When he was diagnosed with double breast cancer in December, David Engle was faced with a dilemma of conscience.

Should the man who holds the right to privacy in high esteem share his ordeal with his friends, neighbors and strangers, or hide away something that could potentially be embarrassing?

He chose to speak out about the disease typically affecting women, as well as men, encouraging everyone to be vigilant regardless of their gender.

“The odd thing is I am a pretty private person,” Engle,70, said. “When I was diagnosed, I had to make this choice. How do I talk about this? Do I just tell people I’ve got cancer and I’ve got to deal with it, or do I call it what it is?”

The Port Townsend resident decided to use the situation to achieve some good, he said.

“At some point very early on, I decided I am just going to say what it is and not be embarrassed by it,” Engle said. “There is that too, men don’t get breast cancer because men don’t have breasts. What I have reminded people, including my doctor, is that we are all mammals. We all have some mammary action in our bodies.”

Engle calls on fellow men to be aware of the potential for breast cancer, encouraging them to be aware of the risks and symptoms to promote early detection.

“Early detection in men is so critical to survival,” Engle said. “It is to anybody, but men typically, according to the Cancer Care Alliance underreport. Women will get it checked. Men just don’t. The majority of men will wait until it is too late. I thought, this is a misfortune for me but I can tell this story. If it helps one family avoid catastrophe, then it is worth it.”

Rare but possible

While less common among men than women, breast cancer can still strike at a moment’s notice.

When Engle was diagnosed with invasive breast cancer Dec. 6, he said he was staggered.

“It was a shock and surprise for everybody,” Engle said. “I have had a couple of friends my age who have had prostate cancer. If the doctor had said that is the diagnosis, I would have said, ‘OK. I know how to deal with that.’”

In 2019, the American Cancer Society estimates about 2,670 new cases of invasive breast cancer will be diagnosed in American men, with 500 not surviving the disease.

Breast cancer is about 100 times less common among white men than among white women. For men, the lifetime risk of getting breast cancer is about 1 in 833, according to the American Cancer Society.

Cancer does not run in Engle’s family, he said.

“My mom is 93 and living independently,” Engle said. “My dad died at 87 after a well-lived life. On my side of the family, they did a history and I have participated in some genetic research.”

Engle is also an avid bike rider, non-smoker, non-drinker and a vegetarian, which makes the diagnosis even more unique.

“The doctor finally told me there is such a thing as unfortunate, unlucky,” Engle said.

Putting the community first

Engle retired as Port Townsend’s Superintendent of Schools in 2016.

Before that, he worked with school systems around the world and in the private sector with the Educational Testing Service while living in New Jersey, he said. He also was principal at Interlake High School in Bellevue and Ballard High School in Seattle.

He has remained active in the community, and is a founding member of the Port Townsend Cycle School and current president of the Rotary Club of Port Townsend.  

“Because people know me in the community, it gives my story some credibility that it might not have from somebody else,” Engle said. “That is why I want to be open about this. My first public outing was at a Rotary meeting. Once I had the diagnosis, I told my Rotarians at the regular meeting I have been diagnosed with breast cancer. Here is the deal treatment-wise, and I want you guys to know this is a Rotary story just unfolding.”

It was during another Rotary meeting that Engle said he learned of the existence of male breast cancer.

“When I took over in July 2018 we had a presenter come, Nancy Hughes from the StoveTeam International project, where they make really efficient little burn stoves for Central America,” Engle said. “They came to do a presentation on this project they were doing in Central America for the Rotary, and she mentioned in passing that her husband had died of breast cancer and she stopped and said, ‘You men out there pay attention to your systems,’ so I assume from that he didn’t.”

Sometime later, Engle began experiencing tenderness in his left breast, he said.

“It wasn’t a big deal, and typically I would have just ignored it, but that story was in my head so I told (my wife) Margaret I am going in to see my general practitioner in Bellingham,” Engle said. “I went into see him and he said, ‘Well, I don’t see anything here but let's do a mammogram, just for precautionary sakes.’ We did the mammogram and, red alert.”

The attending doctors immediately ordered a biopsy.

“Sure enough, they found cancer cells in my left side,” Engle said. “They didn’t find anything on the right side.”

Margaret has undergone many mammograms in the past, and intuitively knew something was wrong because her husband’s testing was taking a long time.

“You go sit in the waiting room and you typically sit in the waiting room longer, spend more time removing clothing and getting dressed,” she said. “So, when I had sat in the waiting room for over an hour and watched lots of women come in and out — and I had seen them come in after David — I knew something wasn't right.”

Surgery

After being diagnosed, David decided to see a surgeon and set up appointments at the Seattle Cancer Care Alliance.

“That was a really good decision, because when we went in the doctor said, ‘I want to look at your right side.’ She was a little suspicious about some of the results they had seen. So, I went in and had another biopsy done and it turns out that not only did I have breast cancer, which is unusual in men, but I had what they call bilateral breast cancer. I had it on both sides, which is a big deal. I was surprised and then another surprise.”

David scheduled a bilateral mastectomy for Jan. 31, and successfully underwent the surgery.

“I was real happy with the results,” he said. “Because I noticed it soon enough, it hadn’t spread to my lymphatic system. It is what they call invasive because it moved outside of the duct cells of the mammary glands, but it hadn’t gone beyond the sentinel nodes. That went well and now I am queuing up to go and see the oncologist and decide on a chemo regimen.”

That meeting is scheduled for March 11, David said.

“They precisely target the cancer with only the chemicals you need,” he said. “I can tell you I have not met anybody who has had chemotherapy who said it was a cake walk. I expect it to be a test.”

Knowing some with breast cancer do not survive, David has had to grapple with his mortality.

“At my age, I have become more aware of it, but what cancer does … there is no way you can’t think of your mortality,” he said. “Now it is kind of an ongoing question, ‘Am I OK? Am I not? Is it spreading? Is it not?”

The situation has inspired David to live in each moment more completely, he said.

“What has driven me to be more aware of the here and now and appreciate the simple things, I don’t think I was not that sort of person, but I definitely think I am dialed in to being more aware of the blessings I have,” David said. “I am not a complainer. I have not been built around that kind of attitude. For me, it is a challenge and fight that I am up for. I try to stay strong around the dark moments because there are plenty. That cancer was an ass kicker. It was a three and a half hour surgery. After that I just felt ripped apart.”

Living on love

David said the support of his family, friends and colleagues has been tremendous.

“I have a great family support system and friends that have offered to help,” he said. “Even in the Rotary, I said ‘I have to take a couple of weeks off,’ and my president-elect said, ‘You don’t have to worry about the meetings or running the Rotary.’ It has been good. People have been rallying around me.”

The illness has also brought David and Margaret closer, they said.

“I appreciate Margaret more,” he said. “That is for sure. Not that I didn’t before. I see the relationships that I have — when you have to lean back against them, it is good that they are robust. You appreciate that more. That is when you know you have a support system that is more than lip service.”

Bringing hope to others

Now that the secret is out, David said he has a sense of relief.

“Once I had been public about it, it got easier to tell people what was up and I am trying to put this story to good use,” he said. “I wasn’t embarrassed, and other people weren't embarrassed, and it was kind of a talking point that could be constructed, not damaging or embarrassing. I have learned a lot from that.”

After sharing his story, David said he has been approached by many cancer survivors in the community who have offered their support.

“I came out publicly and got contacted by people in our community that had survived and never talked about it, and by women who had survived breast cancer who wanted to buy me a cup of coffee and tell me what was in store,” David said. “I really appreciated that. I hadn’t expected that or the community support and interest.”

Margaret pointed out there is an established and robust network of female breast cancer survivors who support each other and the relative obscurity of such a brotherhood among men.

“Women have a community in terms of breast cancer and I think it is easy to call it a bit of a sisterhood,” she said. “There are many women who have survived breast cancer. The issue is for guys. There isn’t that natural community support out there. I think that is part of the reason that I am really proud of him for wanting to talk about it.”

David said he has been contacted already by a man in his 80s who survived a bout with breast cancer as a teenager

“He said, ‘Thank you for being public. When I was a kid I was diagnosed and you just wouldn’t have shared that.’ He said, ‘I have survived into my 80s, so good job. Don’t despair.’ That was really touching for me because he has lived with this embarrassment for all of these years and now, I guess we can talk about it.”

Biding their time

For now, David and Margaret are waiting anxiously for the next step of their cancer journey to begin.

“I am not patient about that kind of stuff,” he said. “It just feels like there is a lot of waiting around. My antidote to that is to stay busy and engaged and working on things. Let the other stuff wait for you. That has worked for me. As soon as I could get up and get around I have been planning days to do things I like to do. I maintain my relationships. And just take on as much as I can.”

“The trickiest part about it is you just have to sit and wait,” Margaret added. “When is stuff going to start? We won’t know until March 11. It is hard because I think knowing is so much easier than waiting.”