Breast cancer is one of the leading causes of death in women, but few people realize men are also at risk. A lack of awareness and screening programs compounds the problem for male breast cancer patients.
Miguel Rein was completely unaware men could get breast cancer before being diagnosed in 2012. The 53-year-old Paraguayan import-export worker had no family history of the disease.
"I had a strong urge to scratch myself on the chest. At first I thought it was just a sting or an insect bite. But then the itch turned into something hard," Rein says as he remembers the symptoms that appeared two years ago.
Each year 600 men are diagnosed with breast cancer in Germany, compared with 74,500 women. That's a very small number of men, says Professor Sabine Kliesch, a urologist and spokesperson for the German Society of Urology (DGU).
But, she points out, education has the potential to save lives. Unaware they can be affected by breast cancer, men tend to wait longer before seeking medical treatment.
One in five
The World Health Organization (WHO) predicted in its World Cancer Report 2014 that, at the current rate, by 2030 one in five men globally will develop cancer before the age of 75, and one in eight men will die from the disease.
A man's likelihood of becoming a breast cancer patient increases with age, but younger males can also be affected. Germany, along with most Western nations, has no screening program in place, like the mammogram services offered to women, to detect breast cancer in men while it is still in the early stages.
"Governments must show political commitment to progressively step up the implementation of high-quality screening and early detection programs, which are an investment rather than a cost," says Bernard Stewart, co-editor of the WHO report.
While researchers are unsure why men suffer from breast cancer, Kliesch says there are a number of known risk factors for men, including a family history of breast cancer among female relatives.
Those who have the little-known Klinefelter Syndrome are also at an increased risk of contracting breast cancer. A genetic disease in which a man has one or more additional X chromosomes, men who suffer from Klinefelter Syndrome have a 15 to 50 percent higher chance of getting breast cancer.
The notion that breast cancer only affects women often leads to men going untreated for longer. Television advertisements, online and magazine campaigns all target women, reminding them to check themselves for early signs of breast cancer. And that's exactly what men need to start doing, says Kliesch, "just like they check their testes for signs of testicular cancer."
She says men need to take two minutes in the shower to have a feel and check for early warning signs. "If men realize [their breast] has changed size, has a hard nodule, or if there are secretions coming from the mammilla [nipple], then they should go straight to the doctor to get it checked," Kliesch emphasizes.
While Rein is now in remission, and "doing fine," he does have one message for men. and their wives: "Men should go straight to the doctor if they have any doubts. Wives are often the first to notice there is something different about their husband's breasts or nipples."
Having symptoms, Kliesch adds, is not necessarily indicative of having breast cancer, but it is a reason to get checked out by a general practitioner.
Just like in women, early detection gives men the best chance of treating the cancer effectively, she says.
Men and women are treated in a similar manner. Gynecologists also treat male breast cancer patients "because they have the most experience with breast cancer treatment," Kliesch says. Removal of cancerous tissue, or breast removal operations, are also commonplace for male patients.
When detected in the early stages, the prognosis for breast cancer in men is similar to that in women of the same age whose cancer is at the same stage. Currently, around 84 percent of men with breast cancer will live five years beyond their diagnosis.
A crew testing how a small group of humans might cope with a trip to Mars has started their 12-month mission. They will have to eat, communicate, and live exactly as they would on Mars - in a tiny dome in Hawaii.
Lemon juice could help patients with Norovirus infections fight off the painful and unpleasant disease, researchers from Heidelberg found. It could also be a good disinfectant during a Norovirus epidemic.
Photographer James Whitlow Delano runs Everyday Climate Change, a successful Instagram feed. It's the best way to reach people, he says. Today, the feed features the work of photographers from all over the world.
Trash is a big problem at the moment for Lebanon - and for governments all over the world. It can lead to major environmental problems. But there are solutions - if the authorities are ready to take them on.