Steve and Marilyn Blethen met in 1969 in Michigan. They exchanged information, but Steve lost Marilyn’s number. Luckily, Steve had given Marilyn his address. She wrote him a letter, they reconnected and married a year later. After 47 years of marriage, Steve and Marilyn have experienced a full life together, but when they met as young college grads, the couple had no idea they would both one day face the ultimate challenge together: breast cancer.
Finding a Lump on His Chest
An avid cyclist, Steve set out on a 20-mile ride in 2008. He wore a Suunto watch and a heart monitor strap around his chest.
He’d worn the watch before, but this ride was different.
Steve noticed his pulse reading was set at zero. He refastened the strap, but again, the pulse rate read zero. He finally got the watch to work properly. When Steve returned home, he experienced a sharp pain in his left breast, and felt a lump.
“Apparently while attempting to adjust the strap, I irritated the lump on my chest,” Steve explains. He called a physician friend. After a checkup and biopsy, Steve was diagnosed with breast cancer.
“I tell my family and friends my watch most likely saved my life,” he says.
Steve had surgery at Cancer Treatment Centers of America® (CTCA) at Midwestern Regional Medical Center (Midwestern) near Chicago, Illinois in August 2008.
“I didn’t know men could get breast cancer, and I was somewhat embarrassed by it.” Steve admits. “I encourage men to do regular self-examinations and not to be too ‘macho.’ Breast cancer is not just a woman’s disease.”
A Dual Purpose
Five years after Steve’s diagnosis, Marilyn underwent a mammogram in 2013. She was advised to get a biopsy, which led to the diagnosis of early-stage breast cancer. She received the news on Valentine’s Day, three days before the Blethens were scheduled to visit CTCA® in Tulsa, Oklahoma, for Steve’s routine checkup.
“That appointment became a dual purpose one as Steve made it his mission to get me accepted as a patient as soon as possible,” Marilyn explains. Marilyn had a lumpectomy and underwent intraoperative radiation therapy (IORT) at CTCA at Southwestern Regional Medical Center (Southwestern) in Tulsa.
The diagnosis was difficult for the Blethens, but Marilyn had faith it would work out. “I felt like it was unfair for us both to have breast cancer. However, I am pragmatic enough to know it can happen to anyone. Cancer doesn’t discriminate,” she says.
Early Detection is Key
Dennis Citrin, MD, PhD, a medical oncologist at CTCA at Midwestern and the author of Knowledge is Power: What Every Woman Should Know about Breast Cancer stresses the importance of early detection.
“Early stage breast cancer is highly curable,” Dr. Citrin explains. “Nearly 90 percent of all patients have early stage breast cancer. It is important that a woman, or man, does not delay when they feel an abnormality in their breast(s).”
Marilyn agrees. “Get your mammograms in a timely manner and follow through with recommendations from your doctor,” she offers. “Do not delay!”
Check Your Genetics
Dr. Citrin says there’s no single factor identified as the sole cause of breast cancer, but there are factors that increase the risk for developing breast cancer, including gene mutations, among others.
Two types of genes — BRCA 1 and BRCA 2 — can help determine a person’s lifetime risk for developing cancer of the breast or ovary.
The National Comprehensive Cancer Network (NCCN) Guidelines recommends testing for any woman diagnosed with breast cancer at age 50 or under, triple negative breast cancer at age 60 or under or ovarian cancer. BRCA testing may also be recommended for individuals with a strong family history of breast, ovarian, pancreatic and prostate cancers. Certain populations, such as people of Ashkenazi Jewish ancestry, are at increased risk of carrying a BRCA mutation.
The Future of Breast Cancer Detection and Treatment
Dr. Citrin points to the 2016 MINDACT study, focused on genomic testing, a new frontier for cancer care that looks at a patient’s tumor to match genetic abnormalities to a drug therapy.
“We now have the ability to understand the genomic profile of a tumor,” Dr. Citrin explains. “We can identify through genomic testing women whose cancer is low-risk and, therefore, can safely avoid chemotherapy. This is huge.” He explains that treatments are more precise and specific to the person’s cancer.
Dr. Citrin recommends patients evaluate all options prior to making treatment decisions. “We are living in the era of personalized cancer care. Every patient deserves a detailed evaluation and explanation, not only of their recommended treatment plan, but also the reasons and rationale for that plan,” he says.