It
makes perfect sense that there are some health conditions that favor one sex
over another. How could it not? Men and women have different genes, anatomy and
predominating hormones. These variances not only influence what symptoms we
experience and how we react to treatments, but also our susceptibility to
disease in the first place. There are some conditions so closely aligned with
women that both doctors and patients overlook them as possible diagnoses in
men. But there are 2 noteworthy diseases (Breast cancer & Systemic Lupus
Erythematosus)
increasingly crossing gender lines to strike men.
Breast
cancer occurs in women because they have breast tissue. But men have breast
tissue too, just much less of it. While less than 1% of breast cancers occur in
men, the incidence is on the rise. So the same advice doctors give women -
investigate any changes that occur in breast tissue - should also be extended
to men.
We
know that high estrogen and low testosterone levels play a major role in male
breast cancer because men who have abnormalities involving the testicles and
problems with fertility are at higher risk for the disease. And like some
breast cancers in women, estrogen seems to be a major player. Breast tumors in
women can be estrogen-receptor positive, meaning they have receptors on the
surface of the cells that have a particular fondness for estrogen. When
estrogen locks into these receptors, they can fuel the growth of certain types
of breast cancers. The same mechanism is also at work in men, whose tumors tend
to be mostly estrogen-receptor positive.
Another
mechanism for breast cancer in men is buried inside of genes. It turns out that
men are not exempt from inheriting (or passing down to their children) breast
cancer susceptibility genes such as BRCA1 and BRCA2, a factor in many breast
cancers that run in families.
What
Raises the Risk in Men?
- Klinefelter's Syndrome - A
genetic disease where men have an extra X (female) chromosome causes
higher estrogen and lower testosterone levels.
- Liver Cirrhosis- Since the
liver is involved with the metabolism of sex hormones, damage (via
infection or alcohol use) increases estrogen levels.
- Overweight - Fat cells convert
male sex hormones into estrogen so being overweight and inactive can increase
estrogen.
- Genetic - Men who have female
family members who have the breast cancer gene, particularly if they test
postive for BRCA or other breast cancer susceptibility genes, are at much
higher risk.
- Radiation exposure -Radiation
treatments received for other conditions can produce changes to breast
cells if the rays are required to go through the chest.
What
Should Men Do?
If
there is a family history of breast cancer it is particularly important to be
vigilant. So genetic testing susceptibility genes makes sense. But there are
some simple things that all men can do.
Men
can perform monthly breast self-exams to check for any lumps or changes breast
tissue. This is done more easily in the shower where you can harness the slippery
soapy surface to traverse the breast area. Use a lawn-mowing pattern to make
sure all surfaces, including the underarms, are examined.
Here's
what men should look for.
- Lumps, bumps or swelling in the
breast or underarms
- Nipple retraction, puckering or
indentation
- Bleeding or discharge from the
nipple
- Redness, scaling or itching of
the skin
Like
women, there are some benign, non-cancerous conditions that can be taken for
male breast cancer, such as gynecomastia, a condition that causes breast
enlargement.
The
diagnostic tools and treatments available to women are also available to men.
Breast cancer in men is diagnosed using mammography, ultrasound and biopsy.
Treatments include surgery, radiation therapy and chemotherapy.
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