Metastatic Male Breast Cancer: A 90-Year-Old's Journey Highlights Advances in Targeted Therapy
Key Insights
Joe Gadawski, a 90-year-old male breast cancer (search) patient, experienced a metastatic recurrence to his bones in 2024 after 16 years of being cancer-free following his initial 2009 diagnosis.
His comprehensive treatment regimen at Roswell Park includes four medications: estrogen suppression, testosterone suppression, a bone-strengthening infusion, and Kisquali (search) (ribociclib) for fighting the cancer.
The patient and his wife, a former nursing dean, emphasize that the treatments available in 2024 did not exist 16 years prior, underscoring the critical role of clinical research and trials.
Joe Gadawski, now 90 years old, knows he is a lucky man. His wife of 44 years, Nancy McGlen, first spotted the inverted right nipple that led to his initial breast cancer diagnosis in 2009. Sixteen years later, in the summer of 2024, a routine blood test revealed that the cancer had returned — this time metastasized into his bones.
Gadawski's case illuminates both the challenges of metastatic male breast cancer (search) and the therapeutic progress made possible through decades of clinical research at comprehensive cancer centers like Roswell Park Comprehensive Cancer Center in Buffalo, New York.
A swift, coordinated response to recurrence
After 16 years of being breast-cancer free with regular mammograms and monitoring, Gadawski began feeling unusually tired and unable to complete his normal rounds of golf with his son and grandson. A blood test showed a higher-than-expected level of a biomarker, signaling that the cancer had returned and spread to his bones.
Within hours of receiving the test results, Gadawski and his wife returned to Roswell Park, where breast oncologist Ellis Levine, MD, and surgical oncologist Helen Cappuccino, MD, reviewed his PET scan. They quickly identified a tumor in the breast tissue on his right side.
"They knew right away by looking at it," Gadawski said. "We met with them on Friday and quickly scheduled a number of tests to determine the best course of treatment."
Dr. Levine expressed particular concern about Gadawski's spine, as bone cancer can be invasive and cause serious complications. The treatment plan included radiation targeting the shoulder, neck, and spine — where the cancer was most concentrated — in addition to chemotherapy.
A comprehensive four-drug regimen
By September 2024, Gadawski began taking Tamoxifen, an estrogen suppressor used to fight breast cancer, to help protect his bones. "Within six months, it was gone," he said, and he remained on the medication for 10 years.
Today, Gadawski remains on four medications: one for estrogen suppression, a testosterone suppressor, an infusion for bone strength, and Kisquali (search) (ribociclib) for fighting his cancer. This comprehensive, multi-pronged approach is designed to keep him healthy and strong.
The role of research and clinical trials
Nancy McGlen, who helped revive Niagara University's nursing program and served as a dean for 16 years, brings a unique perspective to her husband's care journey. With her background in science and medicine, she understands the critical role research has played in making the treatments available to her husband possible.
"We firmly believe it's critical," she said. "What you find today, the next research project may show was false or needs to be modified. That is the important part: Science is not always perfect, or give you a perfect result, but it is correctable and changeable with new information, new studies, new research. That's the heart of what makes Roswell different from a regular clinic."
Gadawski was willing to enroll in any clinical trials that might have been a good fit for him, but he was ineligible. Nevertheless, both he and his wife recognize that he benefited from the trials offered to patients who came before him.
"The new treatments and trials very well could be part of something that might save you or someone else down the road," McGlen said. "It's wonderful that Roswell is here, doing the research, staying abreast of what's happening, innovating in various areas of cancer, because the treatment Joe had wouldn't have existed 16 years ago."
Support beyond treatment
During his second round of treatment, Gadawski discovered the New Era Foundation Elevate Salon, located near the breast clinic on the first floor of the Scott Bieler Clinical Science Center at Roswell Park. The salon provides haircuts and caps for patients undergoing radiation or chemotherapy. "They gave me three! I rotate: a white one, a black one and a blue one," he said.
Reflecting on the care he received, Gadawski became emotional. "We don't know what we have in Buffalo," he said. "We don't know the quality of doctors we have here. I start to cry thinking about it. We don't know how fortunate we are."