, McCabe hopes to run a race to raise cancer awareness sponsored by the Dana Farber Cancer Institute, where he has follow-up treatment every three months.
His advice to other men?
"Don't disregard anything that looks out of the ordinary," he said. "Mine looked like no big deal. I would never have thought I had breast cancer. Most guys, including myself, are dumbfounded they have it."
As for his prognosis, McCabe said, "I hope for the best."
His doctor is optimistic, too.
"We know that people with positive lymph nodes always have more advanced disease, but with proper treatment the chance of clearing all the cancer cells and keep them from coming back, he has a high chance of survival," said Lane. "At this point, seven months out, he is doing very well and is not having any major long-term complications."