Actor Richard Roundtree was the first black-action-movie-star hero, playing private detective John Shaft in the 1971 film Shaft and its sequels. He has been credited with changing the way black men were portrayed in films.

In 1993, at age 51, he was diagnosed with breast cancer and had his left breast removed all the way to his armpit. He received six months of chemotherapy and was so sick that he lost 18 pounds. In 2000, he told People Magazine that “Breast cancer is unusual in men, yes, but you have to be a man to get through this — damn right.” On October 24, 2023, at age 81 and thirty years after his breast cancer diagnosis, he died of pancreatic cancer. The same breast cancer genetic risk factors, BRCA1 and BRCA2, also increase risk for pancreatic cancer (Cancer Epidemiol Biomarkers Prev, 2013;22 (5):803–811).

Early Life and Acting Career
Roundtree was born on July 9, 1942 and grew up in New Rochelle, New York, where he played on the championship high school football team. He went to Southern Illinois University on a football scholarship, but dropped out of college at age 21 to pursue an acting career after spending a summer working as a model. At age 25, he joined the Negro Ensemble Company in New York City and played Jack Johnson in their production of “The Great White Hope”. He had a long and active career in film and television, and is best known for creating the ongoing character of Shaft in the original movie, four sequels from 1972 to 2019, and a CBS television series. He married and divorced twice and had five children.

Breast Cancer in Men
Roundtree had enlarged breasts at age 13, which suggests that he had higher-than-normal levels of female hormones at that time. In 1993, at age 51, he felt a tiny lump under his left nipple, and it turned out to be breast cancer.

Fewer than 3000 U.S. men are diagnosed with invasive breast cancer each year, and about 530 men die from it (CA Cancer J Clin, Jan 2023;73(1):17-48). Risk factors for male breast cancer include:
• Family history, particularly of the BRCA1 or BRCA2 gene mutations.
• Age. The risk of breast cancer in men (as in women) increases with age. The average male breast cancer patient is 72 years old.
• Radiation exposure, most commonly from the treatment of other cancers near the chest.
• Klinefelter Syndrome, in which a male has two female chromosomes (X+X) plus the normal male Y chromosomes. A normal male has X+Y chromosomes. Symptoms include infertility, enlarged breast tissue and low amounts of facial and body hair.
• Obesity: excess fatty tissue releases estrogen to raise blood estrogen levels (J Clin Med Res, Aug 2009;1(3):125–131. (All normal men have some estrogen in their bloodstream.)
• Alcohol abuse: alcohol raises blood estrogen levels by preventing the liver from breaking down estrogen.

Warning signs of breast cancer in men include:
• Nipple pain, inverted nipple or nipple discharge
• Sores on the nipple or area around nipple
• Enlarged lymph nodes under the arm
• Any lump in or near the breast should be checked by a doctor

Pancreatic Cancer
The pancreas produces enzymes that help to digest food, particularly protein, and it makes insulin and glucagon, hormones that help to control blood sugar levels. Nearly 95 percent of pancreatic cancers start in the cells that make digestive enzymes. Risk factors for pancreatic cancer include:
• smoking and exposure to tobacco smoke (associated with more than 25 percent of pancreatic cancers)
• Being overweight
• Having a fat belly, even if you are not overweight
• Diabetes and high blood sugar after meals
• Chronic pancreatitis (long-term inflammation of the pancreas, often caused by smoking or alcohol)
• Exposure to certain workplace chemicals, particularly those used for dry cleaning and metal working
• Age: average age at diagnosis is 70. Almost all cases are in people over the age of 45 and two-thirds are over age 65.
• Sex: Men are slightly more likely to develop pancreatic cancer than women
• Family history of cancer
• Inherited syndromes such as hereditary breast cancer and ovarian cancer syndromes
• Intestinal polyps
• Lack of exercise
• Alcohol
• Infections such as Hepatitis B or helicobacter pylori, the bacteria that causes stomach ulcers

New Treatments for Pancreatic Cancer
Treatments with surgery, radiation and chemotherapy are better than nothing, but often fail. That is why many trials are going on to use a person’s own immune system to try to cure pancreatic cancer. Normal cells live only so long and then die by a process called apoptosis, programmed by DNA. Cancer means that the DNA is damaged so that cells try to live forever. Normal people produce cancer cells every day, but their immune system can tell that a cancer cell is different from a normal cell, so immune cells and chemicals called cytokines attack and kill the cancer cells. Cancer occurs when your immune system loses its ability to tell the difference between a cancer cell and a normal cell and allows the cancer cells to survive. The 2018 Nobel prize in medicine was awarded to Jim Allison for his work on this process, but the drugs that have been developed can sometimes cause a person’s immune system to attack normal cells with disastrous results.

Today many cancer centers are testing new treatments for pancreatic cancer. Immunotherapy uses substances to stimulate or suppress the immune system to help the body fight cancer. One such study using an mRNA vaccine to fight pancreatic cancers is now being offered by Memorial Sloan Kettering Cancer Center at nearly 80 sites around the world. The trials are open to people newly diagnosed with pancreatic cancer who have not yet had surgery or other treatment (such as chemotherapy, immunotherapy, or radiation therapy) and who fit other specific criteria. If this research is relevant for you, talk to your doctor about opportunities to participate in one of the trials.

Richard Arnold Roundtree
July 9, 1942 – October 24, 2023