The Magazine, June 6, 2002
FACE TO FACE
What
every man should know
Breast
cancer in men is one of many battles Dr Rajiv Datta is fighting
By Arun Kristian Das
Sometimes he has to break difficult news to people. It's part of his job, which his patients say he does with great compassion. As chief of surgical oncology and head and neck surgery at South Nassau's Cancer Center, in Valley Stream, New York, Dr Rajiv Datta sometimes breaks bizarre news to his patients, too.
Consider the story of Long Islander James Cratty.
June 2001. Cratty knew something was wrong. While showering, he felt a lump on his chest and saw blood oozing from his nipple. Lump and blood: not good signs.
"When you feel something on your body that's not supposed to be there, you get a feeling from the bottom of your stomach, all the way up, like: 'Oh s***, there's something wrong with me', " says Cratty, 62, of Wantagh, NY.
The ugly fear in his gut was also his salvation. Unlike many men in such a situation, Cratty didn't hesitate to see his family physician, who suspected a cyst. After a mammogram and subsequent surgery, he got the strange news.
Breast cancer. In a man.
That was Datta's diagnosis. Over the last two years, he has treated three men for breast cancer. "It's pretty low percentage-wise, but it can happen," he says. "If any male gets a lump in the breast or bloody nipple discharge, that should not be ignored."
Breast cancer in men is truly rare. According to the National Cancer Institute, less than one percent of all breast cancers in the Unites States occur in men, so the disease receives scant attention from the public, and equally little research.
Most research on breast cancer is based on female patients, and so treatment for men with the disease is, by default, the same (see sidebar, "Seeing and disbelieving"). "Since we don't have enough numbers, our treatment is completely geared towards female breast cancer," says Datta. He is concerned the one-size-fits-both approach to treating the disease is not ideal. But he hopes that will change. "One way is to get cohesive trials from centers around the country," he says, "so that we can accumulate data and come up with some meaningful answers."
For Datta, fighting breast cancer in men is one small battle. He also specializes in treating other soft-tissue sarcomas and melanomas, and performing pancreatic and head-and-neck surgery. With great energy, he drives his professional home of the last two years, South Nassau's Cancer Center.
Datta was director of surgical oncology at Brooklyn's Maimonides Medical Center when, in 2001, the South Nassau Communities Hospital, in Oceanside, NY, asked him to build the surgical oncology program at its new satellite Cancer Center in nearby Valley Stream. The challenge lured him across the city line and into Nassau County on Long Island.
"My aim of coming here [was] to do major surgery which is available locally, so patients don't have to make a trip to the city," says Datta. The Center aims to be a high-quality regional alternative to major players in the New York area, such as Memorial Sloan-Kettering Cancer Center and big university hospitals.
Datta wants cancer patients on Long Island and in eastern Queens and Brooklyn to receive excellent care in a community center setting close to home.
One crucial way of doing this, he says, is to create a comprehensive treatment program incorporating medical, surgical and radiological oncology services provided by specialists in each field. "The patient should be seen by all three specialists," he says. "Research has shown that the multidisciplinary approach gives a better cure rate for patients."
"Three or four heads are better than one in treating these complex diseases," Datta asserts. The treatment improves, he says, and thus the quality of care.
The specialists are backed by staff members trained in nursing care, postoperative speech therapy, pain management, family counseling, oncological psychology and even spiritual guidance. It's a virtual oncology stop-and-shop.
Naturally, the physician to spearhead this effort must be highly trained and motivated. New Delhi-born and Mumbai-raised Datta, 41, has a CV impressive enough to inspire -- or perhaps terrify -- the wide-eyed medical student. He has enough education for three doctors.
With encouragement from his parents, especially his mother, Datta earned his MD from Grant Medical College in Mumbai and followed it up with surgical oncology training at the city's Tata Memorial Cancer Center. He then spent about three years in the United Kingdom, receiving advanced training in surgical oncology and plastic surgery.
Datta came to the United States in 1994, and like many foreign-trained physicians, was required to complete a residency again, in his case at Maimonides in Brooklyn. A research fellowship at New York City's renowned Memorial Sloan-Kettering and two surgical fellowships at Roswell Park Cancer Institute in Buffalo, NY, followed.
The trim and tall doctor, a fellow of both the American College of Surgeons and the International College of Surgeons, finds time for a family. Datta says his wife Arti, a PhD in cell biology, "has been a very positive support" for his career while also raising their two daughters, aged five and seven.
Datta takes great joy in caring for his patients, who regard him as a friend. "I learn every day from these people," he says. "Even if somebody knows they have six months or eight months to live, you should see their attitudes. They go about their lives, spreading happiness."
His patients are clearly taken by the doctor's honest eyes and warmhearted demeanor. "He's such a gentle person," says Cratty, who visits Datta every four months for checkups. "When I was in the hospital [for the surgery], he would come into the room every couple of hours to see how I was doing, and the guy in the next bed said, 'Well who do you know?' "
Datta says his patients "are always delighted if you can do something for them, and they have no regrets if you cannot."
"They make you love taking care of them," he says, "because you are a winner either way."
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