Man Turned Away for Breast Cancer Screening

Even with family history, federal funds don't pay for male breast screening.

April 8, 2010— -- Scott Cunningham has been vigilant about his health since both his parents were diagnosed with breast cancer in the 1990s.

When Cunningham, who is 45 and from Marion, N.C., developed the same symptoms as his father -- "knots" on the chest underneath the nipple -- he put off getting help for months because he had been laid off from his job at a furniture plant and was uninsured.

"My chest is swollen, just like it started with my dad," said Cunningham, who also said he feels tired and "different" than he did just a few months ago.

But as symptoms got worse, he finally called the local health clinic and was turned away -- not for financial reasons, but because he was a man.

The clinic, the Rutherford-Polk-McDowell Health District's National Breast and Cervical Cancer Early Detection Program, is funded by the Centers for Disease Control and Prevention, which only serves women, aged 40 to 60.

The early detection program provides low-income, uninsured and underserved women access to timely breast and cervical cancer screening and diagnostic services.

"I am not the type to ask for anything," he said. "I had to work up the guts to call them. Their reply was, 'We do it for women, not for men.'"

"I didn't know what to do at first," said Cunningham. "I was stunned and confused. Breast cancer used to be just a woman's cancer, but now it's well known men are susceptible."

Helen White, clinical nursing supervisor at the Rutherford-Polk-McDowell Health Department, confirmed that federal breast screening funds are limited to women, but she said everything will be done to help Cunningham find a referral for medical care.

"As with any other situation it would be based on whether he has insurance, Medicaid or is low-income [eligibility]," said White. We would refer him to a couple of options, a free clinic in the county, or Health Plus, which is a sliding scale at the hospital -- whether he was male or female."

White was able to reach Cunngingham today and offer assistance.

While breast cancer among men is 100 times less common than among women, it can be deadly.

The American Cancer Society reported nearly 2,000 cases of male breast cancer in the United States in 2009. About 440 of those men will die from the disease.

Compare that to 240,000 women who will develop the disease and the 40,000 who will die this year.

Though it is most common in older men, it can occur at any age. And, as with women, early diagnosis gives patients a better shot at a cure.

Kiss Drummer, 'Shaft' Actor Both Had Breast Cancer

Like Cunningham, men often delay seeing their doctors, and for that reason many male breast cancers are only discovered when the disease is more advanced.

According to the Mayo Clinic, symptoms include a painless lump or thickening in the breast tissue, changes in the skin or in the nipple, such as dimpling or redness, and discharge.

High-profile men who have had the disease include the late U.S. Sen. Edward Brooke of Massachusetts; Richard Rountree, star of the 1971 movie, "Shaft;" and Peter Criss, the drummer for the 1970s band Kiss.

Criss, now 64 and cancer-free, underwent a lumpectomy in 2008 when he found a lump on his left nipple.

"It can happen to you, and when it does, if you don't deal with it right away, with your 'dude' and your metal and your tattoos, you'll go in the box and we'll see you," he told Reuters earlier this year.

Criss has talked publicly about the stigma and "excruciating" pain associated with treatment designed for women's bodies.

"Whoever invented (mammogram machines) had to do it in the medieval days," he said, but the screening is worthwhile.

That was the case with both of Cunningham's parents, who were diagnosed with breast cancer only six months apart.

His father Bob, a jet-turbine mechanic retired from the U.S. Air Force, has been successfully treated with Tamoxifen. His mother Shirley found her tumor during a breast self-exam and had a double mastectomy.

Both had medical coverage through the Department of Veteran's Affairs.

Bob Cunningham, now 79, had been taken aback by his own diagnosis.

"I sure didn't realize men had breast cancer," he said. "My doctor had seen maybe one or two in his whole practice, but that year he had already had three."

"How many husbands and wives get diagnosed in the same year?" asked Scott, their son. "But they're doing OK."

Scott Cunningham, who is divorced and has an 11-year-old son, has been living with his parents since he lost his job. "I try not to let it get me down," he said.

His mother, Shirley, said the government should provide screening to men, as well as to women.

"It's very discriminating as far as I am concerned," she said. "We have four sons and another one had a physical recently and told his doctor his dad had breast cancer, and they wanted to start having mammograms. But he doesn't have insurance either."

The danger of not getting early screening is that men will get diagnosed at a later stage, when the disease is less treatable. For that reason, death rates are higher among men.

Often it is the stigma of the "female disease" that keeps them away. Both father and son are not bothered by those stereotypes.

"Some men would hang their heads, but no way, I am a man," said Scott Cunningham.

Male Breast Cancer Runs in Families

Male breast cancer has a strong genetic link, according to Dr. Deborah Axelrod, director of the breast program at New York University Clinical Cancer Center.

"The telling factor [in Scott Cunningham's case] is that his father had breast cancer, and that is the number one signal for us to be suspicious," she said. "I suspect the dad had a genetic predisposition and was carrying a [gene] mutation that increases risk for male cancer."

In men with breast cancer, one in six has the BRCA cancer mutation -- the same one that puts women at higher risk, according to Axelrod.

Mutations in the BRCA gene are not sex-linked and can run on both the maternal and paternal side, so patients need to be better informed to share family history with their doctors.

Though she advocates for more public awareness about male breast cancer, Axelrod is not critical of the CDC's female-only screening funds.

"It's designed for women, because only 1 percent of all breast cancers occur in men," she said. "They have to address what is common and It's not common for men. They could use the same equipment, but there are no screening guidelines for men."

Both patients and their doctors should be more aware of the dangers of male breast cancer.

"In this instance the man is asking for help and may not get timely care," said Axelrod. "But men also sometimes don't go on their own for timely care. We don't have big public awareness for men to watch for breast cancer, even among physicians."