Not for Women Only

Oct. 23, 2000 -- John Cope was at a business meeting one Saturday in 1987 when he noticed that his left nipple was rubbing against his shirt and itching continually, "as if I had a mosquito bite."

Later that evening, he pulled off his shirt and realized that the nipple was inverted, instead of protruding slightly as normal. Probing the nipple, he felt something unusual -- "not exactly a lump, more like a hard spot." He called his doctor, got an immediate appointment, and was scheduled for a biopsy. A few days later, he had the results: "Malignant neoplasm of the male left breast." In other words, cancer.

Men with breast cancer account for less than 1% of all cases in the United States, according to the National Cancer Institute. This year, some 1,400 U.S. men will be diagnosed, and 400 will die. Like Cope, they face the problems and isolation of being, as Cope puts it, a guy with a female disease.

Cope's doctor, for instance, had never seen a case of male breast cancer before. All of the books and support groups he found were for women. And a hospital clerk once frowned in confusion when Cope's doctor ordered a CAT scan. "We have no [insurance] code for male breast cancer," she said.

In part because male breast cancer is so rare, men who get it tend to ignore the initial symptoms. A 1998 study of 217 men with breast cancer, published in Cancer, found that they waited an average of more than 10 months before calling a doctor to discuss symptoms. One result: By the time they are diagnosed, 41% of men with breast cancer learn that it has already spread to surrounding tissue, organs, or lymph nodes -- compared to 29% of women. Still, the five-year survival rate for men with breast cancer is quite high -- 81%, compared to 85% for women.

Cope, who was diagnosed with his fourth recurrence of cancer last fall, recounts his unlikely story in a new book, A Warrior's Way. The following is an excerpt:

A Warrior's Way

By John R. Cope

There are moments in life that I will never, ever forget. Good or bad, the details remain rich in memory for a lifetime, always close to the surface: the day President John F. Kennedy was assassinated, the day Martin Luther King was shot. These are milestones in our lives, benchmarks that we recall in minute detail: what we were wearing, the day or time, what the weather was like.

In 1987, I was a training and development manager for a high-technology company in Silicon Valley. I was out of state attending a training program and awaiting the results of a biopsy. The call came about 2:30 pm and I remember the doctor saying, "John, I have your biopsy report in my hand, and I am sorry to tell you that you have cancer." He also went on to say that he would like to do surgery as soon as possible, so the cancer wouldn't spread any further.