David Knipe – Fit and resilient

David Knipe shares how his breast cancer diagnosis in turn helped him to better manage his diabetes.

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David Knipe (73) lives in Hillcrest, Kwa-Zulu Natal with his wife. They have two sons and four grandchildren. 

Diabetes diagnosis

In February 2011, at the age of 59, David went for his bi-annual health check-up and his blood glucose level was high, so his GP sent him for a glucose tolerance test which resulted in him being diagnosed with Type 2 diabetes.

David admits that he didn’t take the diagnosis seriously as he didn’t know much about diabetes. “My father’s mother had diabetes, but she had Type 1. I think the gist of my knowledge was that I knew I had diabetes and had to limit my sugar intake,” David explains.

David was prescribed metformin (2 x 1000 mg daily) though he adds that his triglyceride (a type of fat) level was a concern as it was very high, which put him at an increased risk of heart disease and stroke. He was also prescribed daily medication to manage this.

Adding physical activity into his daily life wasn’t hard as David had played soccer for many years, then joined a running club as a social runner. As he got older, he chose to rather walk for the same club which he has done for the past 15 years.

Regarding diet modifications, David tried to cut down on bread which he admits was hard as it’s one of his downfalls, and he cut out sugar completely.

He continued with his bi-annual health check-ups with his GP where the management of his diabetes was monitored.

Breast cancer diagnosis

In August 2020, at the age of 68, David felt a lump under his left nipple while he was in the shower. “I showed my wife and she could also feel it, but I was a bit naive as I was gyming at that time and thought it was a muscle or something,” he says.

David knew he had his bi-annual check-up with his GP so planned to ask him to check it. The GP did all the usual testing as well as examining the breast lump but was more concerned with David’s blood glucose level being 18 mmol/L than the lump in his breast.

His GP was stern in telling him that he had to better manage his diabetes and referred him to a surgeon for the breast lump, though reassured him that many men get lumps and they are mostly benign.

Biopsy  

The surgeon said the same thing to David that the lump is more than likely benign but to be safe he should have    a biopsy which was set up a few days later.

This was the first time David had ever been in hospital (even though it was a day procedure) so naturally he was nervous but when the anaesthetist walked in, he was surprised to see it was his head boy from high school. 

This chance meeting eased any anxiousness and the biopsy was done smoothly.

When remembering that phone call with the results, David says, “It’s one of those phone calls that you never actually want to receive. It was the surgeon’s secretary asking me to come in and see him. I tried to get it out of her of what seems to be the problem, but she didn’t want to tell me, and I soon realised that is was cancer. I went to see the surgeon that same day and he told me he can remove it the next day.”

Treatment

The surgery was set up for the next day and David thought he would experience his first night in hospital. Though after surgery, where the lump, nipple, and lymph nodes were removed, the surgeon asked David how he was feeling which he responded fine and the surgeon asked him if he wanted to go home. David was discharged from hospital the same day with a drain.

The tumour that was removed was sent for Oncotype DX testing, a breast cancer test that helps determine the likelihood of recurrence and whether chemotherapy is beneficial for early-stage, oestrogen receptor-positive (ER+), HER2-negative breast cancer. His score was low (23) which meant David wouldn’t need chemotherapy.

He also had BRCA gene testing which found that he was a carrier of the inherited mutation, which increased his risk of developing breast cancer, so he informed his two sons who live abroad and left it to them to decide if they wanted to do the test. “My older son had the test and it was negative, thank goodness. But my younger son still hasn’t gone for the test,” he says.

In October 2020, David underwent 15 sessions of radiation and is thankful that he had no side effects from surgery or radiation. He was then prescribed tamoxifen for five years and will be finishing up this November. All this will be discussed in detail at his next check-up with his oncologist.

Thankfully, David hasn’t experienced any side effects from tamoxifen either, apart from not having a big appetite. He adds, “I don’t even know if that is a side effect?”

Support and awareness

David recalls being extremely shocked and scared when he was diagnosed with breast cancer. As was his wife, family, and friends. 

“News travels so fast but with that said I received a lot of support from everyone,” David says. “Once I accepted the diagnosis, I had a lot of hope and with so many people praying for me and giving me support, I had this. I continued exercising and all that I was doing. You have to fight on and beat it.”

Since having the surgery, David has found that when going caravanning, which he does often, walking around without his shirt is a good way to raise awareness for male breast cancer “Quite often I see people look at me twice as they see I only have one breast. Some pluck up the courage and ask me and I explain that I had breast cancer. I don’t care or worry about the lack of a nipple or breast. It gets conversation going,” David says while chuckling.

Getting serious about diabetes management

Since that doctor’s visit in 2020, David made the choice to manage his diabetes better. He bought a glucometer and started testing his blood glucose levels once a week, though it’s advised to test blood glucose daily. “I was also stricter with what I ate,” he says.

Thankfully, David got his diabetes under control and during surgery and radiation, there were no concerns. Since then his levels are generally in the baseline, around 5,8 mmol/L.

He took a step further four years ago when he stopped drinking alcohol. “I wasn’t a sweet or cake type of guy, but I enjoyed watching rugby and drinking beer. I decided to stop it completely as I don’t want to put more toxins in my body,” David says.

Since making this lifestyle choice, he has only improved his diabetes management though he admits that it wasn’t easy.

Fit and resilient

David was put on retirement four years ago though he adds, “I would prefer to carry on working, as in retirement, you never get an increase nor a bonus. It is what it is. I’m still very fit and can still work, even if it’s a menial job, I would take it. I’m fit and resilient and will continue to be.”

Photo by Tuhi Photography | tuhiphotography.com