Breast cancer is not exclusive to women. One man who beat the disease speaks to Karen Stephen.

BACK in June, 1993, Derek Worthington noticed a tenderness around his left nipple. He thought nothing of it, and the then 59-year-old continued his normal life.

His nipple then became inverted and he noticed a slight swelling on his chest, but still he did not contact his GP.

"Looking back, I was stupid not to go to my doctor as soon as I noticed a change," says Derek, now aged 70. "But, in all honesty, I didn't want to hear anything bad."

A visit to the doctor about something else quickly revealed that Derek had breast cancer.

"I'd read about breast cancer in my wife's magazines, but thought it was something only women got," he says.

Things moved quickly, and within a fortnight Derek had seen a consultant, been admitted to the former Bolton Royal Infirmary and was awaiting surgery.

In men, breast cancer is a rare disease, with approximately 300 cases diagnosed in the UK each year - about one man for every 130 women diagnosed.

As with women, the single biggest risk factor for male breast cancer is age, with most cases in men being diagnosed between the ages of 60 and 70.

Other factors include high oestrogen levels, exposure to radiation or a family history of breast cancer.

All men produce some oestrogen - this is perfectly normal - but high levels have been linked to breast cancer and can occur in those who are obese, as oestrogen is made in fat tissues.

Men who have been exposed to radiation repeatedly over a long period of time - particularly from a young age - are more likely to develop breast cancer, as are men with women in their family who have already been diagnosed with this form of cancer.

This is particularly true if the women are close relations, such as a mother or sister, and if they were diagnosed under the age of 40.

Between five and 10 out of every 100 breast cancers diagnosed in women are thought to be due directly to an inherited faulty gene. In men, this may be more common.

But Derek had no reason to believe he would be at risk, and the news floored him.

"My blood pressure was sky high and I was absolutely terrified," he says. "I remember wishing I'd gone to the doctor sooner."

Derek, who has never smoked and drinks very little, had a mastectomy to stop the further spread of what proved to be a malignant growth.

As well as the flesh around his breast and nipple, the surgery had to remove a lymph gland in his right armpit.

He also had a course of chemotherapy, which is used to treat the whole body - the drugs circulate through the bloodstream and will attack the breast cancer cells wherever they are.

Both these treatments can be used to try to lower the risk of the cancer coming back, or treat breast cancer that has spread.

"I was also put on Tamoxifen, which made me feel quite sick for a while," Derek says. "But I stopped taking it after six years - apparently you become immune to it by then."

He was given the all-clear a couple of years ago - he had his last hospital check-up in October, 2003 - and now lives "for every day".

The only physical reminder he has of his breast cancer is a neat scar stretching from his breastbone to underneath his left arm.

He took early retirement from his job at the Town Hall, and now spends much of his time tending his garden.

But the mental reminders are still there. He is fully aware that, had he checked his breasts on a regular basis, he might not have needed surgery.

"The thing with cancer is you don't know it's there," he says. "It's a silent killer. And a lot of men are still completely ignorant to the fact that they can get breast cancer.

"This is why men need to check themselves regularly for any lumps or changes, and, if they do find something, get to the doctor straight away. Don't do what I did and hope it will go away - it won't."

Fact file:

The single biggest risk factor for male breast cancer is increasing age.

Symptoms to look out for include swelling of the breast, an inverted nipple, lumps under the arm, a sore in the skin of the breast or a discharge from the nipple.

Diagnosis can be through an ultrasound, a mammogram or a biopsy.

There are different types of breast cancer, with the most common in both men and women being invasive ductal carcinoma.

Treatment varies, and is decided by the stage of the cancer. Options include surgery, radiotherapy, hormone therapy and chemotherapy. Mastectomy is the most common operation.