Hormone dependent breast cancer

Spencer Hayward is a trans man who was diagnosed with breast cancer at age 50. He underwent a double mastectomy (he was on the waiting list at the time for top surgery) and chemotherapy, followed by a second surgery to provide a better aesthetic closure from his mastectomy.

Spencer recently took part in an advocacy campaign for Dense Breasts Canada as part of a month-long photo essay for Breast Cancer Awareness Month. This campaign was also featured in People magazine. He has discussed his decision to continue to take small doses of testosterone to continue his gender affirming treatment in a piece for the Ottawa Citizen, for the Ottawa Hospital (Gender Diversity Specialty Clinic) and as part of his photo essay:

Because my cancer had receptors for estrogen, progesterone, and testosterone (they tested for androgen receptors because they knew I was taking testosterone as part of my Gender Affirming Care), I had to start hormone suppression medication. Every three months, I currently go to the Cancer Centre at the Ottawa Hospital and get a tiny pellet injected into my abdomen, in order to keep the hormones at bay.

Around this time, in January of 2022, I was introduced to my endocrinologist, Dr. Irena Druce, because my oncologist had wanted me to completely stop taking testosterone. As a trans man, this made for a very difficult decision, because, among other things, there is very little data on trans men with hormone-receptive breast cancer, so there is some guesswork involved with regard to potential treatments.

So far, I am limited to a “micro-dose”, which, in my case, means 0.5mg of gel applied to my lower abdomen, each day. Dr. Druce would actually prefer if I skip doses, which I often do, due to my typical ADHD forgetfulness, but I find that my mood is definitely affected when I skip it for 3 days or so. I see a definite correlation between my mood and the amount of testosterone in my system. As I have said many times during this journey, I would rather have 10 good years of taking testosterone, where I feel happy in my skin, than have 20 years of being miserable without the testosterone.

Spencer shares his tips for healthcare professionals caring for queer, trans & non-binary patients in a five-minute video for QC here.


Read Spencer’s story here.

Images: Dense Breasts Canada