It wasn’t the launch into retirement Mike Fleisher expected. He had just retired on Oct. 1, 2017, and had plans to celebrate the end of his six-days-a-week work schedule by traveling to South America and the Galapagos Islands with his wife. Instead, the day before Thanksgiving, he was diagnosed with breast cancer.

“In a way, it was lucky that I noticed the lump after I retired,” Fleisher said. “If I had been working, I would have put off going to the doctor until April at least.”

And though he received thorough treatment at his hometown, a complication after the treatment led him to seek relief at Keck Medicine of USC, where Fleisher could be seen by one of the only surgeons nationwide who specializes in his issue.

Getting treatment for cancer

Shortly after noticing the lump, Fleisher went to his dermatologist in his hometown of Las Vegas, who took a biopsy. He was diagnosed with breast cancer on the day before Thanksgiving in 2017, then underwent surgery the following February. He had a full mastectomy of his right breast and five lymph nodes removed before beginning six weeks of radiation treatment. Though the radiation treatment was difficult, Fleisher still counts himself as lucky: “I was able to have my surgery pretty quickly after my diagnosis and the cancer was not aggressive. I was able to avoid the chemo.”

But another complication arose: Lymphedema. Lymph nodes help control the flow of lymphatic fluid through the body. Sometimes when lymph nodes are removed, particularly when radiation treatment is involved, the lymphatic fluid no longer has a pathway and can build up in one part of the body. That’s what happened to Fleisher.

“My hand and arm swelled up,” he explained. “They were huge. I looked like I had the hand of a 600-pound man.” Fleisher first handled the swelling by using a pneumatic pump at home every day and wearing a compression sleeve, but coping with the lymphedema became cumbersome. He had to use the pump every day, which meant he had to travel with it, and he hit the point where he was wearing a compression sleeve any time he wasn’t sleeping. He also was going to therapy three times a week to massage the fluid out, and it hurt when he raised his right arm.

Finding relief from lymphedema

In November of 2018, Fleisher traveled to Los Angeles to see Ketan Patel, MD, a microsurgeon who specializes in lymphedema relief at Keck Medicine and associate professor of clinical surgery at the Keck School of Medicine of USC, and one of the few surgeons in the United States to perform this type of surgery.

“The first time I met Dr. Patel, he took out a hardbound book to show me the procedure… Then I looked at it and saw that he had written the book!” Fleisher said.

Patel thought the case was interesting from the start. “It’s unusual for us to see a male patient. Men account for just under 1% of breast cancer cases, and then lymphedema is uncommon as well. He’s a unique and interesting case.”

Many breast cancer patients, male or female, don’t know that lymphedema surgery is available. Patel hopes to get the word out because it can bring profound relief.

“People don’t understand that when you develop arm swelling or hand swelling, there is a huge functional limitation,” Patel explained. “Even the most minor swelling can interfere with day-to-day activities, particularly if it’s your dominant extremity.”

Fleisher underwent surgery with Patel in March of 2019 and, fresh off his second successful follow-up visit, testified that he has experienced great relief. He has reduced his use of the compression sleeve, now only wearing it when exercising or flying, and he doesn’t have to take his pump with him when he travels. Fleisher and his wife finally will be able to take their dream trip to South America in the spring.

In the meantime, Fleisher is making sure to share his story. “Quick diagnosis was key for me. I know how guys can be. Men, when they find a lump, they don’t do anything. I’m putting the word out: If you see something different, get it checked.”

— Lex Davis