Thermography, Thermology and Male Breast Cancer

Promise, Limits and the Work of Dr. Phil Hoekstra

 By: Lennard M. Goetze, Ed.D

Thermal imaging has attracted renewed interest as medicine searches for comfortable, radiation-free methods of assessing breast health. The terms thermography and thermology are often used interchangeably, but they describe different parts of the process. Understanding that distinction is essential—especially when discussing male breast cancer and the work of Dr. Phil Hoekstra.

 Thermography is the imaging technology. A sensitive infrared camera measures heat emitted from the skin and converts those measurements into a color-coded image called a thermogram. The procedure is non-contact, does not compress the breast and does not expose the patient to ionizing radiation.

MEDICAL THERMOLOGY is the broader clinical discipline. It includes standardized patient preparation, controlled room conditions, image acquisition, recognition of thermal patterns, comparison between corresponding areas of the body, clinical interpretation and reporting. Thermography produces the image; thermology provides the scientific framework through which that image is evaluated.

 Why Breast Health Became Thermography’s Best-Known Application: Breast thermography became prominent because the breast is relatively superficial and accessible to infrared measurement. Increased blood flow, inflammation, vascular changes and altered metabolic activity can produce differences in skin temperature. A thermogram may therefore identify asymmetry or an unusual heat pattern that deserves clinical attention.

 Thermography was historically investigated and promoted as a breast-cancer screening method. However, research produced widely variable results, partly because early equipment, acquisition conditions and interpretive criteria were inconsistent. A systematic review found substantial variation in sensitivity and specificity and concluded that evidence was insufficient to support breast thermography as either a screening or diagnostic test by itself.

 Today, the FDA states that thermography has not been demonstrated to be an effective stand-alone test for breast-cancer screening or early detection. It is cleared only as an adjunctive tool, meaning that it may provide supplementary physiologic information but must not replace mammography or another clinically indicated examination. A suspicious thermal pattern is not proof of cancer, while a normal thermogram cannot rule cancer out. FDA, systematic review

 

Dr. Phil Hoekstra’s Contribution

Dr. Phil Hoekstra has devoted decades to thermal imaging and is widely identified within the thermology community as an experienced interpreter and educator. According to Therma-Scan’s published history, Hoekstra and his father established the organization in 1972. His work has emphasized moving beyond the casual production of colorful heat pictures toward a disciplined process involving standardized imaging, clinical-quality interpretation and comparison of thermal findings over time.

 It would be inaccurate, however, to say that Hoekstra “converted thermography into a diagnostic test for cancer.” No thermologist can diagnose breast cancer from temperature patterns alone. The more defensible description is that Hoekstra helped advance thermography toward medical thermology: a structured adjunctive assessment intended to identify physiologic findings that may justify further evaluation. Cancer diagnosis still requires conventional clinical investigation and, ultimately, tissue pathology when warranted. Calling anyone the world’s “leading diagnostic expert” would require independent comparative evidence. Hoekstra can responsibly be described as a longstanding authority and highly experienced specialist in medical thermology, but the limits of the technology must remain clear.

 

What Thermology May Offer Men: Male breast cancer is frequently diagnosed after a man notices a lump, nipple retraction, discharge, skin alteration or another physical change. Because routine population screening is generally not recommended for average-risk men, awareness and prompt evaluation of symptoms are especially important.

Thermology offers practical advantages: it is non-invasive, radiation-free, compression-free and capable of documenting surface-temperature patterns. It may be useful as an adjunct for recording physiologic asymmetry and directing attention to a region requiring conventional examination. These qualities also may make some men more willing to participate in an initial breast-health assessment.

Nevertheless, the claim that mammography “fails men” is not supported by current evidence. Mammography can be highly accurate in symptomatic men; one study reported 92% sensitivity, 90% specificity and a 99% negative predictive value. Ultrasound is also valuable for characterizing a palpable abnormality. The American College of Radiology recommends diagnostic mammography or digital breast tomosynthesis for many men aged 25 or older with an indeterminate breast mass, followed by ultrasound when findings are suspicious or inconclusive. Male mammography study, ACR criteria

 Thermology’s most responsible future is therefore not as a replacement for mammography, ultrasound, MRI or biopsy, but as one component of an integrated diagnostic pathway. For men, the best “new solution” is not reliance on one technology. It is greater awareness, rapid clinical evaluation and thoughtful use of complementary physiologic and structural information—followed by biopsy whenever cancer must be confirmed.

 

Lymphedema Can Appear Years After Treatment

The Delayed Risk of Lymphedema

Written by: Lennard M. Goetze, Ed.D  / Edited by: Daniel Root

For many male breast cancer survivors, treatment ends with the expectation that postoperative problems will gradually fade. Lymphedema does not always follow that timetable. It may develop soon after surgery or radiation, but it can also appear months or years later. Survivors therefore need lifelong awareness—not lifelong fear—of changes in the arm, hand, chest wall, breast or underarm.

Lymphedema occurs when the lymphatic system cannot adequately transport fluid from tissues. Breast cancer surgery may remove or disrupt axillary lymph nodes and vessels, while radiation can produce inflammation and scarring that further restrict lymphatic drainage. The resulting accumulation of protein-rich fluid may cause swelling, inflammation and, over time, thickening or hardening of the tissues. The National Cancer Institute recognizes cancer treatment as an important cause of secondary lymphedema. National Cancer Institute

Risk varies considerably. Axillary lymph-node dissection generally creates greater risk than sentinel lymph-node biopsy because more lymphatic structures are removed. Regional lymph-node radiation, extensive surgery, postoperative infection, higher body weight and reduced mobility may increase risk further. Research involving breast cancer populations—most of whom have been women—suggests that approximately one in five patients undergoing axillary lymph-node dissection may eventually develop lymphedema. Male-specific rates remain less clearly established because men are underrepresented in breast cancer survivorship research.

The earliest symptoms can be subtle. A man may notice that his watch feels tighter, his sleeve fits differently or one hand appears slightly fuller. The arm may feel heavy, fatigued, tight or unusually warm before obvious swelling is visible. Other signs include reduced flexibility, difficulty bending the elbow, aching, tingling, visible skin impressions or swelling around the chest, underarm or surgical scar.

A composite experience frequently described by survivors sounds like this: “My arm did not suddenly balloon. It simply felt heavier at the end of the day, and my shirt cuff became tighter.” Another common observation is, “I thought the chest swelling was ordinary weight gain until I realized it was only on the treated side.” These are representative statements, not quotations from identified patients, but they illustrate why early symptoms can be overlooked.

New swelling should not automatically be labeled lymphedema. Infection, a blood clot, medication effects, heart or kidney disease, and cancer recurrence can also produce swelling. Rapid onset, redness, increasing warmth, fever, severe pain, chest pain or shortness of breath requires prompt medical assessment. A specialist may diagnose lymphedema through history, examination and limb measurements. Bioimpedance spectroscopy, tissue assessment or imaging may be used when the diagnosis is uncertain or when subclinical changes are being monitored.

Although lymphedema is usually considered a chronic condition, early management can reduce swelling, preserve function and help prevent progression. Treatment should be individualized by a clinician trained in lymphedema care. Complete decongestive therapy commonly combines compression, exercise, skin care, education and, when appropriate, manual lymphatic drainage. Compression may involve a fitted sleeve and glove, chest garment or multilayer bandaging. An improperly fitted garment can constrict tissue or worsen symptoms, so professional measurement is important.

Exercise is not generally prohibited. Current clinical guidance supports gradual, progressive, supervised exercise, including resistance training, for people at risk of or living with breast-cancer–related lymphedema. Muscle activity helps move lymphatic fluid, while exercise supports weight management, strength and shoulder mobility. Sudden, excessive loading without conditioning is less advisable than measured progression accompanied by symptom monitoring. Academy of Oncologic Physical Therapy

Skin protection is also important because lymphedematous tissue is more vulnerable to infection. Survivors should moisturize dry skin, clean cuts promptly, protect against burns and insect bites, and seek medical care for spreading redness, warmth, tenderness or fever. These may indicate cellulitis, which can further damage lymphatic vessels and requires timely antibiotic treatment.

No precaution can guarantee prevention, and developing lymphedema does not mean that a survivor failed to care for himself. Some traditional restrictions involving blood-pressure measurements, injections, blood draws or air travel are supported by limited or inconsistent evidence and should be personalized rather than presented as absolute rules.

The most useful strategy is recognition followed by action. Establishing baseline arm measurements after treatment, reporting persistent changes and obtaining early assessment from a certified lymphedema therapist can make the condition more manageable. A survivor’s treatment may be over, but attention to lymphatic health remains an important part of long-term recovery.

References

1. Davies C, Levenhagen K, Ryans K, Perdomo M, Gilchrist L. Interventions for breast cancer–related lymphedema: clinical practice guideline from the Academy of Oncologic Physical Therapy of APTA. Phys Ther. 2020;100(7):1163-1179. doi:10.1093/ptj/pzaa087
2. Executive Committee of the International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2020 consensus document of the International Society of Lymphology. Lymphology. 2020;53(1):3-19. PubMed
3. Gillespie TC, Sayegh HE, Brunelle CL, Daniell KM, Taghian AG. Breast cancer-related lymphedema: risk factors, precautionary measures, and treatments. Gland Surg. 2018;7(4):379-403. doi:10.21037/gs.2017.11.04
4. Kwan JYY, Famiyeh P, Su J, et al. Development and validation of a risk model for breast cancer-related lymphedema. JAMA Netw Open. 2020;3(11):e2024373. doi:10.1001/jamanetworkopen.2020.24373
5. Ren Y, Kebede MA, Ogunleye AA, et al. Burden of lymphedema in long-term breast cancer survivors by race and age. Cancer. 2022;128(23):4119-4128. doi:10.1002/cncr.34489
6. Jørgensen MG, Toyserkani NM, Hansen FG, Bygum A, Sørensen JA. The impact of lymphedema on health-related quality of life up to 10 years after breast cancer treatment. NPJ Breast Cancer. 2021;7:70. doi:10.1038/s41523-021-00276-y
7. McNeely ML, Harris SR, Dolgoy ND, et al. Update to the Canadian clinical practice guideline for best-practice management of breast cancer-related lymphedema: study protocol. CMAJ Open. 2022;10(2):E338-E347. doi:10.9778/cmajo.20200276
8. National Cancer Institute. Lymphedema and cancer treatment. Updated March 6, 2024. Accessed August 30, 2026. https://www.cancer.gov/about-cancer/treatment/side-effects/lymphedema

Closing the Male Breast Cancer Research Gap

 The Missing Men in Breast Cancer Research

Written by: Lennard Goetze, Ed.D / Edited by: Daniel Root

Male breast cancer is uncommon, accounting for approximately 1% of breast cancer diagnoses. Its rarity, however, has produced a serious clinical problem: men have historically been excluded from many of the studies used to establish breast cancer treatment standards. As a result, physicians frequently treat men using evidence generated primarily—or sometimes entirely—in women. Many of these treatment principles are biologically reasonable and clinically effective, but important male-specific questions remain incompletely answered.

A 2018 analysis of 426 breast cancer clinical trials conducted between 2000 and 2017 found that 65% explicitly excluded men. Across the trials included in the enrollment analysis, only 0.42% of participants were male. The investigators also found that some exclusions occurred without a clear scientific justification. These findings should not be interpreted to mean that every current recommendation is unreliable. They demonstrate that the strength and directness of the evidence vary considerably. JAMA Oncology

The American Society of Clinical Oncology’s guideline for male breast cancer illustrates this limitation. Its evidence review identified only 26 descriptive reports or observational studies; prospective randomized evidence involving men was extremely limited. Consequently, many recommendations were adapted from research in women and supplemented by expert consensus. Surgery, radiation, chemotherapy, HER2-directed treatment and management of metastatic disease generally follow the same principles used for women because tumors are classified by stage and molecular characteristics—not simply by the patient’s sex. Nevertheless, direct male data are needed to determine whether effectiveness, dosing, toxicity and long-term outcomes are truly equivalent. ASCO guideline

Endocrine therapy is one of the clearest examples. Most male breast cancers are estrogen-receptor positive, making hormone-blocking treatment essential for many patients. ASCO recommends tamoxifen for men with hormone-receptor-positive early breast cancer when endocrine therapy is indicated, generally for an initial five years. Men who remain at high risk and tolerate treatment may be offered an additional five years. If tamoxifen cannot be used, an aromatase inhibitor may be combined with gonadotropin-releasing hormone suppression. An aromatase inhibitor used alone may not suppress estrogen adequately in men because the testes continue to contribute to hormonal production.

These recommendations are clinically rational, but the unanswered questions are substantial. Researchers need better information about optimal treatment duration, comparative effectiveness and male-specific adverse effects. Tamoxifen can cause hot flashes, sexual dysfunction, reduced libido, mood changes, weight changes and an increased risk of blood clots. These effects may lead some men to interrupt or discontinue therapy. Yet male-specific adherence strategies and symptom-management interventions have received far less study than treatment efficacy in women.

The research gap extends into survivorship. Men can experience lymphedema, neuropathy, persistent pain, fatigue, bone loss, infertility, body-image distress, anxiety, depression and fear of recurrence. Mastectomy can alter a man’s relationship with his chest and sense of masculinity, while being treated in environments designed almost exclusively for women may intensify isolation. Without sufficient male participation, researchers cannot accurately measure how frequently these problems occur, which patients are most vulnerable or which interventions offer the greatest benefit.

Representation also matters in genetic medicine. All men diagnosed with breast cancer should be offered genetic counseling and germline genetic testing, according to ASCO. Pathogenic variants—particularly in BRCA2, but also BRCA1 and several other cancer-susceptibility genes—can influence treatment, future cancer surveillance and risk assessment for relatives. Male participation in genomic studies can help clarify whether certain inherited variants, tumor mutations or molecular pathways affect disease behavior and treatment response differently.

There has been meaningful progress. In 2020, the U.S. Food and Drug Administration finalized guidance recommending that men be included in breast cancer drug-development trials unless a scientific reason justifies exclusion. The FDA also recognizes that conventional male-only randomized trials may be difficult because the disease is rare. It therefore supports combining clinical-trial evidence with observational studies, registries, electronic health records and other real-world data when appropriate. FDA guidance

Inclusion alone is not enough. Trial results should report male enrollment, treatment exposure, adverse effects and outcomes separately whenever the numbers permit meaningful analysis. Research networks must also collaborate internationally because no single cancer center is likely to enroll enough men rapidly. Remote participation, decentralized follow-up and partnerships with male breast cancer advocacy organizations may reduce geographical and social barriers.

Men should ask their oncology teams whether an appropriate clinical trial, registry, tissue study or survivorship study is available. Participation is always voluntary, and declining a study should never compromise standard care. Greater participation, however, can help move male breast cancer treatment from reasonable extrapolation toward directly demonstrated evidence. Men are not merely a small subgroup within breast cancer research. They are a clinically distinct population whose treatment experiences, toxicities and survivorship needs deserve to be measured, understood and represented.

References

1. Hassett MJ, Somerfield MR, Baker ER, et al. Management of male breast cancer: ASCO guideline. J Clin Oncol. 2020;38(16):1849-1863. doi:10.1200/JCO.19.03120
2. Duma N, Hoversten KP, Ruddy KJ. Exclusion of male patients in breast cancer clinical trials. JNCI Cancer Spectr. 2018;2(2):pky018. doi:10.1093/jncics/pky018
3. Corrigan KL, Mainwaring W, Miller AB, et al. Exclusion of men from randomized phase III breast cancer clinical trials. Oncologist. 2020;25(6):e990-e992. doi:10.1634/theoncologist.2019-0871
4. Reinisch M, Seiler S, Hauzenberger T, et al. Efficacy of endocrine therapy for the treatment of breast cancer in men: results from the MALE phase 2 randomized clinical trial. JAMA Oncol. 2021;7(4):565-572. doi:10.1001/jamaoncol.2020.7442
5. Cardoso F, Bartlett JMS, Slaets L, et al. Characterization of male breast cancer: results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program. Ann Oncol. 2018;29(2):405-417. doi:10.1093/annonc/mdx651
6. Ruddy KJ, Giobbie-Hurder A, Giordano SH, et al. Quality of life and symptoms in male breast cancer survivors. Breast. 2013;22(2):197-199. doi:10.1016/j.breast.2012.12.014
7. US Food and Drug Administration. Male Breast Cancer: Developing Drugs for Treatment—Guidance for Industry. Published August 2020. Accessed August 30, 2026. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/male-breast-cancer-developing-drugs-treatment

When New Symptoms Shouldn’t Be Ignored

After Male Breast Cancer: Why Every New or Persistent Symptom Deserves Attention

Written by: Lennard M. Goetze

Completing treatment for male breast cancer is an important milestone, but “cancer-free” does not mean that follow-up care should end. Most men treated for early-stage breast cancer will not experience a recurrence. Nevertheless, breast cancer can return months or years after treatment, and recognizing a concerning change may permit earlier diagnosis and more timely treatment. A previous cancer history should therefore increase clinical attentiveness—not become a reason to dismiss a new symptom as insignificant.

Breast cancer recurrence is generally classified in three ways. A local recurrence develops in the remaining breast tissue, mastectomy area, skin or surgical scar. A regional recurrence involves nearby lymph nodes, including those under the arm, around the collarbone or within the chest. A distant recurrence—also called metastatic or stage IV breast cancer—occurs when breast cancer cells establish disease in another organ, most commonly the bones, lungs, liver or brain. Even when found elsewhere, the disease remains breast cancer and is treated according to its breast-cancer biology. American Cancer Society

Men should report a new lump or thickening in the breast, chest wall, mastectomy scar or underarm. Other potentially important findings include persistent redness, ulceration, puckering, dimpling, warmth, skin thickening, nipple retraction or unexplained nipple discharge. Swelling above the collarbone, beneath the arm or along the chest may indicate an enlarged lymph node, although infection and other noncancerous conditions can produce similar findings. Arm or hand swelling may represent lymphedema resulting from lymph-node surgery or radiation, but new, rapidly worsening or unexplained swelling still requires evaluation.

Symptoms outside the chest also matter. Persistent, localized bone or back pain—particularly pain that worsens at night, occurs at rest or is not associated with an injury—may require assessment. Breast cancer can spread to bone, although arthritis, osteoporosis, muscle strain and treatment-related changes are far more common explanations. A fracture occurring after minimal trauma, new difficulty walking, leg weakness, numbness, or loss of bladder or bowel control demands urgent medical attention because spinal-cord compression must be excluded.

Possible lung-related symptoms include a persistent cough, increasing shortness of breath, wheezing, chest discomfort or coughing up blood. These symptoms may arise from asthma, infection, heart disease, a blood clot or treatment-related injury, as well as cancer. Sudden breathlessness, severe chest pain, fainting or coughing blood should be treated as an emergency rather than deferred to a routine oncology appointment.

Liver involvement may produce persistent right-upper abdominal discomfort, loss of appetite, nausea, abdominal swelling, itching, dark urine or yellowing of the skin and eyes. Possible neurological warning signs include a new or progressively worsening headache, seizures, confusion, personality changes, impaired balance, visual or speech changes, or weakness or numbness on one side. Sudden neurological symptoms warrant emergency evaluation because stroke and other immediately dangerous conditions must also be considered.

General symptoms—such as unintended weight loss, unusual fatigue, reduced appetite, recurring nausea or a decline in physical functioning—are less specific. They are commonly caused by medication effects, hormonal therapy, anemia, infection, sleep problems, depression or other medical conditions. Their importance lies in persistence, progression, lack of an obvious explanation or occurrence alongside more localized signs. Men should not assume that every ache indicates recurrence, but neither should they repeatedly ignore a change that is new, worsening or unresolved.

Evaluation begins with a careful history and physical examination. The clinician should review the original tumor’s stage, lymph-node involvement, estrogen-receptor, progesterone-receptor and HER2 status, previous treatments, current medications and hereditary risk. Testing is then directed by the symptom. It may include diagnostic mammography or ultrasound for a chest-wall or breast abnormality; CT, MRI, PET or bone imaging for suspected distant disease; and laboratory studies when liver, blood or metabolic abnormalities are possible. A suspicious lesion generally requires biopsy because imaging alone cannot definitively establish whether it represents recurrence, a new primary cancer or a benign condition.

Routine whole-body scans and tumor-marker blood tests are generally not recommended for asymptomatic survivors of early-stage breast cancer because they have not been shown to improve outcomes and can generate false alarms. Symptoms or abnormal examination findings, however, change the equation and may create a clear indication for diagnostic testing. The American Cancer Society specifically notes that men generally do not require routine blood or imaging tests after treatment unless signs or symptoms suggest possible recurrence. American Cancer Society

The practical message is vigilance without panic. Survivors should maintain scheduled follow-up visits, follow their individualized survivorship plan and promptly document when a symptom began, whether it is worsening and what makes it better or worse. If a concern is dismissed but persists, requesting reassessment or an oncology review is reasonable. Having “beaten” breast cancer should never disqualify a man’s new symptoms from thoughtful medical evaluation.

References

1. Hassett MJ, Somerfield MR, Baker ER, et al. Management of male breast cancer: ASCO guideline. J Clin Oncol. 2020;38(16):1849-1863. doi:10.1200/JCO.19.03120
2. Khatcheressian JL, Hurley P, Bantug E, et al. Breast cancer follow-up and management after primary treatment: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31(7):961-965. doi:10.1200/JCO.2012.45.9859
3. Runowicz CD, Leach CR, Henry NL, et al. American Cancer Society/American Society of Clinical Oncology breast cancer survivorship care guideline. CA Cancer J Clin. 2016;66(1):43-73. doi:10.3322/caac.21319
4. Loibl S, André F, Bachelot T, et al. Early breast cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2024;35(2):159-182. doi:10.1016/j.annonc.2023.11.016
5. Yadav S, Sangaralingham L, Payne SR, Giridhar KV, Hieken TJ, Boughey JC. Surveillance mammography after treatment for male breast cancer. Breast Cancer Res Treat. 2022;194(3):693-698. doi:10.1007/s10549-022-06645-w
6. Niell BL, Lourenco AP, Moy L, et al. ACR Appropriateness Criteria® evaluation of the symptomatic male breast. J Am Coll Radiol. 2018;15(11S):S313-S320. doi:10.1016/j.jacr.2018.09.017
7. National Cancer Institute. Follow-up medical care. Updated December 2, 2024. Accessed August 30, 2026. https://www.cancer.gov/about-cancer/coping/survivorship/follow-up-care
8. American Cancer Society. After male breast cancer treatment. Updated October 15, 2025. Accessed August 30, 2026. https://www.cancer.org/cancer/types/breast-cancer-in-men/after-treatment.html

SURVIVORSHIP PROGRAM: A Whole-Person Approach to Recovery

BUILDING A STRONGER MODEL FOR CANCER SURVIVORSHIP

Recurrence-Risk Reduction and Quality of Life

Written by: Lennard M. Goetze, Ed.D  /  Edited by: Bobbi Kline, MD

Finishing cancer treatment is an extraordinary milestone. But ringing the bell, completing radiation, recovering from surgery or receiving the final infusion does not necessarily mean that cancer care should end. For many survivors, it marks the beginning of an entirely different phase of healthcare: survivorship.

Cancer and its treatments can leave lasting effects on strength, cardiovascular health, metabolism, bone health, cognition, sleep, emotional wellness, sexuality, nutrition and mobility. Survivors may be cancer-free yet continue to experience fatigue, weakness, neuropathy, lymphedema, anxiety, hormonal changes, cognitive difficulties and uncertainty about how to regain their health.

This is particularly important in male breast cancer, where men may already feel underserved within a disease traditionally associated with women. Male breast cancer survivors require the same serious attention to rehabilitation, physical conditioning, nutrition, emotional recovery, surveillance and long-term quality of life as every other cancer survivor.

The Cancer Survivorship & Recovery Program proposes a simple philosophy: Cancer care should not end when treatment ends—and wellness should not have to wait until treatment is over.

Two Pathways, One Continuum of Care

The first pathway begins during active cancer treatment. Rather than viewing exercise and wellness only as post-treatment activities, medically appropriate movement can help individuals preserve strength, mobility, independence and quality of life while undergoing chemotherapy, radiation, immunotherapy, hormonal therapy, surgery and other treatments.

This is not conventional fitness training. Cancer-informed exercise may incorporate aerobic conditioning, resistance exercise, flexibility, balance, mobility and restorative movement, modified according to treatment schedules, fatigue, surgical restrictions and individual medical circumstances.

For a man undergoing male breast cancer treatment, for example, recovery may include addressing upper-body mobility following surgery, deconditioning, treatment-related fatigue, hormonal effects, cardiovascular fitness and the psychological impact of a diagnosis many men never imagined they could receive.

The second pathway addresses post-treatment cancer recovery. Its central question is one almost every survivor eventually asks: “What can I do now to become healthy again?” The answer must extend beyond surveillance scans.

Ten Areas of Survivorship

A comprehensive survivorship strategy addresses interconnected areas of health: exercise oncology and physical reconditioning; cancer-informed nutrition; recurrence-risk reduction and preventive health; cardiovascular and metabolic health; strength, bone health and mobility; lymphedema, neuropathy and physical rehabilitation; sleep, stress and emotional recovery; sexual and hormonal health; cognitive health; and returning to work, family and everyday life.

Exercise oncology can help survivors progressively move from recovery to conditioning, from conditioning to strength, and ultimately toward sustainable lifelong activity. Nutrition should similarly move beyond miracle foods and restrictive trends toward sustainable eating patterns supporting protein needs, healthy body composition, cardiovascular and metabolic health, bone health and overall nutritional adequacy.

Recurrence is understandably one of survivors' greatest concerns. No responsible program should promise that lifestyle can prevent cancer from returning. Survivorship care can, however, help individuals address modifiable health factors through physical activity, nutrition, tobacco avoidance, healthy weight management where appropriate, medication adherence, recommended surveillance and cardiovascular and metabolic risk management.

For male breast cancer survivors, survivorship also means recognizing needs that may receive insufficient attention. Men can experience lymphedema, reduced mobility, changes in body image, sexual concerns, hormonal effects, fear of recurrence, anxiety and difficulty discussing the emotional consequences of breast cancer. These are not secondary issues. They are part of survivorship and quality of life.

An Individual Survivorship Health Plan

Every survivor should ultimately have an Individual Survivorship Health Plan reflecting cancer history, treatment exposures, present health, functional limitations and personal goals.

The plan can address exercise, nutrition, rehabilitation, surveillance, cardiovascular and metabolic health, bone health, lymphedema and neuropathy, sleep, cognition, emotional wellness, sexual and hormonal health, family support and return-to-work goals. Progress can then be reassessed over time rather than leaving the survivor with the vague instruction to simply “take care of yourself.”

This requires a multidisciplinary approach involving oncology, primary care, exercise oncology, nutrition, physical and occupational therapy, behavioral health, rehabilitation and other specialists as appropriate.

For organizations serving the male breast cancer community, this broader model offers another opportunity: ensuring that men are not simply represented during diagnosis and treatment, but supported throughout the years that follow.

Measuring More Than Survival

Cancer medicine appropriately measures survival, treatment response, disease progression and recurrence. Survivorship asks us to measure something else: How well is the survivor living? Strength matters. Mobility matters. Sleep matters. Relationships matter. Returning to work matters. Emotional health matters. Being able to enjoy family, travel, exercise and everyday life matters. For male breast cancer survivors—and indeed for all people affected by cancer—the objective cannot be merely adding years after treatment. It must also be helping survivors put health, strength, independence, confidence and quality of life back into those years.

Survivorship should not simply mean that treatment stopped. It should mean that another phase of care has begun.

This report is brought to you by the Institute for Progressive Health Sciences, in collaboration with BeMore Advisory™, the National Cancer Collective and the Male Breast Cancer Global Alliance. All Rights Reserved.

 

The Strength of Solidarity (NCC Part 3) - DRAFT- DO NOT SHARE/PUBLISH

 LIVESTRONG and the National Cancer Collective Find Common Ground

8/21/2026 - In the cancer world, progress is often measured in research discoveries, new therapies, improved diagnostics and survival statistics. Yet another form of progress can be equally powerful: the decision to work together.

That spirit defined a recent meeting between representatives of LIVESTRONG and the newly formed National Cancer Collective (NCC)—a conversation that began as an introduction and quickly became an exploration of shared purpose, survivorship, advocacy, exercise oncology, education and collaboration.

Representing LIVESTRONG were Kristyn Arnold, Director of Mission and Impact and Elyse A. Bernal, Vice President, Mission and Philanthropy. Their participation brought both programmatic and advocacy perspectives into the discussion, creating an immediate bridge between LIVESTRONG’s national survivorship work and the collaborative mission being advanced by the NCC.

The National Cancer Collective was designed and co-architected by Lennard Goetze, CEO of Firefighters Against Cancers & Exposures and the New York Cancer Resource Alliance, alongside Cheri Ambrose of the Male Breast Cancer Global Alliance, with survivor-advocate Scott Baker serving as the NCC’s lead ambassador. Its founding premise is deliberately simple: cancer organizations can accomplish more when their knowledge, resources, audiences and advocacy strength are connected rather than isolated.

As Goetze summarized during the meeting, cancer is not conquered by one organization or one person: “It is won by a village.” The NCC was created to help build that village by encouraging organizations to learn from one another, share resources and pursue advocacy through collective thought and action.

That philosophy found immediate common ground with LIVESTRONG.

Scott Baker provided the human bridge between the organizations. Following his second stem-cell transplant in 2013, Baker entered the LIVESTRONG at the YMCA program in Saratoga Springs, New York. He subsequently became a mentor and estimates that he has interacted with nearly 500 people through the program—exercising beside them, sharing experiences and building community. During the meeting, he raised one particularly ambitious possibility: bringing advocates together to pursue a comprehensive survivorship bill.

His experience also illustrated a larger principle underlying the NCC: survivorship is strengthened when survivors become resources for one another. Baker recalled how people visited him while he was hospitalized and isolated, conversations that remained meaningful years later. His continued outreach to other people facing cancer is, in many respects, an act of paying that support forward.

“Sometimes the most powerful resource we can give another survivor is not an answer. It is our presence—and the assurance that they do not have to walk forward alone.”

A Shared Definition of Survivorship

One of the strongest points of alignment involved what happens beyond cancer treatment.

Bernal described LIVESTRONG’s advocacy work as deeply rooted in survivorship and quality of life, including the needs of caregivers and the many challenges that continue after active treatment has ended. Her comments reinforced a concern shared by the NCC: too many people reach the end of treatment only to discover that the formal system of support suddenly becomes much quieter.

Arnold added the programmatic perspective, particularly in the area of exercise oncology. Her discussion demonstrated how LIVESTRONG has built multiple access points for survivors, including LIVESTRONG at the YMCA, CancerFit-certified professionals, virtual programming and approximately 250 free on-demand exercise videos. The approach recognizes that recovery is not linear and that people need options that reflect how they feel on any given day.

This resonated strongly with the NCC participants. The conversation advanced the idea that survivorship should be viewed as a continuum of cancer care beginning at diagnosis, rather than as a separate phase that begins only after treatment ends.

From Conversation to Collaboration

Several practical ideas emerged from the meeting.

Arnold offered to provide direct pathways to LIVESTRONG’s CancerFit video resources, search tools and exercise survey, while NCC participants discussed sharing those resources with their own communities. The organizations also explored reciprocal newsletter visibility, professional-network engagement and the possibility of continuing communication through LinkedIn and other digital channels.

Another exciting possibility involved the Male Breast Cancer Global Alliance’s developing Exercise Fest—a livestream and educational video initiative focused on movement and survivorship. The discussion opened the door to potentially connecting that concept with LIVESTRONG resources and expertise, while also examining how existing CancerFit content could complement rather than duplicate new programming.

That distinction matters. Collaboration does not require organizations to surrender their identities or reproduce one another’s work. It asks a better question:

“What do you already do extraordinarily well—and how can we help more people find it?”

That may ultimately be the most important outcome of the meeting.

The NCC is not being built to become another organization competing for space in an already crowded cancer landscape. Its larger opportunity is to become a connector of organizations, advocates, clinicians, educators, survivors and resources—a place where one group’s strength can become another community’s resource.

LIVESTRONG and the NCC share an important belief: survivorship is not passive. It involves movement, education, advocacy, connection, caregiving, policy and the restoration of quality of life. Most importantly, both recognize the extraordinary value of community.

The National Cancer Collective will continue reaching outward—to large national organizations, small community nonprofits, specialized cancer groups, survivor networks and emerging advocacy programs—with the same invitation:

Bring what you know. Share what you have learned. Tell us where the gaps remain. And let us discover what becomes possible when we work together.

Because solidarity is more than standing beside one another. Solidarity is turning many individual missions into collective momentum.

And as the National Cancer Collective continues to grow, that remains its commitment: to connect rather than compete, to share rather than isolate, and to keep building the village that no person facing cancer should ever have to live without.

BUILDING THE NATIONAL CANCER COLLECTIVE (Part 1)

 MBCGA and NCC Open Collaborative Dialogue with FORCE

By Catherine Crowley & the UNCOVERED Editorial Team

8/11/2026- The cancer advocacy community possesses extraordinary expertise, resources, and committed organizations. Yet many of the challenges facing patients and survivors—early detection, genetic risk, access to care, rehabilitation, mental health, survivorship, research, and public policy—extend well beyond the boundaries of any single cancer diagnosis.

This reality is helping drive the development of the National Cancer Collective (NCC), a national initiative designed to bring cancer organizations, survivors, advocates, healthcare professionals, researchers, educators, and policy stakeholders into a larger collaborative community.

An important early step in that effort occurred recently when the Male Breast Cancer Global Alliance (MBCGA) hosted a strategic discussion with FORCE (Facing Our Risk of Cancer Empowered). Representing FORCE was Lisa Schlager, Vice President of Public Policy. The meeting included MBCGA CEO Cheri Ambrose, NCC, Firefighters Against Cancers and Exposures President Lennard Goetze, Ed.D, survivorship ambassador and NCC leader Scott Baker and Assoc. Director of IPHS (Institute for Progressive Health Sciences) Dan Root.

The NCC team is especially appreciative of FORCE and Schlager for taking the time to meet, exchange ideas, and explore areas of common interest. The conversation represented precisely what the National Cancer Collective hopes to encourage across the country: organizations meeting organizations, advocates meeting advocates, and leaders discovering where their missions intersect.

Collaboration Without Losing Identity

The NCC is not being created to compete with or replace established cancer organizations. Quite the opposite. Its purpose is to help connect them.

Cancer advocacy in America is extensive but decentralized. Individual organizations have developed important expertise within particular cancers, patient populations, research priorities, and policy initiatives. NCC seeks to provide connective infrastructure through which those organizations can maintain their identities while gaining access to a broader advocacy network.

As Goetze explained, the cancer community does not necessarily need organizational duplication. What is often missing is an infrastructure that enables existing organizations, advocates, survivors, and professionals to find one another and identify where their priorities intersect.

That philosophy places partnership-building at the center of the NCC mission.

Potential collaborations may include educational programs, shared communications, research partnerships, survivorship initiatives, professional introductions, legislative advocacy, public awareness campaigns, and coordinated outreach.

Learning from FORCE

The meeting with FORCE was particularly meaningful because of the organization's established experience in hereditary cancer education, advocacy, community engagement, and public policy. For a developing national network such as NCC, conversations with experienced organizations provide opportunities to learn, understand existing priorities, avoid unnecessary duplication, and identify where additional collaboration may create value.

Schlager emphasized that effective public policy becomes stronger when patient and family experiences are connected with accurate information and organized advocacy. Creating better communication among these constituencies can ultimately contribute to more informed healthcare policy.

Importantly, the meeting was an introductory dialogue rather than the announcement of a predetermined formal partnership. That distinction reflects NCC's philosophy: meaningful alliances should grow from communication, mutual respect, complementary capabilities, and clearly identified opportunities to work together.

Building the National Network

This meeting is only a beginning. The National Cancer Collective's immediate priority is outreach and relationship development. NCC intends to meet cancer organizations across disease categories and invite survivors, advocates, healthcare leaders, researchers, educators, and policy stakeholders to participate in building a more connected national cancer community.

The goal is not for every organization to become the same. The goal is to create solidarity where common interests exist. NCC believes organizations can accomplish more when mechanisms exist to communicate efficiently, share knowledge, support important initiatives, and collaborate where missions intersect.

The National Cancer Collective therefore extends a simple invitation to the cancer advocacy community: Come to the table. Bring your expertise, your mission, your experiences, and your voice.

NCC extends its sincere appreciation to FORCE and Lisa Schlager for joining this early conversation and to MBCGA for helping open the door. One meeting does not build a national collective. But one meeting can begin a relationship—and enough relationships can build a movement.