Mathew Knowles, MBA, PhD: Speaking Out About Male Breast Cancer

In July 2017, Mr. Mathew Knowles, a music industry executive, businessman, and university lecturer, noticed that his new white T-shirts had little dots of blood. When he mentioned this to his wife, she said that she herself had noticed that the sheets on his side of their bed had some small spots of blood.

Knowles recalled a seminar he had attended years ago, when he was selling radiology equipment for Xerox, that talked about small blood spots in the chest area as a possible sign of breast cancer.

“And at that time, I knew it might be breast cancer. I knew that because I have a family history of breast and prostate cancer,” he said.

When he spoke to his primary care physician about his concerns, he was met with skepticism. His doctor told him he had only encountered one case of male breast cancer in 40 or 50 years of practice. Mr. Knowles had extensive experience in the medical imaging field, so despite the skepticism from his physician, he insisted on getting a mammogram, which led to his diagnosis of stage IA breast cancer.

A diagnosis of breast cancer in men is more common than people realize, with more than 2,700 cases per year. Compared to White men, Black men are 50 percent more likely to be diagnosed with breast cancer, and twice as likely to be diagnosed with triple- negative breast cancer, the most aggressive form of the disease.

“No one wants to hear the words that you have cancer,” Mr. Knowles said, “For me, it was a moment of silence, because it just takes the breath away. And anyone who has heard those words has had those moments of silence where the brain is processing a mile a minute and asking, ‘Why me?’.”

Quickly, Mr. Knowles consulted with oncologists in Philadelphia and Houston. After those discussions he decided to undergo a mastectomy just days after his diagnosis. Following his surgery, his breast tissue was tested for mutations in genes that are associated with a family history of cancer. His care team found that Mr. Knowles had a mutation in BRCA2, a gene commonly associated with causing breast cancer when a mutation in it is inherited from one or both parents. Knowing that he has a BRCA2 mutation, Mr. Knowles has increased his adherence to surveillance testing for breast and other types of cancer.

“I have an annual mammogram. I also get an annual PSA for prostate cancer, a dermatologist visit, and an MRI for pancreas cancer,” he said.

Unfortunately, genetic testing for cancer in the United States is suboptimal, with rates even lower in the Black population. As a result, many people are unaware of their genetic risks for cancers and other diseases, leading to lower rates of active prevention and early detection.

Policy makers, Knowles said, should understand the importance of making genetic testing and other technologies more affordable and accessible to everyone to increase the use of these potentially lifesaving technologies.

“The first thing that I would say to policymakers is, ‘You might be saving your own life, or saving your son’s or your daughter’s life’,” he said. “Because when you’re talking about your family, it hits differently. The more progress we make, the more lives we save.”

And, Mr. Knowles explained, addressing the accessibility and cost of lifesaving technology is critical to reducing health disparities in the country.

“The percentage of deaths is much greater if cancer is not found early,” he noted.

Another challenge men in general, and Black men in particular face, is the stigma associated with being diagnosed with a type of cancer typically associated with women.

“No man wants to say he has breast cancer,” he said. “Words matter. The fact that medical centers say ‘women’s breast cancer center’ instead of ‘women’s and men’s breast cancer center’ or just ‘cancer center,’ makes a difference,” he said.

“The phrase that I use is male ‘chest’ cancer,” he said. “It might not be the accurate description but that’s not what we’re trying to do, we’re trying to save men’s lives, and if male chest cancer makes it more comfortable, then maybe we should consider it. Whatever gets us the greatest results.”

Since his diagnosis, Mr. Knowles has adopted a healthier lifestyle, exercising regularly, decreasing his intake of alcohol, and reducing the amount of meat he eats.

“I’m just grateful for my health,” he said. “I feel better today than before my diagnosis. A lot of that had to do with my lifestyle change,” which has resulted in the loss of 37 pounds.

And he’s grateful that his cancer was caught early—at stage IA.

“If you find cancer early, you’ve got a shot at being OK. And if we can give the tools that physicians need, which only comes from research, it makes it even better.”