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An unexpected diagnosis

What it’s like to be a man with a 'woman’s cancer'

Feb. 9, 2016 | By Dr. Sabrina Richards / Fred Hutch News Service

Male breast cancer survivor Dan Roark

Male breast cancer survivor Dan Roark of Bonney Lake, Wash., never suspected that he would be diagnosed with the same type of cancer as his mother. The disease hits about 2,600 men in the U.S. every year.

Photo by Robert Hood / Fred Hutch News Service

Join us Thursday at 11 a.m. PT for a tweetchat on male breast cancer. To participate, use the hashtag #ChatFredHutch.

Editor’s note: This is the second in a two-part series on male breast cancer. Read part one here.

Steve Del Gardo was at the pool when he noticed the stares again. This time it was a group of 12-year-old boys gawking. They weren’t the only ones who had stared that summer, and Del Gardo was getting a bit tired of the attention.

“So when one of them said, ‘Mister, what happened to your nipples?’ I leaned over and asked him, ‘Do you know that game, nipple twister?’” Del Gardo recalled. The boy nodded. “I said, ‘I played that game, and mine fell off.’ The look of horror on his face was priceless.”

The boy’s mother didn’t find Del Gardo’s tall tale particularly precious and stomped over to tell him so — but stopped short when she saw the mastectomy scars carved into both sides of his chest. It wasn’t childhood hijinks that had left him nipple-less. Del Gardo is one of a rare group: men diagnosed with breast cancer.

Cancer feels like a betrayal, a mutiny of the body. Facing an unexpected type of cancer, a cancer they didn’t even consider to be physically possible, leaves some patients feeling doubly shocked and betrayed. Men diagnosed with a disease most people associate exclusively with women can feel confused and isolated.

Del Gardo, who has made male breast cancer outreach and education his mission, estimates that about 98 percent of people who approach him are women, on behalf of men in their lives with breast cancer.

“Men are too afraid to come forward,” he said.

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How one man with breast cancer is helping researchers learn

Much of what’s known about breast cancer is based on studies of women; after Dr. Oliver Bogler was diagnosed, he decided to help change that

Feb. 8, 2016 | By Dr. Sabrina Richards / Fred Hutch News Service

Dr. Oliver Bogler

About 2,600 men, such as Dr. Oliver Bogler, are diagnosed each year with breast cancer, according to the American Cancer Society. But much of what is known about treatments, such as the chemotherapy, radiation and mastectomy he underwent, are based on trials of women, not men.

Photo courtesy of David Jay Photography

Join us Thursday at 11 a.m. PT for a tweetchat on male breast cancer. To participate, use the hashtag #ChatFredHutch.

Editor’s note: This is the first in a two-part series on male breast cancer. Read part two here.

Based on the statistics, Dr. Oliver Bogler couldn’t imagine that his suspicions were true. He’d found a lump in his chest but knew that male breast cancer is “so rare, it’s statistically quite improbable,” he said.

Bogler, a scientist who spent much of his career researching brain tumors, depends on numbers and data. So even as his suspicion of breast cancer began to gnaw, he wondered if it was all in his head.

“I prevaricated several months [after finding the lump],” he said. He’d supported his wife, Dr. Irene Newsham, when she was diagnosed with breast cancer just five years earlier but yet, “I couldn’t think of how to broach the subject with [her].”

In the U.S., “men with breast cancer make up ½ to 1 percent of breast cancer patients,” said Dr. Julie Gralow, a breast cancer researcher at Fred Hutchinson Cancer Research Center and the University of Washington who also treats breast cancer patients at Seattle Cancer Care Alliance. “But even so, several thousand men each year are affected.”

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Screening tool aims to better identify distressed patients

Caring for patients doesn’t just mean physically; a new tool helps doctors find, and support, those struggling with depression and other forms of psychosocial distress

Feb. 5, 2016 | By Susan Keown / Fred Hutch News Service

Moreen Dudley and Petr Horak in their SCCA office

Seattle Cancer Care Alliance's Moreen Dudley, a clinical operations director, and Petr Horak, a program administrator for the Palliative Care Service, collaborated with oncologist Dr. Elizabeth Loggers to implement psychosocial distress screening for patients.

Photo by Robert Hood / Fred Hutch News Service

Editor’s note: This is the second in a two-part series on cancer and depression. Read part one here.

In a typical half-hour appointment with one of her sarcoma patients, Dr. Elizabeth Loggers has enough time to talk through a patient’s course of treatment and make sure she answers all their questions — and not much else.

But these matters are just one portion of the host of concerns that cancer unleashes on patients and their families: from depression and anxiety to loss of physical function from lymphedema to fears for their children.

It’s easy for doctors to run out of time, or just not ask the right questions to uncover these concerns, Loggers said. And this means that patients too often don’t receive — or even know about — supportive services that can help, such as psychological counseling, physical therapy or nutrition assistance.

To ensure that patients and their families are connected with supportive services that can improve their overall wellbeing, Seattle Cancer Care Alliance — Fred Hutchinson Cancer Research Center’s patient-care arm — is implementing systematic screening for psychological and social concerns, with referrals to supportive services, for all new patients.

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Good News at Fred Hutch

Celebrating faculty and staff achievements

Feb. 4, 2016 | By Fred Hutch News Service staff

Dr. Marco Mielcarek

Dr. Marco Mielcarek

Photo by Robert Hood / Fred Hutch News Service

New study led by Dr. Marco Mielcarek may change the practice of blood stem-cell transplantation

New findings from a study led by Dr. Marco Mielcarek and colleagues in the Clinical Research Division at Fred Hutchinson Cancer Research Center offer new hope for reducing the risk of graft-vs.-host disease, or GVHD, in patients who receive transplants of matched related and unrelated donor blood stem cells for leukemia and other high-risk blood cancers.

GVHD occurs when newly transplanted donor cells attack the organs of the transplant recipient, regarding them as foreign. It affects up to 80 percent of patients who receive donor stem cell transplants. Symptoms, including skin rashes, nausea, diarrhea, weight loss and liver problems, among others, may develop within a few months after transplant (known as acute GVHD) or much later, and symptoms sometimes last up to a lifetime (known as chronic GVHD), which can significantly reduce quality of life.

The study found that treating patients with an immune-suppressing drug called cyclophosphamide three and four days after transplantation, followed by another immunosuppressive drug called cyclosporine on day five, reduced the relative risk of chronic GVHD by more than half: from the expected 35 percent to 16 percent.

The researchers also found that this post-transplant treatment reduced the risk of severe acute GVHD from the expected 10 to 15 percent to zero. 

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Depression: cancer’s invisible side effect

Three in four depressed cancer patients don’t get enough help; survivors tell what it’s like to slip ‘down the rabbit hole’ — and how to climb back out

Feb. 4, 2016 | By Mary Engel / Fred Hutch News Service

Cancer patient Ruth Kaminski meets with Dr. Jesse Fann for a counseling session at the SCCA in Seattle.

Cancer patient Ruth Kaminski meets with Dr. Jesse Fann for a counseling session at Seattle Cancer Care Alliance.

Photo by Robert Hood / Fred Hutch News Service

Editor's note: This is the first of a two-part series on cancer and depression. Part two will focus on a new screening tool to help identify patients at risk.

When Ruth Kaminski learned that the “spot of concern” on her mammogram was breast cancer, first she had a good cry. Then she tried to reassure herself, her stricken husband and her three grown children that the cancer was caught early. Her mantra became, “It’s no big deal.”

In January 2015, she had a lumpectomy. A month later, she started the first of what would be seven weeks of Monday-through-Friday radiation treatments.

On the outside, Kaminski, then 60, was her laughing, clowning self, “always sweet and smiling and up to shenanigans, trying to cheer up my radiation buddies,” she said. As long as she focused on others, she could pretend that everything was OK.

But everything was not OK. She took to crying in the shower.

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Zika virus: 6 key things we don’t yet know

From lack of data to inconclusive blood tests to the unique challenges of pregnancy, experts weigh in on the knowledge gaps in this emerging infection

Feb. 2, 2016 | By Rachel Tompa / Fred Hutch News Service

Mosquito spraying in Peru

A health worker fumigates against the Aedes aegypti mosquito, a vector of the Zika virus, inside a house in Lima, Peru, Friday, Jan. 29, 2016. The Zika virus causes only a mild illness in most people, but may cause the devastating birth defect known as microcephaly if pregnant women are infected.

Photo by Martin Mejia / AP

In the wake of the World Health Organization’s announcement Monday that Zika virus constitutes a public health emergency, research groups and public agencies are mobilizing to tackle the emerging infection and its suspected links to a devastating form of a birth defect known as microcephaly.

WHO officials emphasized the lack of a working vaccine, the absence of a reliable blood test for the virus and the dearth of natural immunity in the Western Hemisphere. Their recommended first steps are to control the disease’s vector, the mosquito known as Aedes aegypti, and for at-risk women to take precautions to avoid mosquito bites.

The sudden appearance of the virus in the Americas — and the seemingly new tie to the birth defect where infants’ brains don’t fully develop during pregnancy — underscore the huge gaps in our knowledge about the disease, said Fred Hutchinson Cancer Research Center virologist Dr. Trevor Bedford.

Any infection carries its own set of mysteries. But the Zika outbreak is frustratingly puzzling, even for a relatively new disease, Bedford said.

“At the moment it seems like there are a huge number of questions, more so than I’m even used to in these situations, [that is], emerging viral diseases,” he said.

To that end, we asked Bedford and other infectious disease experts at the Hutch to point out what we still don’t know about Zika — and how research groups may start to plug those holes in the effort to halt the virus’ spread.

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