Q. I need information or possibly first hand knowledge of how Tamoxifen affects men. I am a male with breast cancer undergoing this treatment and I'm not sure how I'm supposed to feel but it doesn't feel normal. Can you help?

A.

This is an important question and one that is not asked often, because of the rarity of male breast cancer. In fact, male breast cancer accounts for only 1% of all breast cancers. Men have a lifetime risk of about one-tenth of 1%, or one in 1,000, of developing breast cancer, according to the American Cancer Society. Most male breast cancers occur between the ages of 60 and 70, although a diagnosis can occur at any age.

All men have a small amount of breast tissue, which is located directly behind the nipples and produce a small amount of the female hormone, estrogen. Research has established that higher than normal levels of estrogen can result in gynecomastia, a condition in which the male breast is abnormally enlarged, or male breast cancer. Other risk factors that may lead to male breast cancer are: a family history of breast cancer, either male or female; overexposure to radiation of the chest area; cirrhosis of the liver; and obesity.

Male breast cancer can manifest as a firm, non-painful mass located just below the nipple or may cause skin changes on or around the tissue of the nipple such dimpling, redness, scaling, discharge or retraction. As with women with breast cancer, treatment depends on many factors, including the stage at diagnosis and the overall health of the patient.

Most male breast cancers are hormone-dependent, so estrogen-blocking treatments including Tamoxifen are often used. Possible side effects for men taking Tamoxifen include headaches, nausea, hot flashes, skin rash, fatigue, sexual dysfunction, and weight and mood changes. For more information about Tamoxifen and other hormonal therapies, read the National Cancer Institute’s, “Male Breast Cancer Treatment” and “Tamoxifen Questions and Answers”, and the American Cancer Society’s “Breast Cancer in Men”.

In addition to coping with treatment side effects, you may also be experiencing new feelings and emotions. From my research, most men state that having breast cancer doesn’t feel normal and this can create additional stress. I strongly suggest you talk to other men who have been diagnosed, both for support and also to learn new ways to cope with treatment side effects.

CancerCare offers publications about coping with treatment side effects, Connect Education Workshops, individual counseling, and support groups (online, telephone and face-to-face).

Finally, make sure you speak with your oncologist about any side effects or feelings you have, so that he or she can work with you to help you better manage your situation.