Norman Smith
March 2017

I am a 63-year-old high school technology teacher. During Christmas break a couple of years ago, I was working on my car. I didn’t quite fit on the creeper to get underneath my car and scraped my chest. There was a great deal of pain and a lump. I happened to have had a physical scheduled during the break from school, so I mentioned it to Dr. Laurie Caines, my primary care physician.

Between Christmas and New Years Eve I had a mammogram, ultrasound and biopsy and received the results on January 12, 2015. It turned out the lump was a tumor around my nipple, and the diagnosis was stage II breast cancer.

Right after my diagnosis, it was suggested I meet with Robin Schwartz, a genetic counselor at UCONN Health Center, because of the high incidence of cancer in my family; my mother’s fraternal twin sister had breast cancer. My dad’s sister also had breast cancer and her daughter had breast cancer. Her daughter predeceased her mother with breast cancer. My dad’s mother had cancer, but they didn’t know what type of cancer. It was in her abdominal area, so it could have been ovarian cancer.

After my wife and I met with Robin, we decided to have the complete genetic testing done. I found out several weeks later that I carry the BRCA 1 gene mutation. My oldest sibling, my sister, tested negative. My brother, the middle child, does have the faulty gene. I have two boys and the older, who has a son and a daughter, does not have the mutation. My younger son is positive as well. His wife is pregnant with their second child, so we are concerned about his kids. My brother also tested positive for the BRCA1 gene mutation. He had a prostatectomy about 13 years ago. He had one child, a boy who had Hodgkin’s Lymphoma. My nephew has not been tested yet and he has two daughters.

I stayed at school teaching until the end of the first semester in January and started treatments during mid-year exams. I took accumulated sick leave, starting at the beginning of the second semester (January), and was out until school let out in June. I returned to full-time teaching at the end of August while still receiving daily radiation treatments. For the first three weeks of school, I would leave school, drive to the hospital for treatment, and once home, eat dinner and go to bed. That was a very tiring time.

Within two weeks of learning the results of the biopsy, I had seen my gastrointestinal doctor, cardiologist, and urologist to verify I was in good condition and able to start treatments. I had a port installed and started a fairly aggressive form of chemo. I had an infusion every three weeks for 18 weeks. After the chemo and a couple weeks of recovery, I had surgery.

I chose a double mastectomy even though I was told the chance of the breast cancer recurring in the other breast was low. The only reason the doctor felt it would be good for me to have both breasts removed, would be for me to feel more “balanced” cosmetically. My feeling was that I, as a male, had less than a 4% chance of getting breast cancer, even with a BRCA gene mutation, but I was not willing to take the chance. I already had breast cancer on one side and didn’t want to go through the chemo, radiation and surgery again. My surgery was on 15 June, 2015.

Unfortunately, the pathology from the surgery came back with live cancer cells. This was not expected with the type of chemo I had especially since the tumors shrank and were hardly visible in the ultrasound. This meant I would need to consider radiation to insure no cancer survived. After several weeks of recovering from the surgery, I started daily radiation treatments. I was still receiving radiation for the first two weeks after the start of the school year in September, 2015.

The reason I left teaching for the rest of the school year was for fear of being exposed to too many germs at school. During that time the administration and I decided it would be good for students to hear my story. I recorded a short video about my illness and the video production class put it together as a presentation to the students during all the different lunch waves. This was during breast cancer awareness month and seemed to go over very well. Many students still come up to me to ask how am doing. The school did a fundraiser where some teachers offered to cut their hair or dye it pink if their goals were met.

I was recently released by my radiologist, but am still seeing my oncologist and my surgeon every six months. I am taking tamoxifen for 5-10 years to reduce the potential for the cancer recurring.

The most important reason for sharing my story is a man’s prognosis after a breast cancer diagnosis is generally worse than woman’s because they are diagnosed later. I don’t think men typically do self-exams. Doctors should check men’s breasts during physical exams, but often don’t. People need to know breast cancer in men can be a fast-growing cancer and needs to be detected early. I was lucky because I happened to have had a physical scheduled right after I scraped my breast and discovered the lump. Even at that point, I thought the lump was from the injury and not cancer. It never crossed my mind, even with the family history.