Cancer men
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Understanding Cancer in Men: Breast and Prostate Cancer
Male Breast Cancer: Epidemiology and Risk Factors
Incidence and Demographics
Male breast cancer is a rare condition, accounting for less than 1% of all breast cancer cases and less than 1% of all cancers in men . Approximately 1,500 new cases are diagnosed annually in the United States, with around 400 deaths . The median age at diagnosis is 68 years, slightly older than the median age for women.
Risk Factors
Several risk factors have been identified for male breast cancer. These include genetic predispositions such as BRCA2 mutations, which significantly increase the risk, while BRCA1 mutations are less commonly associated . Other risk factors include a family history of breast cancer, Klinefelter syndrome, testicular dysfunction, and conditions that alter the estrogen/androgen ratio, such as obesity and liver disease . Additionally, Jewish ancestry and radiation exposure have been linked to higher risks .
Clinical Presentation and Diagnosis
Men with breast cancer often present with a painless subareolar mass, but due to a lack of awareness, many are diagnosed at an advanced stage . Diagnosis typically involves clinical assessment, mammography, ultrasound, and biopsy.
Treatment and Prognosis
Treatment for male breast cancer generally follows protocols established for female breast cancer due to the lack of specific research in men. This includes surgery (mastectomy), radiation, and hormone therapy, particularly for hormone receptor-positive tumors, which are more common in men . The prognosis largely depends on the stage at diagnosis and lymph node involvement.
Prostate Cancer: Epidemiology and Management
Incidence and Demographics
Prostate cancer is the most prevalent cancer in men, particularly affecting those aged 70 and older . The median age at diagnosis is 68 years, and it is a leading cause of cancer-related deaths among men .
Risk Factors and Genetic Alterations
Key genetic alterations in prostate cancer include fusions of TMPRSS2 with ETS family genes, amplification of the MYC oncogene, and mutations in PTEN and TP53. The disease is often diagnosed through prostate-specific antigen (PSA) testing and digital rectal examination, followed by a biopsy.
Treatment Options
Treatment for localized prostate cancer includes active surveillance, radical prostatectomy, and ablative radiotherapy. For advanced stages, androgen deprivation therapy (ADT) combined with chemotherapy or novel androgen signaling-targeted agents is common. Despite treatment, advanced prostate cancer can progress to a castration-resistant state, which is incurable but manageable with various therapies, including AR-targeted agents and chemotherapy.
Management in Older Men
The management of prostate cancer in older men should be tailored to individual health status rather than chronological age. Recommendations include standard treatments for 'healthy' patients, adapted treatments for 'frail' patients, and palliative care for those with terminal illness.
Conclusion
Both breast and prostate cancers in men present unique challenges due to their rarity and the lack of specific research. Awareness and early detection are crucial for improving outcomes. While treatment protocols for male breast cancer are often extrapolated from female cases, prostate cancer management is more established but requires adaptation for older patients. Further research is essential to develop tailored treatments and improve survivorship for men with these cancers.
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