'I thought it was a gym injury' but man's pea-sized lump was stage 3 breast cancer

'I thought it was a gym injury' but man's pea-sized lump was stage 3 breast cancer James Richards was 36 when he was diagnosed with breast cancer and is now welcoming Coronation Street's new storyline hoping it will highlight that it is not just a woman's disease Fans of Coronation Street are set to follow Kit Green’s devastating diagnosis of stage three breast cancer. For many watching, it may be the first time they realise that men can get a disease still overwhelmingly associated with women. The Weatherfield police detective is floored to discover his health concerns result in the cancer diagnosis - something shared by more than 400 men in the UK every year. While it is rare compared with more than 55,000 women, Kit’s story reflects a very real experience faced by hundreds of men every year. James Richards knows the statistics only too well for in 2023, at the age of 36, he was diagnosed with stage three breast cancer. At the time, life was looking good - his career was going well and he had moved in with his partner, then came the shock diagnosis. He says: "Breast cancer was the last thing I thought would turn my life upside down. In truth, it wasn’t something I had ever seriously considered could happen to me. And it was that lack of awareness that stopped me contacting my doctor when I first found a pea-sized lump just behind my nipple. "I put it down to 'just one of those things', or perhaps some sort of injury picked up at the gym, and carried on with my life as though nothing had happened. I did that for three months before I finally, and reluctantly, booked an appointment with my GP. Thank God I did. "A week later, I found myself in a breast clinic having a mammogram, ultrasound and biopsy. A few days after that came the diagnosis, followed by a treatment plan that would involve months of chemotherapy, surgery and radiotherapy. "Coming to terms with cancer was one thing, but being diagnosed with what I - and much of society - still saw as essentially a 'women’s disease' brought its own feelings of embarrassment, isolation and, at times, shame. "What I hadn’t expected was to discover just how much of the world around breast cancer still assumes the person going through it will be a woman. From information about wearing bras, to support services I couldn’t access because I was a man, I repeatedly found myself in a healthcare system that knew men could get breast cancer, but often didn’t seem designed for us." He says he "couldn’t see himself" in the position he found himself in - not in the literature, the support being offered or the awareness campaigns that could have flagged up the risk. As a result, during treatment, he decided to do something about it and founded moobs, the UK’s first organisation dedicated specifically to improving awareness and support for men affected by breast cancer. "Since then, one of the things I’ve learned is that my experience is far from unique," he explains. "Again and again, I hear from men whose stories are strikingly similar to mine: they didn’t know they could get breast cancer, they delayed seeking help, and when they entered the breast cancer system, much of what surrounded them felt as though it had been designed for somebody else. "That is why Kit’s Coronation Street storyline matters. Putting a man’s breast cancer diagnosis in front of millions of viewers is an opportunity to do more than simply remind men to check themselves." He adds: "We should also be asking whether the support waiting for them if they do receive a diagnosis is good enough." James says he believes there are five things which "we need to do better" for men affected by breast cancer. Men need to know they can get breast cancer He says: "If there is one thing we need to do better, it is making men aware that they can get breast cancer - it’s the whole ethos behind moobs. Like all cancers, the earlier breast cancer is discovered, the better the chances of a good outcome. "We don’t need to frighten men into thinking breast cancer is common, but they do need to know that it is possible and understand the changes they should be looking out for. Prostate Cancer UK has done an excellent job of getting men to think about their risk of prostate cancer, why should breast cancer be any different? "This matters because research has shown a 19% higher mortality rate among men diagnosed with breast cancer than women with the disease. Awareness has to be part of that conversation, because if men don’t know breast cancer is something they can get, how can we expect them to recognise when something might be wrong?" Patient information needs to be more inclusive James says: "Once I was diagnosed, I was bombarded with a huge amount of information about breast cancer, but nearly all of it had been written with women in mind. One of the first pieces of information I was given included advice about wearing a loose-fitting bra." He adds: "That might sound trivial on its own, but when you have just been told you have cancer, every reminder that the system wasn’t really expecting someone like you makes you feel a little more isolated. Throughout treatment, I received information about services, events and support that were either explicitly for women or clearly written on the assumption that the person reading it would be one. "Nobody is suggesting that information for women should disappear. Women make up the overwhelming majority of breast cancer diagnoses and their needs obviously have to remain central, but making information more inclusive of everyone who gets the disease does not take anything away from women." Support services need to be genuinely open to men "While I was going through treatment, one of the hardest things was the perceived lack of support available to me; but that becomes even harder when the support that does exist actively excludes you," he says. "Every time I checked in at the breast clinic, I would have to explain that I was there because I had breast cancer, with staff often assuming I had come to the wrong department. "Having to repeatedly disclose my diagnosis in public was embarrassing enough, but one of my lowest points came when I was referred to a physiotherapy class for people with breast cancer, only to be turned away because I was a man and the class was for women only. "And this kind of experience isn’t unique to me. One man moobs has supported had told me he was refused his tamoxifen prescription because it was assumed the medication was intended for his wife and that his name had been added in error. "These incidents might seem small individually, but they add up. You find yourself repeatedly having to explain that, yes, you really do have breast cancer and, yes, this service or medication really is for you. Men don’t need to be separated from breast cancer care, we simply need to be properly included in the treatment and support that already exists for people with the disease. Research needs to reflect that men get breast cancer too James says: "Although the treatment I received from my oncology team was second to none, one of the realities of being a man with breast cancer is that much of the evidence behind the treatment pathway has been built around women. This was something I came up against again and again. At one stage, I was heading towards major surgery that I later discovered would have been unnecessary, largely because the established pathway was based on 'what we do for women'. "It was only after doing my own research and independently speaking to people at the cutting edge of breast cancer in men that I was able to question that approach and ultimately avoid it. But the problem extends far beyond primary treatment and affects how I think about my future too. "Some of the drugs I take to reduce the risk of my cancer returning have very limited evidence around their effectiveness and long-term impact in men. In many respects, it feels like I am going into parts of treatment blind. "And because breast cancer in men is most commonly diagnosed later in life, there is also far less long-term evidence for someone diagnosed as young as I was. I don’t have generations of men diagnosed in their 30s whose experiences over the following 20, 30 or 40 years I can look to. "Of course, breast cancer in men is rare, and that makes research more difficult, but the rarity of a disease cannot become a reason not to try. If we want men to receive treatment based on evidence that reflects them too, they need to be included in the research that shapes those decisions." The language and imagery around breast cancer needs to change James says: "When you think of breast cancer awareness, you traditionally think of pink ribbons, bras and images of women. Although awareness campaigns have achieved enormous things, they have also created such a strong association between breast cancer and women that many men simply don’t see themselves as being at risk - and the language reinforces that. "The iconography and language around breast cancer awareness has to be more inclusive. Men need to see and hear from other men who have had the disease, so that breast cancer feels like something they are part of the conversation around too. "And when breast cancer in men is talked about, we should be careful not to make it sound like a separate condition. It isn’t “male breast cancer”; it’s breast cancer. We don’t assign gender to other cancers, so why breast cancer? Unintentionally, that language can only widen the awareness gap further. "Ultimately, awareness is still the most important thing. Men need to know that breast cancer is something that can happen to them, and that is why Coronation Street telling Kit’s story is such a positive and important step. Putting that message in front of millions of viewers could genuinely save lives. "But awareness also has to be backed up by a breast cancer system that recognises men once they enter it. If a man receives the same diagnosis as Kit and me, the world waiting for him should feel like it was designed with him in mind too."