A man living in Kanagawa Prefecture was first diagnosed with breast cancer when he was 45. He noticed a lump on his left nipple and felt some pain. He didn't think much of it and, busy with work, he didn't immediately see a doctor. But his wife found a shirt smeared with blood and urged him to go. After an examination, the doctor told him he had breast cancer.
"For the first time in my life, my mind went completely blank. I couldn't even think what to do." Until then, he didn't know men could even develop the disease.
He had surgery to remove a part of his left breast. He relapsed when he was 55 and 64, undergoing an operation each time. He is now 73 and his condition is stable. But he receives monthly injections to prevent another relapse.
Like women, men develop breast cancer in their mammary glands. Because these are undeveloped compared to those of women, men are far less susceptible to the disease. But they can still develop it. Currently, 0.6 percent of breast cancer patients in Japan are men.
Terumasa Sawada is an associate professor at Showa University specializing in breast surgery. "Awareness of men's breast cancer is low in society," he says. "Because it usually develops at older ages than in women, the disease tends to be detected late. And since there are fewer cases, there are many things that are still unknown."
Male patients are also affected by a lack of social understanding. Places to learn about the disease and exchange information about treatment are rare in Japan. And many patients say they feel they can't tell colleagues about their illness since many people still don't know that men can develop breast cancer. Even going to the hospital to get treatment can be stressful, they say. One patient says he often gets weird looks as the only man in the reception area.
But efforts are being made to increase support for male patients. CancerNet Japan, a non-profit that provides information for patients, started holding meetings this January for male patients to learn and share information about the disease.
Koichiro Noguchi, a freelance writer, is among the participants. He is planning to form a group of male breast cancer patients to raise public awareness about the illness and promote early detection and prevention.
Noguchi takes inspiration from the Male Breast Cancer Coalition, a group of male patients in the US. Noguchi attended a meeting in Kansas in April 2017.
The group holds a patients' meeting once a year and organizes lectures by doctors on the latest research. Its website shows the kind of treatment more than 100 patients have undergone. The group also works to advocate for early detection.
"I want to raise public awareness of men's breast cancer and lead to early detection," says Noguchi. "I also want to ensure that people diagnosed with the illness will know they can get correct information and meet others in similar situations if they come to us."
The National Cancer Center projects the number of breast cancer patients to increase in the coming years. But Noguchi says he hopes his group can offer support to men with the disease, and eventually reverse this trend.