Photo Credit: Jackie, top left
My cousin Jackie was always the quiet one in the family. While the rest of us fed into our parents' greed for academic accomplishments, career wins, marriages and babies, Jackie seemed to coast along with little commotion. Moving to New York from China at the age of 16, squeaking through a public high school and bouncing between odd jobs after graduation, Jackie lived (enviably) under the radar until a stage 2 breast cancer diagnosis. At 31, he finally had everybody's undivided attention.
Jackie had noticed a lump in his chest in August 2009. But, since breast cancer wasn’t even in his realm of possible realities, he dismissed it as a wart (albeit a large one) and figured it would just go away on its own. A couple of weeks later, his chest started to hurt, but he just chalked that up to too many pushups. Another week passed. The pain did not subside and the “wart” failed to disappear, so he went to see his family physician.
His general practitioner thought it could be cancer and referred him to an oncologist (who, in his 20 years of practice, had apparently never seen a case of male breast cancer before). Though both suspected what it was, they were in disbelief until an ultrasound, a mammogram and finally a biopsy confirmed that it was indeed breast cancer.
Jackie’s mother was with him at the doctor’s office for the diagnosis -- she had insisted on tagging along. It was pointless, though, as Jackie had asked the nice Chinese doctor to deliver the news in English to spare his mom from hearing any bad news. It was nothing, he told her. Just a harmless little lump they can take out. No big deal. And so, for an awkward week, shocked and confused, Jackie carried around his dirty little secret while his mom carried bushels of offerings to the temple to thank the gods for sparing her son. He didn’t know how to break it to her, or anyone else, that he had breast cancer. He was afraid of all the “I told you so’s” concerning his weight -- the family has always bugged him to lose weight, for reasons concerning health (and love). He thought this breast cancer was weird, and because it was weird, nobody would understand that it wasn’t his fault. He also feared that he would be seen as less of a man and more of a freak.
Although the fear of stigma is common among men with breast cancer, it is often unfounded, says National Director of Breast Cancer for the American Cancer Society Debbie Saslow. “Once men start talking about it, they often realize the stigmas are all in their head.”
And that’s what Jackie discovered after a week of self-torture. His doctor finally convinced him that familial support was integral to beating any kind of cancer. And so, he told his mother the truth.
Before telling the rest of the family, Jackie got a second opinion. When he was sure of the enemy, his mom got on the horn, and an army of aunts swarmed in to help -- making enough gingseng soup to flood a small village and organizing family field trips to the temple to make group offerings (this time to beg the gods to spare our cousin). At the temple, family acquaintances would come over to gossip. They’d ask why we were there. We’d ask them to pray for Jackie. They’d ask what was wrong with Jackie. We’d tell them it was breast cancer and then watch a blank, does-not-compute look befall their faces. It wasn’t the horror or the disgust that Jackie had feared. They just didn’t understand how a man, his age, could have breast cancer.
While affecting 1 out of 8 women every year, breast cancer is only found in one of every thousand men. The causes (family history, radiation exposure) and symptoms (lumps, swelling, skin discoloration around the nipple) are the same for both genders, but because most of us think of it as a “women’s disease,” many men ignore these symptoms, which often means their breast cancer is found in the later stages when it’s more complicated to treat. Jackie was one of these cases -- his would need chemotherapy, surgery and radiation to beat it.
Treatment started immediately, just two weeks after Jackie’s initial diagnosis. First, eight rounds of chemotherapy were administered to reduce the size of the lump. Then there was a mastectomy, followed by radiation, Monday through Friday, for 10 weeks. After his western treatment was complete, his mom flew him to China to see Chinese herbalists recommended by the ladies at the community center where she practiced Chinese opera. Some of them were battling cancer as well, and they swore that herbal remedies were the key to ridding the body of bad juju and keeping the cancer away. Skeptical at first, Jackie is now a believer -- he drinks a combination of medicinal teas and bitter-melon smoothies (also recommended by the ladies) just as religiously as he takes his Tamoxifen every day. This will be his ritual for the duration of his five-year recovery period.
The most amazing thing is, as much as everyone was freaking out on his behalf, Jackie never complained -- not when he lost his hair, not when he was so tired he could barely keep his eyes open at family dinners. He even joked that this cancer was a godsend because he was finally losing weight.
To him, once he got over the perceived stigma, it was “just” cancer, non-differentiated from any other form of the life-threatening disease. And when you think about it, why should it be? He actually doesn’t talk about it much now -- he doesn’t go to counseling and he doesn’t know of a single male breast cancer patient with whom he can commiserate.
Right after the surgery, I told him I was always around if he needed to chat. He smiled, thanked me for my offer and then told me that beating cancer was just another item on the to-do list. Nothing to worry about. Just gotta get it done.
And he is getting it done. This October -- Breast Cancer Awareness Month -- marks two years since Jackie was diagnosed with cancer. While he is now cancer free, if will take three more years before his doctors declare him in remission. But for now we are just thankful that he will not be one of the 450 men who die from breast cancer every year. I am also forever thankful for having witnessed the grace and dignity with which he took on his illness. My unassuming cousin Jackie is perhaps the most accomplished of us all.