Breast Cancer in men

Chemotherapy

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. The aim of chemotherapy is to do the maximum damage to cancer cells while causing the minimum damage to healthy tissue. Men with breast cancer may have chemotherapy before surgery to shrink the cancer. This is known as neo-adjuvant chemotherapy after surgery if doctors think there is a risk of the cancer coming back. This is known as adjuvant chemotherapy.

Chemotherapy drugs are usually given as an outpatient, either by injection into a vein (intravenously) or as tablets. A course of chemotherapy is likely to take 4–6 months. Here men talk about their experiences of chemotherapy and its side effects. A number of men said they felt very nervous before their first session of chemotherapy because they did not know how they would react to it. Some men remember being warned by hospital staff about possible side effects and how best to prepare for them. Bill, for example, was warned that he might lose his hair, he might have a sore mouth and eyes, and he would find it tiring. He experienced most of these symptoms. Many men were apprehensive before they started their chemotherapy.
Stuart had been able to have his chemotherapy in his own home because of the type of private health care cover he had. He said this had taken a weight off his shoulders as well because he was “dreading” going into hospital.
 
For most men with breast cancer, there are fewer choices to make about treatment after their surgery than there are for women with breast cancer (see Making choices about treatment). However, some still felt involved in the decisions that were made and one man did choose not to have chemotherapy. The doctor estimated that it would only give him an extra two percent chance of survival and he did not feel it was worth going through the possible side effects for that. Dan did not want to have chemotherapy at first, until it was explained to him that he could not have Herceptin if he did not have chemotherapy.
Most of the men who did not need to have chemotherapy were very relieved not to have to have it.
 
At the start of each treatment men had a blood test to check that their blood counts were high enough for the treatment to begin. Treatment could be delayed if their white blood cell count was too low. Some men had their treatment in rooms with cubicles, others were in communal rooms. RG said he felt exposed in an all female environment and he would have preferred a separate cubicle while having his chemotherapy. Tom found it helpful to listen to music while having his treatment as he couldn’t concentrate to read. Stuart appreciated being able to have his treatment in the ‘comfort of his own home’. This saved him a lot of waiting around in the hospital and travelling that other men found tiring.
A few talked about being given steroids alongside chemotherapy. Some described what it was like when the chemotherapy was being given to them and talked about the immediate side effects.
 
A few men had quite minor side effects from the chemotherapy and were able to keep working throughout their treatment. Most men, however, had more significant side effects and many men found having chemotherapy a difficult experience.
 
Common side effects include tiredness, weakness, nausea, vomiting, diarrhoea, hair loss, weight change, and altered taste. A couple of men had severe constipation. Some men also experienced bone and joint pain, loss of fingernails and toenails, mouth sores and numbness in fingers and toes.One man described being in ‘huge discomfort’ when the skin came off the bottom of his feet after chemotherapy. Often, men experienced worse symptoms as their treatment progressed but they also tended to follow a pattern so men were able to expect the side effects and try to manage them.

Often, men experienced worse symptoms as their treatment progressed but they also tended to follow a pattern so men were able to expect the side effects and try to manage them.
Occasionally people experience unusual symptoms as they are receiving their chemotherapy. Interview 32 describes one occasion when this happened to him.
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People reacted differently to the loss of facial, head or body hair. Mike C said it didn’t make much difference to him and he kept it short in the summer anyway so he wasn’t sure that anyone even noticed. RG was surprised that he did feel bothered when he lost his hair.
A couple of men had been reluctant to get their last treatment because of how severe the side effects had become. Bill felt his initial tiredness ‘was being built upon each time’ and he found chemotherapy ‘just so horrible’ that his wife really had to persuade him to go to the last treatment.
A few men caught infections because their immune system was affected while they were undergoing their chemotherapy treatment.
Many men were given medication and treatments to help prevent the chemotherapy side effects. A couple of men said they were given a bag of medication to take home after their first treatment. Bill felt very nauseous until he asked for a different anti-sickness pill (Ondasetron) on the advice of a relative who was a health professional. Some found that these treatments alleviated the side effects of chemotherapy, especially the anti-sickness medication. A few men, however, felt they also suffered side effects from the medication they were given to prevent the chemotherapy side effects.
Although most men recovered from chemotherapy after their course of treatment had finished, some men experienced longer term side effects. A few said that their hair was thinner or a different texture after chemotherapy and one man’s hair never grew back. A few said their toenails remained ridged and discoloured and a small number of men said they still experienced pain or numbness in their hands and feet. A couple of men wondered whether the experience of chemotherapy had altered their character. John thought it gave him ‘a terrible short memory lapse’ and another man thought he had become more anxious. Men recognised it was difficult to separate out the effects of this treatment from everything else that had happened.
Men’s families often really helped them to get through their chemotherapy (see also Support from family, friends and colleagues), although a few men talked about how it was also extremely difficult for their partners and family to see them go through the chemotherapy and its side effects.
 
Most men felt extremely relieved after their last session of chemotherapy, but one man described a feeling of ‘absolute abandonment’ after his last treatment.
Some of the men also described how they were often the only man in a room full of women when they were having their chemotherapy (see Experiences as a man in different breast cancer treatment settings’).

Several of the other cancer sites on Healthtalkonline, including the site on ‘Breast Cancer in women’, also describe people’s experiences of having chemotherapy.

Last reviewed October 2013.
Last updated October 2013.

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