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Introduction

Chickenpox is a mild and common childhood illness that most children catch at some point.
It causes a rash of red, itchy spots that turn into fluid-filled blisters. They then crust over to form scabs, which eventually drop off.
Some children have only a few spots, but in others they can cover the entire body. The spots are most likely to appear on the face, ears and scalp, under the arms, on the chest and belly and on the arms and legs.
Chickenpox (medically known as varicella) is caused by a virus called the varicella-zoster virus. It's spread quickly and easily through the coughs and sneezes of someone who is infected.
Chickenpox is most common in children under 10. In fact, chickenpox is so common in childhood that 90% of adults are immune to the condition because they've had it before.
Children usually catch chickenpox in winter and spring, particularly between March and May.

What to do

To prevent spreading the infection, keep children off nursery or school until all the spots have crusted over.
Chickenpox is most infectious from one to two days before the rash starts, until all the blisters have crusted over (usually five to six days after the start of the rash).
If your child has chickenpox, try to keep them away from public areas to avoid contact with people who have not had it, especially people who are at risk of serious problems, such as newborn babies, pregnant women and anyone with a weakened immune system (for example, people having cancer treatment or taking steroid tablets).

Chickenpox treatment

Chickenpox in children is considered a mild illness, but expect your child to feel pretty miserable and irritable while they have it.
Your child is likely to have a fever at least for the first few days of the illness. The spots can be incredibly itchy.
There is no specific treatment for chickenpox, but there are pharmacy remedies which can alleviate symptoms, such as paracetamol to relieve fever and calamine lotion and cooling gels to ease itching.
In most children, the blisters crust up and fall off naturally within one to two weeks.

When to see Dr. B C Shah

For most children, chickenpox is a mild illness that gets better on its own.
But some children can become more seriously ill with chickenpox. They need to see a doctor.
Contact Dr. B C Shah straight away if your child develops any abnormal symptoms, for example:
If the blisters on their skin become infected
If your child has a pain in their chest or has difficulty breathing

Chickenpox in adults

Chickenpox may be a childhood illness, but adults can get it too. Chickenpox tends to be more severe in adults than children, and adults have a higher risk of developing complications.
As with children, adults with chickenpox should stay off work until all the spots have crusted over. They should seek medical advice if they develop any abnormal symptoms, such as infected blisters.
Adults with chickenpox may benefit from taking antiviral medicine if treatment is started early in the course of the illness.

Who's at special risk?

Some children and adults are at special risk of serious problems if they catch chickenpox. They include:
Pregnant women
Newborn babies
People with a weakened immune system

These people should seek medical advice as soon as they are exposed to the chickenpox virus or they develop chickenpox symptoms.
They may need a blood test to check if they are immune (protected from) chickenpox..

Chickenpox in pregnancy

Chickenpox occurs in approximately three in every 1,000 pregnancies. It can cause serious complications for both the pregnant woman and her baby.

Chickenpox and shingles

One you have had chickenpox, you usually develop antibodies to the infection and become immune to catching it again. However, the virus that causes chickenpox, the varicella virus, remains dormant (inactive) in your body's nerve tissues and can return later in life as an illness called shingles.

It is possible to catch chickenpox from someone with shingles, but not the other way around.

Is there a vaccine against chickenpox?

There is a chickenpox vaccine but it is not part of the routine childhood vaccination schedule. The vaccine is only offered to children and adults who are particularly vulnerable to chickenpox complications.

Symptoms of chickenpox

The most commonly recognised chickenpox symptom is a red rash that can cover the entire body.

However, even before the rash appears, you or your child may have some mild flu-like symptoms including:
Feeling sick
A high temperature (fever) of 38ºC (100.4ºF) or over
Aching, painful muscles
Headache
Generally feeling unwell
Loss of appetite
These flu-like symptoms, especially the fever, tend to be worse in adults than in children.

Chickenpox spots

Soon after the flu-like symptoms, an itchy rash appears. Some children and adults may only have a few spots, but others are covered from head to toe.
The spots normally appear in clusters and tend to be:
Behind the ears
On the face
Over the scalp
Under the arms
On the chest and belly
On the arms and legs
But the spots can be anywhere on the body, even inside the ears and mouth, on the palms of the hands, soles of the feet and inside the nappy area.
Although the rash starts as small, itchy red spots, after about 12-14 hours the spots develop a blister on top and become intensely itchy.
After a day or two, the fluid in the blisters gets cloudy and they begin to dry out and crust over.
After one to two weeks, the crusting skin will fall off naturally.
New spots can keep appearing in waves for three to five days after the rash begins. Therefore different clusters of spots may be at different stages of blistering or drying out.

Unusual symptoms

Most healthy children (and adults) recover from chickenpox with no lasting ill-effects simply by resting, just as with a cold or flu.
But some children and adults are unlucky and have a more severe bout than usual.
Contact Dr. B C Shah straight away if you or your child develop any abnormal symptoms, for example:
If the skin surrounding the blisters becomes red and painful
If you or your child start to get pain in the chest or have difficulty breathing
In these cases, prescription medicine, and possibly hospital treatment, may be needed.

Causes of chickenpox

Chickenpox is caused by the varicella-zoster virus. You catch it by coming into contact with someone who is infected with the virus.
It's a very contagious infection. About 90% of people who have not previously had chickenpox will become infected when they come into contact with the virus.

How you catch the virus

The chickenpox virus is spread in the same ways as colds as flu. It's contained in the millions of tiny droplets that come out of the nose and mouth when an infected person sneezes or coughs. You can then become infected with the virus by breathing in these droplets from the air.
You can also become infected by handling a surface or object that these droplets have landed on, then transferring the virus to yourself by touching your face.
It takes seven to 21 days for the symptoms of chickenpox to show after you have come into contact with the virus. This is called the ‘incubation period’.
Someone with chickenpox is most infectious from one to two days before the rash appears until all the blisters have crusted over. This usually takes five to six days from the start of the rash.

Shingles

If you have not had chickenpox before, you can also catch chickenpox from someone with shingles (an infection caused by the same virus). However, it's not possible to catch shingles from someone who has chickenpox.

Diagnosing chickenpox

You or your child should not usually need any medical tests to diagnose chickenpox. You can be pretty sure that it is chickenpox if there are the key symptoms of a mild fever followed by an itchy rash, blisters and scabs.
Chickenpox spots are usually distinctive enough to distinguish from other rashes, although occasionally they can be easily confused with other conditions that affect the skin, such as insect bites or scabies (a contagious skin condition that causes intense itching).
If you're still uncertain about what is causing the symptoms, Dr. B C Shahcan carry out a simple blood test to identify the virus.

When to contact Dr. B C Shah

1. See Dr. B C Shah if you're not sure whether you or your child have chickenpox.
2. Contact Dr. B C Shah urgently if you have been in contact with someone who has chickenpox or you have chickenpox symptoms and:
You are pregnant
You have a weakened immune system (the body’s defence system)
Your baby is less than four weeks old
Chickenpox in these instances can cause serious complications if left untreated. It is essential to seek medical advice so that you can receive any necessary treatment.
3. Contact Dr. B C Shah if you have chickenpox and are breastfeeding. They can advise about whether you should continue breastfeeding your baby.

Having a blood test

Once you have contacted Dr. B C Shah, you may need a test to see if you're already immune from chickenpox.
If you have had chickenpox in the past, then it is extremely unlikely that you will develop chickenpox for a second time. If you've never had chickenpox, or you're unsure whether you've had it, then you may need an immunity test.
This is a blood test that checks whether you are producing the antibodies to the chickenpox virus.
If your blood test result shows that you have the antibodies, you'll be naturally protected from the virus.

Treating chickenpox

There is no cure for chickenpox, and the virus usually clears up by itself without any treatment.
However, there are ways of easing the itch and discomfort, and there are important steps you can take to stop chickenpox spreading.

Painkillers

If your child is in pain or has a fever (high temperature), you can give them a mild painkiller, such as paracetamol. Paracetamol is available over-the-counter in pharmacies. Always read the manufacturer's dosage instructions.
You should avoid giving your child ibuprofen if they have chickenpox. This is because there have been some cases where using ibuprofen and other non-steroidal anti-inflammatory drugs(NSAIDs) has caused serious skin infections.
Ibuprofen should also be avoided if you or your child hasasthma, or a history of stomach problems, such as stomach ulcers.
If you're not sure whether ibuprofen is suitable, check with Dr. B C Shah. If your child is younger than three months old, always speak to Dr. B C Shah before you give your child any kind of pain relief.
If you're pregnant and need to take painkillers, then paracetamol is the first choice. You can use it at any stage of pregnancy. Only take ibuprofen during the second trimester (weeks 14-27 of the pregnancy).
If you're pregnant and you have chickenpox, you should visit Dr. B C Shah as soon as possible. You may need to have antiviral medicine or immunoglobulin treatment to prevent your symptoms from getting worse (see below).

Keeping hydrated

It is important for children (and adults) with chickenpox to drink plenty of water to avoid dehydration. Sugar-free ice-lollies are a good way of getting fluids into children. They also help to soothe a sore mouth that has chickenpox spots in it.
Avoid any food that may make the mouth sore, such as salty foods. Soup is easy to swallow as long as it is not too hot.

Stop the scratching

Chickenpox can be incredibly itchy, but it's important for children (and adults) to not scratch the spots so as to avoid future scarring.
One way of stopping scratching is to keep fingernails clean and short. You can also put socks over your child's hands at night to stop them scratching the rash as they sleep.
If your child's skin is very itchy or sore, try using calamine lotion or cooling gels. These are available in pharmacies and are very safe to use. They have a soothing, cooling effect.
A stronger medicine called chlorphenamine can also help to relieve the itching. It's available from your pharmacist over the counter or it can be prescribed by Dr. B C Shah. Chlorphenamine is taken by mouth and is suitable for children over one year old.

Cool clothing

If your child has a fever, or if their skin is sore and aggravated, dress them appropriately so that they don't get too hot or too cold. Loose-fitting, smooth, cotton fabrics are best and will help stop the skin from becoming sore and irritated.
If your child has chickenpox, avoid sponging them down with cool water. This can make your child too cold, and it may make them shiver.

Stronger treatments
Antiviral medicine

Aciclovir is an antiviral medicine that is sometimes given to people with chickenpox.
Aciclovir may be prescribed to:
Pregnant women
Adults, if they visit Dr. B C Shah within 24 hours of the rash appearing
Newborn babies
People with a weakened immune system (the body’s defence system)
Ideally, aciclovir needs to be started within 24 hours of the rash appearing. It does not cure chickenpox, but it makes the symptoms less severe. You normally need to take the medicine as tablets five times a day for seven days.
If you are taking aciclovir, make sure you drink plenty of fluids. Side effects are rare but can include nausea and diarrhoea.

Immunoglobulin treatment

Immunoglobulin is a solution of antibodies that is taken from healthy donors. Varicella-zoster immunoglobulin (VZIG) contains antibodies to the chickenpox virus.
Immunoglobulin treatment is given by drip. It is not used to treat chickenpox but to protect people who are at high risk of developing a severe chickenpox infection. This includes:
Pregnant women
Newborn babies
People with weakened immune systems
In the case of pregnant women, immunoglobulin treatment also reduces the risk of the unborn baby becoming infected.
As the supply of VZIG is limited, it will only be considered if a high-risk person has:
Been significantly exposed to the virus – significant exposure could be face-to-face contact with someone who has chickenpox
Been in the same room for 15 minutes with someone who has chickenpox
Had a blood test to confirm that they've not had chickenpox before
In some cases, newborn babies may be given immunoglobulin treatment without having a blood test first.

Complications of chickenpox

Complications of chickenpox are rare in healthy children. The most common complication is where the blisters become infected with bacteria.
A sign that the blisters have become infected is when the surrounding skin becomes red and sore.
If you think that your child's blisters have become infected, contact Dr. B C Shah as the child may need a course of antibiotics.
The people who are most at risk of developing chickenpox complications are:

Adults

Pregnant women
Babies under four weeks old
People with a weakened immune system
Adults
Chickenpox can be more serious in adults than in children. Adults with the virus are more likely to be admitted into hospital. Approximately 5-14% of adults with chickenpox develop lung problems, such as pneumonia. If you smoke, your risk of developing lung problems is much greater.
Although it is more serious in adults, most people will still make a full recovery from the chickenpox virus.

Pregnant women

If you're pregnant, chickenpox can occasionally cause complications.
For example, your risk of developing pneumonia is slightly higher if you're pregnant, especially if you smoke. The further you are into your pregnancy, the more serious the risk of pneumonia tends to be.
If you get chickenpox while you're pregnant, there is also a small but significant risk to your unborn baby.
If you are infected with chickenpox during the first 20 weeks of your pregnancy, there is a risk that your unborn baby could develop a condition known as foetal varicella syndrome.
This syndrome is rare. The risk of it occurring in the first 12 weeks of pregnancy is less than 1%. Between 13 and 20 weeks, the risk is 2%.
Foetal varicella syndrome can cause serious complications, including:
Scarring
Eye defects, such as cataracts
Shortened limbs
Brain damage
There have been reports of damage to the unborn baby from foetal varicella syndrome when a pregnant woman catches chickenpox after week 20. But the risk at this late stage in pregnancy is thought to be much less than 1%.
However, there are other risks from catching chickenpox after week 20 of pregnancy.
It is possible that your baby may be born prematurely (before week 37 of the pregnancy).
And if you are infected with chickenpox seven days before or seven days after giving birth, your newborn baby may develop a more serious type of chickenpox. In a few severe cases, this type of chickenpox can be fatal.
See Dr. B C Shah urgently if you're pregnant or have given birth in the last seven days and you think you may have chickenpox, or if you've been exposed to someone who has chickenpox.

People with a weakened immune system

Your immune system is your body's way of defending itself against disease, bacteria and viruses.
If your immune system is weak or does not work properly, you are more susceptible to developing infections such as chickenpox. This is because your body produces fewer antibodies to fight off the infection.
You may have a weakened immune system if you take immunosuppressive medication. This is medicine that works by damping down your immune system.
Immunosuppressive medication such as steroid tablets may be used if, for example, you have an inflammatory condition such as rheumatoid arthritis, lupus or certain blood conditions.
If you have a weakened immune system, you're also more at risk of developing complications from chickenpox. These complications include:
pneumonia
septicaemia (blood poisoning)
meningitis
See Dr. B C Shah urgently if you have a weakened immune system and you've been exposed to the chickenpox virus.

Preventing the spread of chickenpox

If your child has chickenpox, inform their school or nursery and keep them at home while they are infectious, which is until the last blister has burst and crusted over. This usually takes five or six days after the rash begins.
If you have chickenpox, stay off work and at home until you're no longer infectious.
If either you or your child has chickenpox, it is also a good idea for you, or them, to avoid contact with:
Pregnant women
Newborn babies
Anyone who has a weak immune system, such as people who are having chemotherapy (a treatment for cancer) or taking steroid tablets
If you or your child have recently been exposed to the chickenpox virus, you may not be able to visit friends or relatives in hospital. Telephone the ward to check first.

Travelling on a plane

If you or your child have chickenpox, you may not be allowed to fly until six days after the last spot has appeared.
You and your child should be safe to fly once you're past the infectious stage and all of the blisters have crusted over. But it's best to check the policy of your airline first. Inform the airline as soon as chickenpox is diagnosed.
It is also important to let your travel insurer know if you or your child have chickenpox. You need to make sure that you'll be covered if you have to delay or cancel your holiday, or if you need to extend your stay until your child is well enough to fly home.

Stop the virus spreading

Chickenpox can sometimes be spread through contact with objects that have been infected with the virus, such as children's toys, bedding or clothing.
If someone in your household has chickenpox, you can help stop the virus spreading by wiping any objects or surfaces with a sterilising solution and making sure that any infected clothing or bedding is washed regularly.

Vaccination

There is a chickenpox vaccine that is used to protect people who are most at risk of a serious chickenpox infection or of passing the infection on to someone who is at risk.
People who may be considered for chickenpox vaccination include:
healthcare workers who are not already immune – for example, a nurse who has never had chickenpox and who may pass it to someone they are treating if they become infected
people living with someone who has a weakened immune system – for example, the child of a parent receiving chemotherapy
The vaccine is not suitable for pregnant women. Avoid getting pregnant for three months after having the vaccine. The vaccine is also not suitable for people with weakened immune systems.

Introduction

Breast cancer is often thought of as a condition that only affects women, but men can also develop it.
However, breast cancer in men is much less common than breast cancer in women.
The most common symptom of breast cancer in men is a hard, painless lump that the develops on one of the breasts.

When to see Dr. B C Shah

You should always visit Dr. B C Shah if you notice a lump in your breast, or you have symptoms that affect your nipples, such as retraction or discharge.
While these symptoms are unlikely to be the result of breast cancer, they should be investigated further.

Treating breast cancer in men

In most cases of breast cancer, surgery is used to remove a section of the breast. This is usually followed by a long-term course of hormone therapy using a medication called tamoxifen.
Tamoxifen helps to block the effects of hormones on breast tissue that are known to stimulate the growth of cancerous cells. It should help to prevent the cancer from returning.
In some cases, radiotherapy and/or chemotherapy may be used for the same purpose.

Causes

The causes of breast cancer in men are unclear, but a number of risk factors for the condition have been indentified. These include:
Age – most cases of male breast cancer affect men who are over 70 years of age
Having a family history of breast cancer (both male or female)
Obesity - a body mass index (BMI) of 30 or more
Alcohol consumption

Who is affected?

The average age of diagnosis is 71 years of age.

Outlook

The outlook for breast cancer in men is less favourable than for breast cancer in women. This is because there is less awareness of the condition, so it often takes longer to diagnose.
Healthcare professionals assess the outlook for cases of cancer by measuring how many people survive for five years following the initial diagnosis. This is known as ‘the five year survival rate’. However, many men who are diagnosed with breast cancer survive for much longer than five years.
The estimated five year survival rate for:
Stage 1 breast cancer is 75-100%
Stage 2 to 3 breast cancer is 50-80%,
Stage 4 breast cancer is 30-60%

Symptoms of breast cancer in men

The most common symptom of breast cancer in men is usually a hard, painless lump in one of your breasts. However, in around 1 in 20 cases, the lump can be painful.
The lump is usually located underneath the nipple and areola (the circle of dark coloured skin that surrounds the nipple).
Less common symptoms of male breast cancer usually affect the nipple. These can include:
the nipple begins to turn in on itself (nipple retraction)
the nipple becomes hard, inflamed, and ‘sore looking’ (nipple ulceration)
fluid leaking from the nipple (nipple discharge)
Additional symptoms usually only develop if the cancer spreads from your breast to other parts of the body, such as your bones, liver or lungs. This is known as metastatic breast cancer.

Symptoms of metastatic breast cancer include:
Bone pain
Swelling of the lymph nodes (glands) near your breast; usually in, or around, the armpit
Shortness of breath
Feeling unusually tired all the time
Feeling sick (nausea)
Itchy skin

When to seek medical advice

You should always visit Dr. B C Shah if you notice a lump in your breast or if you have symptoms that affect your nipples, such as retraction, ulceration or discharge. While symptoms such as these are unlikely to be of the result of breast cancer, it is important that they are investigated further.

Causes of breast cancer in men

Cancer begins with an alteration to the coding information in cells that tells them when to grow and replicate. The code is read from the deoxyribonucleic acid (DNA) that is found in all human cells. A change in the code is called a mutation and can alter the instructions that control cell growth.
If a mutation occurs, the cells carry on growing instead of stopping when they should. The cells reproduce in an uncontrollable manner, producing a lump of tissue that is known as a tumour.

How cancer spreads

Left untreated, cancer can quickly grow and spread to other parts of your body. There are two ways that breast cancer can spread:
Directly - where the cancer spreads outs of the breast tissue into surrounding muscle and skin

Indirectly - where cancer cells spread via the blood or lymphatic system (see below) to more distant parts of the body, such as the lungs and liver

The lymphatic system is a series of glands (or nodes) that are distributed throughout your body in a system that is similar to the blood circulation system. The glands produce many of the specialised cells that are needed by your immune system.

Risk factors for breast cancer in men

It is not clear exactly what causes the DNA inside the cells of the male breast to behave in this manner. However, a number of risk factors that can increase your risk of breast cancer developing have been identified (see below).

Due to the rarity of breast cancer in men, even if you had most of the risk factors outlined below (with the exception of having Klinefelter's syndrome), your risk of developing the condition would still be very small.

Genetics and family history

A genetic mutation is where the instructions that are carried in all living cells become scrambled in some way which means that one or more of the body’s processes do not work in the way they should.
There are a number of genetic mutations known to increase your risk of developing breast cancer. The most significant mutation identified to date is known as the BRAC2 mutation. One study that was carried out in the UK found that 1 in 20 men with breast cancer have the BRAC2 mutation.
There is also evidence that breast cancer can run in families, as 1 in 5 men who develop breast cancer, have a first-degree relative, such as a mother or sister, who also has a history of breast cancer.

Oestrogen exposure

There is evidence that prolonged exposure to the hormone oestrogen can increase the risks of breast cancer in men.
Compared to women, men tend to have low levels of oestrogen, but there are a number of circumstances that can increase the levels of oestrogen in men.
These include:
Hormone treatments – man-made (synthetic) versions of oestrogen are often used to treat prostate cancer and are also given to transsexuals who are undergoing a male to female sex change
Obesity – obese men have higher levels of oestrogen than normal
There is also rare genetic condition called Klinefelter's syndrome where baby boys are born with much higher levels of oestrogen than normal. It is estimated that 1 in every 1,000 people are affected by Klinefelter's syndrome.
Klinefelter's syndrome is a major risk factor for breast cancer in men. Men who have the condition are 20 times more likely to develop breast cancer than the male population at large.

Occupational risks

There is evidence that men who work in hot environments are twice as likely to develop breast cancer compared with men who work in cooler environments. Environments that have been linked to an increase risk of breast cancer in men include:
Blast furnaces
Steel works
Rolling mills – a factory where metal (usually steel) is shaped using rollers
Car manufacturing plants
One theory to help explain the link between working environment and the increased risk of developing breast cancer is that excessive heat may damage the testicles, which could lead to an increase in oestrogen levels.
Another theory is that working in hot environments usually involves exposure to certain chemicals which may increase a the risk of developing breast cancer in men.
Rates of breast cancer are also unusually high in men who manufacture perfumes and soaps.
They are seven times more likely to develop breast cancer than the male population at large. The reason for this increased risk is still unclear, although exposure to certain chemicals seems to be an obvious, although as yet unproven, factor.

Radiation

Exposure to radiation has been linked to an increased risk of developing breast cancer in men.
Research has found that men who received a course of radiotherapy (where high energy X-rays are used to kill cancerous cells) directed at the upper chest were seven times more likely to develop male breast cancer compared to the population at large.
However, it is important to put the increase risk in context. Even a seven-fold increase means that the chances of developing breast cancer is still very low at around 1 in 14,285.

Breast cancer in men – Diagnosis

If you have symptoms which might indicate breast cancer, such as a hard, painless lump in one of your breasts, Dr. B C Shah will carefully examine your breasts. During the examination, they will also be looking for other possible signs of male breast cancer, such as swollen lymph nodes (glands).
It is likely that your Dr. B C Shah will refer you for further tests. There are three tests that are used to help diagnose male breast cancer. These are:
A mammogram,
An ultrasound
A biopsy

Mammogram

A mammogram is a type of X-ray that can help determine whether there are any changes in breast tissue that could be the result of cancer.
During the mammogram procedure, a radiographer (a specialist in taking X-rays) will compress one of your breasts between two X-ray plates. This should not be painful, but you should tell the radiographer if you find it uncomfortable.
Once your breast has been correctly positioned, an X-ray will be taken which will produce a clear image of the inside of your breast. The procedure will then be carried out on your other breast.

Ultrasound

Ultrasound uses high frequency sound waves to produce an image of the inside of your breasts (in the same way that an unborn baby can be seen in the womb).
An ultrasound probe or sensor will be placed over your breasts to create an image of the inside of your breasts on a screen. The image will highlight any lumps or abnormalities that may be present in your breasts.

Biopsy

A biopsy may be recommended if a mammogram or an ultrasound scan highlight any lumps or abnormalities in your breasts. A biopsy is a test that can either confirm or rule out a diagnosis of male breast cancer. It involves taking a sample of suspected cancerous tissue and examining it in a laboratory for the presence of cancerous cells.
A type of biopsy that is known as a core biopsy is usually recommended for the diagnosis of breast cancer in men. This type of biopsy can usually indicate whether the cancer has started to spread from the breast into the surrounding area, which is known as invasive breast cancer.
During a core biopsy, a local anaesthetic will be used to numb your breasts. A hollow needle will then be used to remove a number of small tissue samples from the breast lump.
If cancer is found, it will also be possible to check whether there are special proteins, known as oestrogen receptors, on the surface of the cancerous cells. This is important because if oestrogen receptors are found (they are in an around 90% of cases), it is possible to treat the cancer using a medication called tamoxifen.

Staging

After breast cancer has been diagnosed, your care team should be able to provide information about what stage your cancer is at.
Staging is a system that is used to describe how far a cancer has spread at the point of the diagnosis. The higher the stage, the more advanced the cancer and the further it has spread. The staging system for male breast cancer is outlined below.
Stage 1 - the cancerous tumour is less than 2cm (three quarters of an inch) across and there are no signs that the cancer has spread to the lymph nodes near the armpit.
Stage 2 - the cancerous tumour is 2-5cm (three quarters to two inches) across and/or there are signs that the cancer has spread to the lymph nodes near the armpit.
Stage 3 - the cancerous tumour is larger than 5cm (2 inches) across and has started to move into surrounding tissues, such as skin and muscle. Near-by lymph nodes are also affected but there is no sign that the cancer has spread beyond the breast and armpit.
Stage 4 - there are signs that the cancer has spread to other parts of the body, such as the lungs or bones. This is known as secondary, or metastatic, cancer.
A cure may be possible in cases of stage 1, 2 and 3 male breast cancer. In cases of stage 4 breast cancer, a cure is unlikely but it may be possible to control the symptoms and slow the spread of the cancer.

Coping with a diagnosis

Being told that you have breast cancer can cause a wide range of emotions, such as shock, fear, confusion and, in some cases, embarrassment.
Most people assume that breast cancer only affects women, so it can be difficult for many men to come to terms with the diagnosis.
Feelings of isolation and being alone are common in men with breast cancer. This may be because there is little in the way of advice and support for men with breast cancer, particularly when compared to the support that is available for women with the condition.
Sometimes, men who find themselves in this situation can become depressed. You may be depressed if during the past month you have felt very down and you are no longer interested in doing activities that you used to enjoy. If you think that you may be depressed, you should visit your Dr. B C Shah. There are a range of effective treatments, such as medication and counselling, that can help relieve feelings of depression.

Treating breast cancer in men

Many hospitals use multidisciplinary teams (MDTs) to treat breast cancer in men. MDTs are teams of specialists that work together to make decisions about the best way to proceed with your treatment.
Members of your MDT may include:
A surgeon
A clinical oncologist (a specialist in the non-surgical treatment of cancer)
A pathologist (a specialist in diseased tissue)
A radiologist (a doctor who specialises in analysing the results of imaging tests such as X-rays and ultrasound scans)
A dietitian
A social worker
A psychologist
As well as having a specialist MDT, you may also be assigned a key worker who will usually be a specialist nurse. They will be responsible for co-ordinating your care.
Deciding what treatment is best for you can often be confusing. Dr. B C Shah will recommend what he think is the best treatment option but the final decision will be yours.
Before visiting hospital to discuss your treatment options, you may find it useful to write a list of questions that you would like to ask the specialist. For example, you may want to find out the advantages and disadvantages of particular treatments.

Your treatment plan

Your recommended treatment plan will depend on how far the cancer has spread. If the cancer has not spread significantly beyond your breast (stage 3 or below), a complete cure may be possible.
Surgery to remove the affected breast is usually recommended followed by radiotherapy, hormone therapy and /or chemotherapy to help prevent the cancer returning.
If the cancer has spread beyond your breast into other parts of your body, such as your lungs (stage 4 breast cancer), a complete cure will not be possible. However, hormone therapy and chemotherapy can be used to relieve symptoms, slow down the spread of the cancer and prolong lifespan.

Surgery

Surgery is the first treatment option that is often recommended for breast cancer and usually involves an operation called a modified radical mastectomy. This is where Dr. B C Shah removes the entire breast as well as the lymph nodes (glands) in the armpit.
Once surgery has been completed there will be a scar where your nipple used to be and an indentation in your chest where the breast tissue was.
It is possible to have reconstructive surgery after having a modified radical mastectomy. Tissue can be taken from other parts of your body, such as your lower abdomen or buttocks, and be used to recreate the shape of the breast.
An alternative option is to use breast implants that are similar to those that are used in cosmetic surgery. However, they are obviously much smaller. In many cases, reconstructive surgery can be carried out immediately after a mastectomy has been performed.
It is also possible to restore the appearance of a nipple by having a tattoo on your chest. ‘Nipple tattoos’ can be created in around 30 to 40 minutes and have a very realistic appearance.
You should discuss the various options for reconstructive surgery with Dr. B C Shah.

See more at: http://drbcshah.com/breast-cancer-in-men/

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