By: Dr. Barbara Bartlik
Male
breast cancer remains one of the most misunderstood and underdiscussed
diagnoses in oncology. For integrative psychiatrist Dr. Barbara Bartlik, the
silence surrounding men’s emotional and sexual health in the wake of cancer is
a gap that demands urgent attention. Her holistic perspective challenges the
status quo and offers hope for survivors navigating the complex terrain of
healing.
When most people think
of breast cancer, they imagine women fighting a disease that has become a
rallying cry for global awareness. But for men, who make up a small yet
significant percentage of breast cancer diagnoses, the reality is
different—quieter, lonelier, and often laden with stigma.
“Most men keep it very
quiet. They don’t share it. They’re embarrassed about it because it seems to be
a woman’s problem,” says Dr. Bartlik. This isolation leaves male survivors
adrift in a healthcare system that is rarely designed with their unique needs
in mind.
As an integrative
psychiatrist, Bartlik occupies a rare position at the intersection of physical
and mental health. Her work goes beyond traditional talk therapy, encompassing
clinical insight into how cancer treatments affect the
body, mind, and relationships. “You’re not just therapists at that level,” she
explains. “You’re also clinical. That means understanding the real effects of
treatments like Tamoxifen, which are killing the sex drive, damaging the immune
system, and leaving patients depressed—even suicidal.”
The
Andropause of Cancer Treatment
Andropause,
often referred to as ‘male menopause’, is a condition that is associated with a
decrease in testosterone levels in men as they age. Tamoxifen, a mainstay in
breast cancer care, is central to Bartlik’s concerns. Commonly prescribed to
male survivors post-surgery, it effectively induces a chemical andropause, akin
to menopause in women. “They may experience hot flashes, mood swings, fatigue,
depression, and a loss of libido,” she says. “It’s a long haul because they
often have to be on it for five years, sometimes more. Most people do not like
Tamoxifen. They’ve lost their energy, and it’s a very unpleasant feeling.”
For many men, these side
effects strike at the core of their identity, compounding feelings of shame and
alienation. Unlike women, who have networks of support groups and survivor
organizations, men with breast cancer often navigate their journey in solitude.
“Women have organizations where they can meet with other survivors. But for
men, there’s very little support out there. They may never meet another man who
has breast cancer,” Bartlik explains.
This profound sense of
isolation is not just an emotional issue—it’s a public health concern. Without
adequate mental health support, survivors may spiral into depression, anxiety,
or worse. “Cancer in itself is a downturn for a person. It makes everything so
bleak. Even just trying to survive it—the depression, the PTSD—it’s massive,”
she adds.
A
Call for Holistic Intervention
Dr. Bartlik believes the
traditional oncology model, which focuses on
eradicating tumors, often overlooks these critical aspects of healing.
“Surgeons and oncologists are focused on killing the cancer. They may not think
about bringing in a psychiatrist or helping support the man in adjusting to
this new way of life—living with low testosterone, for instance.”
Her approach involves
more than just medication. Bartlik incorporates nutritional strategies and
natural supplements designed to mitigate some of the sexual and mood-related
side effects of cancer treatment. “There are supplements like ginkgo biloba and
tribulus to boost sex drive, long jack for erectile function, and amino acids
like L-arginine and citrulline that open blood vessels. Magnesium helps too,
because it relaxes and opens blood vessels.”
However, she underscores
the importance of collaboration. “We have to work with the oncologist because
some of these supplements can increase testosterone, and that’s not desirable
in certain cases.” This careful balance reflects her integrative philosophy: which treats the whole person, not just the disease.
Sexual
Health as Mental Health
Beyond Tamoxifen,
Bartlik highlights how other cancer treatments further complicate male sexual
health. “We’re talking about testosterone blockers in men with prostate cancer
and surgeries that inevitably affect sexual functioning,” she explains. “Some
men are lucky and can retain some of it, but for others, the changes are
devastating.”
She notes that early post-surgical
interventions can make a difference. “If you take Cialis a month after surgery
and continue daily, it can help blood flow and possibly restore some function.”
For men struggling with lingering dysfunction, Bartlik’s protocols include
pharmacological and technological aids, as well as natural remedies.
“Sexual health is mental
health,” she emphasizes. “When these men lose their sexual identity, it impacts
their relationships, their mood, and their overall quality of life. Addressing
this is not optional—it’s essential.”
Breaking
the Stigma
For Bartlik, male breast
cancer advocacy is more than a professional interest—it’s a mission. She sees
an urgent need to break through stigma and silence, empowering men to seek help
without shame. “Pursuing clinical care for men with breast cancer is a huge
platform I didn’t even think about until I started realizing how sexual health
and depression are all over cancer care—and specifically men’s cancer.”
Collaborations with
advocacy groups and publishing her insights could amplify this message. “This
is an area where we can make a huge difference in men’s health. It’s lifesaving
work—because killing the stigma is just as important as killing the cancer.”
Toward a New
Standard of Care
As she reflects on her
role, Dr. Bartlik envisions a future where psychiatry is woven seamlessly into
oncology care for men. “These patients are dealing with far more than just
physical illness. They’re coping with loss of health, of identity, of intimacy.
Our job is to help them heal in every sense of the word.”
For the men still
suffering in silence, her message is clear: help exists, and they are not
alone. With the right support, recovery can be about more than survival—it can
mean reclaiming a full, vibrant life.
