In 2020, life was busy for Scott. At 44 years old, he was married, a dad of four young boys aged eight and under and had a high-pressure job working for a US investment bank. The last thing he expected was a breast cancer diagnosis, but when his nipple became inverted, he discovered he was one of the more than 200 men diagnosed with breast cancer in Australia every year. Juggling treatment, work and family meant life suddenly got a whole lot busier. Almost two years later, he is finding a new normal as he navigates life on Tamoxifen and the complications it causes.
Life was normal for Scott in 2020. His boys were aged eight, seven, four and three and they would regularly roughhouse, wrestle, and jump on him, but he noticed it was painful when an elbow or knee hit his left nipple. Now that it had his attention, he noticed that in late 2020 it was also inverted.
“From December 2020 through to early February 2021, I Googled on and off as my concerns grew about what it could be, it could be this or that, but I thought, Nah, it can’t be cancer,” he says.
“Fast forward to February 2021 and I just woke up one morning because of a complete stress attack during my sleep. I knew I had to go get checked out, I’d waited long enough.”
The GP felt a hardness under and around his left nipple, but the ultrasound and mammogram results were inconclusive, so he was sent for a biopsy. A few days later, the GP called to tell him it was breast cancer. A scan revealed there were in fact two lumps, 10mm and 8mm respectively.
“I was shocked when I got the diagnoses, no one on either my mum’s or dad’s side of the family has had cancer, let alone breast cancer, before…why is this happening to me!”
Scott had a mastectomy and then a lymph node clearance. Although his cancer was caught early, he didn’t have clear margins which meant he needed chemotherapy and radiation to ensure the cancer was completely eradicated from his body.
“I had two operations in nine days, one of the affected lymph nodes they couldn’t get out because it was under the collarbone, so they hit that with additional targeted radiation,” Scott says.
Scott had a month to recover before he started chemotherapy, four rounds of AC on a fortnightly basis, then another 12 weekly rounds of paclitaxel.
Then another month break before he then had five weeks (or 25 sessions) of daily radiation.
Scott says it was “kind of good” being sick throughout Covid. It meant he could work full-time from home and it was easier to make appointments with doctors and specialists.
“Treatment is a slog. It’s a marathon going through this process, you have blood tests every week (I had over 20 in total), you feel terrible and are always very fatigued,” he says.
“For me the drugs I was prescribed during Chemo were very effective in treating nausea, but there are other side effects like really bad reflux and heartburn and there is no medication to solve for the constant fatigue.
“Going through treatment is hard, but knowing it’s been caught early is a comfort. You know you are being looked after. My wife lost both her parents recently to cancer, it was caught late and was metastatic so they did chemo and radiation, but it didn’t achieve anything. I knew that I would do this and I would be OK. My wife was an absolute superstar through all of this, especially given what she had gone through with her parent, she just took control of everything for me to relieve me of as much stress from daily life as possible so I could just focus on getting through the treatment and recovering…I am forever grateful for her love, support, and strength!”
Scott worked his way through treatment, naively thinking he would be bored otherwise.
“I wouldn’t recommend it, although I did have a very supportive manager and team,” he says.
“At the time, I was thinking, ‘What am I going to do? Just sit at home and not work?’ It was almost like a coping mechanism to keep my mind off cancer. It’s amazing though, your mind takes over and says to plough through it.”
“Looking back on it now, this year (2022) was a lot tougher than last year. I had to take a month off work in April, because of the stress and anxiety caused by my medication.”
A male perspective on Tamoxifen
Scott’s cancer was hormone positive, so he is now on Tamoxifen for at least five years to suppress his estrogen levels and prevent a recurrence.
While not technically menopause, Scott experiences the same menopausal-like symptoms women do.
“It takes some adjusting. I get tired easily because the drug picks up on stress and anxiety. I have a job that creates a lot of stress, and Tamoxifen sends it through the roof. I had to go on Lexapro, an anti-anxiety drug, to counteract the effects of Tamoxifen. This drug also has its own side effects including fatigue,” he says.
“I also get hot sweats and it affects my cognitive thinking as well, which is a challenge. I also don’t have the energy and endurance I used to. I’ve been told by the doctors this should all improve over time, fingers crossed!”
Talking to children about cancer
Scott’s eldest two children were old enough to grasp Dad was sick.
“We talked to them about it and their school was very good as well. The counsellor would speak to them regularly, just to talk about stuff and to make sure they were coping,” Scott says.
“Thankfully, they’re pretty resilient and over time they’ve almost forgotten about it. They didn’t get to see much, just that I was tired and sleeping a lot.”
“We tried not to make it a big deal. I wasn’t fighting for my life, my frame of reference was it’s not necessarily a death sentence. I was going to treat it as an illness that I had to get over.”
Men and breast cancer
Scott knew men could get breast cancer, he just never thought he’d be one of them.
“I’m from Adelaide, I moved to Sydney in 2001 and I clearly remember this day – what the weather was like and where I was. I bought the paper with the weekend magazines and read an article about Nick Greiner (former NSW Premier) having breast cancer,” Scott says.
“I thought, wow that’s really interesting. It was the first time I realised men could get it. That article really stuck with me.”
When Scott broke the news to his family, friends and colleagues, most were surprised that men could get breast cancer.
“That’s the thing, a lot of men don’t think it will happen to them. The challenge with guys, and I’m guilty of this too, is that they don’t like going to the doctor and put it off,” he says.
“The cancers men think about are testicular or prostate, breast cancer is even further removed from their thinking. It’s often driven by estrogen and guys have a lot less of it than women”.
“For guys, it all comes down to checking these things out and not ignoring them”.
“I could’ve gone to the doctor earlier, maybe it would’ve been just surgery and not chemo. That’s why if you see anything, get onto it straight away. It’s better to get the bad news early rather than late because the outcome will be far worse. It’s not going to go away. It will only get worse – or stay the same if you’re lucky.”
“In a lot of cases, sometimes their partners really have to force the issue so they go for their own good.”
The Pink Test has a new meaning
While Scott enjoys watching the cricket, he never thought he’d personally benefit from the Pink Test.
“The fact of the matter is it’s pink, the psychology behind it is female and most guys see breast cancer as a women’s issue. I was definitely supportive of it, we’ve all got important women in our lives, but it was something we were doing to help out women,” he says.
“It’s now resonating with me a lot more. At work, we have complimentary breast scan and skin checks so I’m always sending emails out encouraging colleagues, especially the men, to do it.”
“They know my story, there may be a stigma for some men about having breast cancer, but I don’t have that.”
McGrath Breast Care Nurse Clare John’s role in Scott’s recovery
Clare got in touch with Scott early on and was there to provide the information he needed.
“She was very good, she knew my case and explained everything. Talking to nurses gives you more insights than doctors can, because they have more time and deal with so many patients, so their experience means they have seen and heard everything, they do a really important and fantastic job!” he says.
“She told me I could counteract the effects of Tamoxifen with Lexapro, she had seen many other patients do the same. She had a lot of experience and was always available whenever I needed to talk to her.”
Scott relied on Clare more for practical information rather than emotional support.
“I probably didn’t need as much emotional support, but I could see why women would lean on the nurses a lot. On that basis alone, they provide a very valuable service.” he says.
“Maybe it’s just a guy thing that I wanted practical support. I can understand why psychologically, for women, treatment is very traumatic, especially if they lose their breasts and hair.”