What Happens After Treatment for Breast Cancer in Men?

For many men with breast cancer, treatment can remove or destroy the cancer. The end of treatment can be both stressful and exciting. You may be relieved to finish treatment, but it's hard not to worry about cancer coming back. This is very common if you've had cancer. For other people, the cancer may never go away completely. Some people may get regular treatments with chemotherapy, radiation therapy, or other therapies to try to help keep the cancer in check. Learning to live with cancer that does not go away can be difficult and very stressful.

Follow-up care

Even after you have completed breast cancer treatment, your doctors will want to watch you closely. It’s very important to go to all of your follow-up appointments. During these visits, your doctors will ask if you are having any problems. They may do exams and lab tests or imaging tests to look for signs of cancer or treatment side effects. Almost any cancer treatment can have side effects. Some might only last for a few days or weeks, but others might last a long time. Some side effects might not even show up until years after you have finished treatment. Visits with your doctor are a good time for you to ask questions and talk about any changes or problems you notice or concerns you have. However, if you have additional concerns about your cancer, you do not have to wait until your next scheduled visit. You can call your doctor immediately.

Typical follow-up schedules

Doctor visits: At first, your follow-up doctor visits will probably be scheduled for every few months. The longer you have been free of cancer, the less often the appointments are needed. After 5 years, they are typically done about once a year.

Mammograms: Routine screening mammograms, even after a breast cancer diagnosis in a man, is not common, and it is unclear how helpful they are.

Bone density tests: If you are taking an aromatase inhibitor or a luteinizing hormone-releasing hormone (LHRH) analog, you may be at increased risk for osteoporosis (thinning of the bones). Your doctor may want to monitor your bone health and may consider testing your bone density.

Other tests: Other tests such as blood tumor marker studies, blood tests of liver function, bone scans, and chest x-rays are not a standard part of follow-up. Getting these tests doesn’t help someone treated with breast cancer live longer. They will be done (as indicated) if you have symptoms or physical exam findings that suggest that the cancer has recurred. These and other tests may be done as part of evaluating new treatments by clinical trials.

If symptoms, exams, or tests suggest cancer may have recurred, imaging tests such as a chest x-ray, CT scan, PET scan, MRI scan, bone scan, and/or a biopsy may be done. Your doctor may also measure levels of blood tumor markers such as CA15-3, CEA or CA27-29. The blood levels of these substances go up in some men if their cancer has spread. They are not elevated in everyone with recurrence, so these tests aren't always helpful. However, if your are elevated, they may help your doctor monitor the results of treatment. Men who have had breast cancer can also still get other types of cancer. Talk to your doctor about genetic testing to see if you have a hereditary cancer syndrome that might put you at a very high risk for other cancers. Male breast cancer survivors also have a normal risk for other types of cancers.

Ask your doctor for a survivorship care plan

Talk with your doctor about developing a survivorship care plan for you. This plan might include:

A suggested schedule for follow-up exams and tests

A schedule for other tests you might need in the future, such as early detection (screening) tests for other types of cancer, or tests to look for long-term health effects from your cancer or its treatment

A list of possible late- or long-term side effects from your treatment, including what to watch for and when you should contact your doctor

Diet and physical activity suggestions

Reminders to keep your appointments with your primary care provider (PCP), who will monitor your general health care

Keeping health insurance and copies of your medical records

Even after treatment, it’s very important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think about their cancer coming back, this could happen. At some point after your cancer treatment, you might find yourself seeing a new doctor who doesn’t know about your medical history. It’s important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment.

Can I lower my risk of breast cancer progressing or coming back?

If you have (or have had) breast cancer, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. Research has shown that some things that might be helpful but the studies have been done in women with breast cancer, since breast cancer in men is so rare. Many of the recommendations, however, have been shown to help reduce a person’s risk of developing cancer, in general. Staying as healthy as possible is more important than ever after breast cancer treatment. Controlling your weight, exercising, and eating right may help you lower your risk of your breast cancer coming back, and may help protect you from other health problems.

Getting to a healthy weight

If you have had breast cancer, getting to and staying at a healthy weight might help lower your risk. A lot of research suggests that being overweight or obese (very overweight) raises the risk of breast cancer coming back. It has also been linked with a higher risk of getting lymphedema, as well as a higher risk of dying from breast cancer. Of course, for men who are overweight, getting to a healthy weight can also have other health benefits. Getting to a healthy weight might also lower your risk of getting some other cancers, as well as some other chronic diseases. Because of the possible health benefits of losing weight, many health care providers now encourage men who are overweight to get to and stay at a healthy weight. Still, it’s important to discuss this with your doctor before trying to lose weight, especially if you are still getting treatment or have just finished it. Your health care team can help you create a plan to lose weight safely.

Being physically active

Among female breast cancer survivors, studies have found a consistent link between physical activity and a lower risk of breast cancer coming back and of dying from breast cancer. This has not been well studied in men, but may also apply. Physical activity has also been linked to improvements in quality of life, physical functioning, and fewer fatigue symptoms. It’s not clear exactly how much activity might be needed, but more seems to be better. More vigorous activity may also be more helpful than less vigorous activity. But further studies are needed to follow up on these findings. Some people used to think that breast cancer survivors with lymphedema should avoid certain arm exercises and vigorous activities. But studies have found that such physical activity is safe. In fact, it might actually lower the risk of lymphedema, or improve lymphedema for someone who already has it. As with other types of lifestyle changes, it’s important to talk with your treatment team before starting a new physical activity program. This will likely include meeting with a physical therapist as well. Your team can help you plan a program that can be both safe and effective for you.

Eating a healthy diet

Most research on possible links between diet and the risk of breast cancer coming back has looked at broad dietary patterns, rather than specific foods. In general, it’s not clear if eating any specific type of diet can help lower your risk of breast cancer coming back. Studies have found that female breast cancer survivors who eat diets high in vegetables, fruits, whole grains, chicken, and fish tend to live longer than those who eat diets that have more refined sugars, fats, red meats (such as beef, pork, and lamb), and processed meats (such as bacon, sausage, luncheon meats, and hot dogs). But it’s not clear if this is due to effects on breast cancer or possibly to other health benefits of eating a healthy diet. Many people have questions about whether soy products are safe to eat after a diagnosis of breast cancer. Soy foods are rich sources of compounds called isoflavones that can have estrogen-like properties in the body. However, some recent large studies have not found that soy food intake affects breast cancer coming back or survival rates. While eating soy foods doesn’t seem to pose a risk, the evidence regarding the effects of taking soy or isoflavone supplements is not as clear. Soy in your regular diet is likely safe, but if you are thinking about consuming high levels of soy you should discuss this with your physician. While the links between specific types of diets and breast cancer coming back are not certain, there are clearly health benefits to eating well. For example, diets that are rich in plant sources are often an important part of getting to and staying at a healthy weight. Eating a healthy diet can also help lower your risk for some other health problems, such as heart disease and diabetes.

Dietary supplements

Some people want to know if there are any dietary or nutritional supplements they can take to help lower their risk. So far, no dietary supplements (including vitamins, minerals, and herbal products) have been shown to clearly help lower the risk of female breast cancer progressing or coming back. This doesn’t mean that none will help, but it’s important to know that none have been proven to do so. Dietary supplements are not regulated like medicines in the United States – they do not have to be proven effective (or even safe) before being sold, although there are limits on what they’re allowed to claim they can do. If you're thinking about taking any type of nutritional supplement, talk to your health care team. They can help you decide which ones you can use safely while avoiding those that might be harmful.

Alcohol

It’s clear that alcohol – even as little as a few drinks a week – increases a woman’s risk of getting breast cancer. But whether alcohol affects the risk of breast cancer coming back is not as clear. Drinking alcohol can raise the levels of estrogen in the body, which in theory could increase the risk of breast cancer coming back. But there is no strong evidence from studies to support this. Although there is no specific research in men with breast cancer and alcohol, alcohol use has been linked with several cancers. It is best not to drink alcohol. For men who do drink, they should have no more than 2 drinks a day to help lower their risk of getting certain types of cancer. Because this issue is complex, it’s important to discuss it with your health care team, taking into account your risk of breast cancer coming back (or getting a new breast cancer), your risk of heart disease, and your risk of other health issues linked to alcohol use. source: cancer.org