NORMAL — William Caisley, a 75-year-old retired circuit court judge, has heard his share of improbable stories over the years.
But one unexpected story is his own.
Caisley is a breast cancer survivor.
"Women are pretty well informed but men need to be aware of it," Caisley said of breast cancer. "Most men don't think of getting breast cancer but one of every 111 breast cancer patients is a guy."
"The ratio is small," admitted Dr. Pramern Sriratana of Mid-Illinois Hematology & Oncology Associates.
But because breast cancer isn't on the radar screen of most guys, by the time they do detect a lump, the cancer often is at an advanced stage, meaning more aggressive treatment is needed.
"It's very uncommon but if a lump is detected, it needs to be addressed quickly," Sriratana said. "Get a mammogram or ultrasound. When it's detected later, there are greater odds of lymph node involvement."
Caisley, who swims four miles a week, was having his annual physical with his primary care physician, Dr. Michael Cochran, in spring 2006 when Caisley said that he had recently detected a "bump on my chest."
"He said 'Men get breast cancer but it's very rare' and he sent me for an ultrasound," recalled Caisley, who already had retired from the bench.
Ultrasound images were inconclusive but Cochran told Caisley that there was no reason for him to have the lump in his left breast so it should be removed.
Dr. Richard Trefzger performed the outpatient surgery and told Caisley and his wife, Mary, afterward that he thought it was malignant. A pathologist confirmed breast cancer.
"I was surprised because it is so rare," Caisley said.
"I was totally surprised," Mary Caisley said.
"He said he didn't get enough of a margin and he thought I needed a lumpectomy," William Caisley said. He went to Northwestern University Feinberg School of Medicine to get a second opinion and a doctor there agreed.
Caisley had a lumpectomy and a sentinel node procedure to determine whether the cancer had spread to his lymph nodes.
"All came back clear, so that was good news," he said.
But doctors agreed that Caisley still needed a mastectomy.
"If a doctor gives you good advice, you'd better damn well take it," Caisley said.
Trefzger performed the mastectomy.
Was Caisley self-conscious when he resumed swimming?
"Certainly I was," he admitted. "I wore a T-shirt when I went to the beach or the pool, which I wouldn't have done previously."
Six months later, Dr. Laura Randolph performed breast reconstructive surgery. After that, Caisley resumed shedding his shirt for swimming.
Meanwhile, genetic testing resulted in a recommendation that Caisley also have chemotherapy. Sriratana became his oncologist.
Caisley had four treatments — one every two weeks. His hair fell out overnight.
At the same time, Caisley was making his first run for the McLean County Board for the November 2006 election and that included door-to-door campaigning.
"To campaign against cancer and to campaign for the county board all at the same time is not recommended procedure," Caisley said with a laugh.
"But he likes to campaign," Mary Caisley said. "It helped to divert his attention so he was not so centered on his condition."
"He's a very strong individual," she continued. "I tried to get him to slow down. He didn't listen to me."
"I'm doing fine," Caisley said. "I don't tell people I'm cured. But it's been successful so far. It's nine years out. I believe it (the cancer) is gone but once you've had it, there's always a chance for a recurrence."
Two years ago, the Caisleys' daughter, Margie, who lives in California, was diagnosed with inflammatory breast cancer at age 37. She had chemotherapy, surgery and radiation.
"She is doing just great," Mary Caisley said of their daughter, a hydraulic civil engineer, mother and triathlete.
"I would hope that men who discovery a lump in their chest would have it checked," William Caisley said. "It's probably not breast cancer. But it might be."
Sriratana further recommends that men with breast cancer have genetic testing.
Men who carry mutations of the BRCA2 gene have a greater risk of developing breast cancer than other men, according to the Journal of the National Cancer Institute.
"If men are BRCA-position, their tempo of treatment is different," Sriratana said.
In addition, if someone has a gene mutation, their immediate family members are more likely to have the same gene mutation, which means they should be tested.