STATEN ISLAND, N.Y. -- When Anthony Ferreri became president and CEO of Staten Island University Hospital 10 years ago, it was the culmination of 30 years in hospital administration and a homecoming to take care of his community -- family, friends and strangers.
At the hospital's recent annual charity ball, he took his role of caring for the community to an even more deeply personal level by sharing the news of his breast cancer diagnosis.
Nearly everyone knows a woman who has had breast cancer, but few even know that men can develop breast cancer. The general public and physicians themselves are not aware of the disease that accounts for 1 percent of all breast cancer cases -- some 2,000 diagnoses every year.
Ferreri asked himself, "Would it do some good if I went public with this and would it make physicians and men more aware that when they have signs like this -- men ignore lumps and bumps and doctors don't correlate the same symptoms that they see in women [alarm them] because they believe it could be breast cancer. They don't think breast cancer -- same symptoms -- they don't think breast cancer in men."
"I think I have an obligation. I really do -- because of my position in this community," said the 62-year-old Ferreri, who is currently undergoing chemotherapy treatment.
Ferreri, who combines an executive image with boyish good looks, admits the "chemo knocks the hell out of you" when he met with a reporter and photographers.
His dark eyes, warm and reflective, often spark with humor or passion for the people he knows and the issues that are important.
"The problem is breast cancer in men isn't discovered until a much later stage because it is ignored. By that point it is at a much more dangerous stage," said Ferreri.
The site of his cancer is his armpit -- not the expected location for breast cancer. Known as ectopic -- or displaced -- breast tissue, it is something that happens during development in utero.
The lump in his armpit was identified 35 years ago during a pre-employment physical. In the last six years, it had grown to the size of a golf ball, but he was counseled to let it be since it was causing no problems.
However, about six months ago, it became inflamed and tender. In February, a surgeon removed it, on the grounds that it was causing discomfort and didn't need to be there.
He got the unexpected report that the tumor was cancerous on Feb. 20 and in a follow-up surgery with Dr. Cynara Coomer, chief of breast surgery and director of the Comprehensive Breast Center, it was found the cancer was in a lymph node.
With a stage 2A diagnosis, Ferreri is relieved to be able to report a very positive prognosis when he shares the news with family and colleagues.
In what will add up to six months of treatment, he will also undergo radiation, to be sure of eradicating all the cancer cells.
Ferreri's symptom was not the most common, but paying attention to the change in the swelling under his arm was key.
The most common symptom is a lump in the breast. A change in the nipple, either a retraction or discharge, is also a symptom that should be brought to a doctor's attention. Most of this is painless; however, if ignored, pain around the breast and under the armpit can develop.
What breast tissue and milk ducts a man has are similar to a woman's. The cancer is similar biologically too according to Dr. Coomer, and so is the treatment.
The biopsy determines if it is estrogen-driven or not. Testing can also determine if it is genetically driven -- the BRCA2 is the gene marker for men.
Reaction to the diagnosis is similar too.
"The first thing someone wants to know when they hear cancer is: 'Am I going to survive this?'" she said.
Once a course of treatment is determined, "men are concerned abut the cosmetic outcome as much as women," she said.
The scar from a mastectomy, whether they will lose the nipple and areola are of concern. The side effects such as losing hair and ability to function and work normally during chemotherapy are also concerns.
"The difference for men is they are dealing with a disease we think of as a woman's disease," added Dr. Coomer. "You have to be aware of how uncomfortable a man might be in an office surrounded by women."
The new Comprehensive Breast Center will have less pink and less silk flowers, she quipped.
Ferreri says he "didn't think twice about treatment" at the hospital, in part because of the very good breast program they have developed.
Curtailing his usual 12- to 14-hour work day while he weathers the effects of chemotherapy is one adjustment Ferreri is making.
Telling people has been difficult. He was preparing to tell his two children, Joseph and Toni Ann Spinella, both in their 30s, when his son came to the table with a pair of NBA player Kevin Durant pink breast cancer awareness sneakers and plopped them in the chair nearby, giving his dad the perfect opening.
Colleagues and staff have been "shocked and extremely supportive." Hospital employees at every level talk to him about their cancer treatments, he said, and conclude, "You'll be fine."
The support of people who are going through the same thing, so easy to find for women with breast cancer, is difficult if not impossible for a man apart from online sites.
Ferreri's general doctor urged him to speak with a retired doctor they both know who had also had breast cancer. They were talking for about a half-hour when the doctor quipped, "Two men talking about breast cancer, it's as odd as rocking horse manure."
Ferreri has marveled a lot at the improbabilities, not the least of which include his being diagnosed with breast cancer the year the annual ball was dedicated to raising funds for the new Comprehensive Breast Center.
It is an irony he could do without, but he has accepted the significance of the challenge.
"This is a very special job to have when you have an impact on your own community's health care. But when it's the place where my great-grandparents settled. ... I have so many ties in this community. We take care of my neighbors and my friends. We take care of my family. To be able to make a difference to your own people, your own community, is gratifying beyond words."