Joey Wahler (Host): It's relatively rare. So, we're discussing male breast cancer. Our guests are Dr. Duane Moores, a hematologist and oncologist and his oncology patient, Tony Adams. This is Health Matters from Southeast Georgia Health System. Thanks so much for joining us. I am Joey Wahler. Hi there, Dr. Moores. Tony, welcome.

Duane P. Moores, MD, PhD: Hello.

Tony Adams: Hey.

Host: Great to have you both aboard. We appreciate the time. So, first, Dr. Moores, in a nutshell, what initially triggered your interest in both healthcare and, specifically, your specialties, hematology and oncology?

Duane P. Moores, MD, PhD: I actually went to medical school to become a psychiatrist. And, as time went on, I realized that my calling, my actual vocation, if you will, was hematology oncology. And it has proved right. It is a fantastic field with breakthroughs on a daily basis. And like I said, it's truly a vocation for me.

Host: And, Doctor, what first brought you to the area and how long have you been with the health system?

Duane P. Moores, MD, PhD: I have been here for—actually this month, I moved here 27 years ago. So, I've been with the health system for almost 27 years. I came here from Charleston, South Carolina, the greatest city in the United States and wanted to live on the coast. And we're tucked away far enough to avoid hurricanes for the most part. So, I sought this area out. And, again, I've been here for 27 years as of March of 2026.

Host: So, a long time resident here now, but still repping for Charleston. Love it.

Duane P. Moores, MD, PhD: Absolutely.

Host: That's great. So Tony, tell us just a little bit about your background, where you're from. And you're an entertainer, which can mean different things for different people. What does it mean in your case?

Tony Adams: That's a jack of all trades, basically. Originally from South Carolina. I moved down here in 1999, fell in love with the Golden Islands. And Dr. Moores and I have some ties to Charleston. That's why we were fans of Charleston. So, I'm still a South Carolina boy at heart. Most of my adult life has been I'm a trained vocalist and started out in the music industry. And then, all of a sudden, I started getting white hair and it kind of went—I haven't been the Easter bunny yet, but it has gone into Santa Claus. And it's turned out I've just kind of followed my pathway.And it's been very, very rewarding. Very rewarding for me.

Host: Wonderful. So Tony, when did you first realize you had a health issue and when diagnosed with now breast cancer in October of 2024. What was your first reaction?

Tony Adams: Well, shock of course. I had had just a small marble size knot for quite some time. And it never grew. It never did. So, I didn't think anything about it. But that summer, it started growing and grew quite a bit, quite rapidly. Even the day that I went into the ER, breast cancer was the last thing on my mind. I just thought it's a cyst, whatever it may be. So when I found out, it was quite an awakening for me, because, like I say, even though I had a huge knot on my chest, I never thought breast cancer, never. Not once.

Host: And with good reason, because of the fact that most of society associates it with women first. So, performing publicly as you do, how concerned were you about your professional future?

Tony Adams: I think, later on, I had some time to reflect, I thought, "Well, this is certainly going to be different, you know? Because nobody wants to come see somebody, look at the kind of shape I am. But it also gave me determination to get on the backside of this and get back out in front of people, because I've been doing it for almost 35, 40 years. So, it's my home is being on stage. So, that was a motivational thing for me as well.

Host: I am sure because it gave you something to strive for and get back to, right? So, Dr. Moores, how rare in fact is male breast cancer? And what should men and their doctors be looking out for if it's suspected?

Duane P. Moores, MD, PhD: Breast cancer is not what comes to mind when we feel a mass in a male breast, because it occurs in less than 1% of the total breast cancer cases. So across the board, it is rare. Actually of male cancers across the board, it only accounts for less than a half a percent.

Now, what you should look for is that if you have a mass in your breast and you're a male, statistically, it probably is not going to be cancer. But certain aspects of it that you need to be aware of is if it starts to ulcerate, if you see skin changes, redness, if there's skin retraction, if there's evidence of nipple retraction and any swollen lymph nodes in the armpit, those are issues that you need to get taken care of. You need to get it evaluated. But for the most part, the mass probably isn't breast cancer. It probably isn't, because it is rare.

Host: Anything—looking back now, Doctor—that stood out about Tony's case.

Duane P. Moores, MD, PhD: Well, let's see. He had advanced breast cancer. He's a male and he's Santa Claus.

Host: Other than that, it was just run of the mill.

Duane P. Moores, MD, PhD: Having been here for so long, I've seen, obviously, breast cancer in males. But typically, what happens is men breast cancer tends to be more advanced. Because, again, if we feel a mass, we don't run to the doctor. So, typically, this unfortunately is the case. It tends to be more advanced by the time the diagnosis is actually made.

Host: Gotcha. So Tony, speaking of you playing Santa every year. How did your diagnosis wind up affecting that?

Tony Adams: Well, the calendar was kind of unique in that everything happened in October. And it was almost like a whirlwind. I didn't have really time to wrap my brain around it. I had the surgery. And then, i met with Moores and I was just trying to take it all in. And then, all of a sudden Santa came to mind. And I thought, "This is something that's so very important to me." And I thought, "Would Dr. Moores look at me as being childish by even mentioning it?" But he didn't. He wrapped his arms around me. He said, "You know what? We can make this happen," because I knew I needed to start treatment right away because I was told it was advanced cancer.

I was fighting my sister who wanted it started yesterday. And I mean, so, you know, she was looking out for her brother. And Dr. Moores says, we can do this. We can buy you enough time, then you'll be fine. And the thing that made a difference to me is having complete and total trust in Dr. Moores, because never once—he didn't always tell me what I wanted to hear, but he always told me what I needed to hear. And we just gained a trust that way. And so, I tell other guys to go find somebody that you have faith and confidence in, because it means all the world. And he said, we can do this. And I never had a doubt after that. And sure enough, he worked his magic. I don't know what he did, but we pulled it off. And I think we made a lot of kids smile because of it. So, it was a very rewarding season for me.

Host: I can imagine.So, speaking of that, Dr. Moores. What did you have to do in weighing the decision to delay Tony's treatment, which eventually consisted of chemotherapy? And what exactly did you pull off that he's alluding to here?

Duane P. Moores, MD, PhD: Well, most male breast cancer patients, all I've ever seen are estrogen receptor positive. So, that means it's feeding off of estrogens within the body. So, no, for the record, I was not pleased about putting treatment off at all. But obviously, he had a commitment. And we weren't that far off.

But with estrogen receptor positive, I'm able to give hormonal manipulation. So, it's not like I didn't give him any treatment. If he would've been a triple negative breast cancer where I could not have given him hormonal manipulation, I would've held Santa down, and we would've made sure treatment got going.

So, I was able to still give him treatment in the form of tamoxifen, a selective estrogen receptor modulator. So, he actively did get treatment during that timeframe until he finished doing his Santa role. And then, I pulled the trigger with therapy.

Host: And so, Tony, what was playing Santa that year like compared with the others, knowing what was just ahead? I would imagine it took on a more special meaning, yes?

Tony Adams: It did. I think I was more grateful to be able to do it. I had just stepped into a new role, as Sea Island Santa. So, I didn't have to travel like I had in the past. So, everything, it's like the stars lined up for me that in that particular season. And I think everything—I never said once to myself that this will be my last time doing it, because I had that much faith and belief in what Dr. Moores told me, because I kept bugging him. Every cancer patient wants to know where am I at, how am I doing, what am I—and he said, "Listen, we're going to judge success five years from now, you come to my office and still be Santa Claus. And so, that's what I went for. And so, I had no doubt that next year I was going to be doing Santa as well. But I did embrace it quite a bit.

Host: Dr. Moore, it sounds to me like you didn't have a choice at the end of the day, because I mean, the presence, the sleigh, the reindeer were ready. You couldn't keep the kids waiting, right?

Duane P. Moores, MD, PhD: Correct.

Host: So, Doctor, are men's breast cancer treatments different in any way than for women? And what was Tony's treatment plan? Simply put over time.

Duane P. Moores, MD, PhD: So, the treatment for men mirrors that of women. So, we try to avoid chemotherapy. I ran what's called a genomic test that indicated, unfortunately, he needed chemotherapy. So, he got a standard what's called adriamycin and Cytoxan, paclitaxel. These are intravenous chemotherapy agents. And as Tony will tell you, it is not easy. But it kills, you know, if there are cancer cells, it will kill them. It will kill roaches. And so, I got him through the—that was a joke, by the way—the patient, he did well through chemotherapy for the most part, for the most part. And then, he went through radiation, adjuvant radiotherapy to his chest wall. Then, I resumed the tamoxifen, the estrogen receptor modulator. And then, we made an attempt, the old good old college try that Tony gave, to do Verzenio, which is a newer type of adjuvant treatment called a CDK inhibitor.

So again, all of this mirrors what we do with females. Now, the difference sort of is, obviously, that men tend to be older at diagnosis in women and tend to be more advanced. But by and large, they tend to be estrogen receptor positive. So like I said, that bought him some time being able to give him the tamoxifen as treatment, which he will remain on for the next 10 years.

Host: I'm going to ask Tony in a moment about going through that experience, of course. But one more for the moment, Doctor, how about the importance of support systems when going through chemo in terms of family and loved ones? Because what you just mentioned sounds daunting.

Duane P. Moores, MD, PhD: It is, and without a doubt. So, what I tell my patients, first off, this is not a weight loss program; that patients, I tell them, especially Santa Claus, don't lose weight. Do not drop the weight down. Stay active. You've got to stay active. You need to be exercising. And as far as support systems, you have to lean on your family and friends.

I mean, without a doubt, the outcomes are poorer in patients who have no or little social support. So, without a doubt, that is imperative going through something as difficult and emotionally wrenching as chemotherapy.

Host: So, speaking of which, Tony, how did you prepare yourself to go through chemo? And then, what was that experience like at the health system?

Tony Adams: I was fortunate enought to have a good support system, even though I live by myself, I'm a widower. I have family that is close by and friends. And because of what I do for a living, I've got tons and tons of people that just circle the wagons. And so, from that ask point, I felt covered.

The fact I know the most is I had so many questions, when I was told that I had cancer. And I know I must have asked some really dumb questions, but you're just in shock. You want to take it all in. You want to make it make sense. "How could it be me? "You know, that kind of thing.

And that's where I appreciated what I got from Dr. Moores and his group more than anything. They're a team, they're truly a team. They sat me down. They said, "All right, let's look at everything from financial assistance to whatever you need." And it's been that way from day one. And what I said about confidence, that's what really has changed it for me.

For instance, I was a diabetic as well and the minute Dr. Moores said, "This chemo's going to affect your diabetes, we'll get you in there." And so, I don't know if every patient that he has gets moved to the top of the list, but he makes you feel that way. And I certainly felt like I was getting special treatment when I know I was just another patient. But that's a gift that he has. And it goes a long ways. And he could come to me right now and say, "Tony, we need to do whatever" and I'd say, "Yes, sir. Let's do it." That's how much faith and confidence that I have in him and his entire team.

The biggest blessing of all was this past Christmas, he and I, without telling anybody, worked it out to where Santa could show up at his company Christmas party. Nobody knew about it. His assistants didn't know, his nurses didn't know. And all of a sudden, I knocked on the door, full regalia. And the eyes and the—oh, it was a special moment. And I said, I'm going to do that a lot more. I mean, every year, you can count on me.

Host: Doc, you arranged to get this treatment taken care of in a timely manner. In exchange for which, Santa shows up to make an exclusive appearance, taking time out from his very busy schedule. One hand washing the other here, right?

Duane P. Moores, MD, PhD: Absolutely.

Host: So Tony, what about the experience itself of going through chemo? How would you describe it, handling any differences you experienced, Tony, with appearance or voice changes? What were they and how did you manage to get through that part of it?

Tony Adams: The other thing that I am very appreciative of is nothing that I went through, was not something I was told about ahead of time. Now, not everything they told me about happened, but nothing happened that they didn't tell me about. So, nothing came as a surprise to me. And so, you know, I lost my hair, even my eyebrows, and it's just something you deal with. It was certainly a different look. But I didn't hide behind it. In fact, I embraced it. I'm a big social media guy. As he would say, you need to get out and do a walk every morning. And I'd go out there with my old bald head, and we'd go around and my neighbor's like, "Hey, you looking good." I was like, "Yeah, right."

And the other thing that I said, "Doc, tell me that by December I'm going to have my beard back." And he said, "Don't worry about it. The minute we get you out, it's going to start." And it was right within two weeks. I mean, I had remarkable hair growth. So, everything you go through, I'll tell my other patient, it's temporary. It's temporary. And it's the price you have to pay to still be here today. So, that's kind of how I looked at it. I said, load the wagon. Let's get through this. Because the goal we've got is pretty significant.

Host: And you led me beautifully into my next question, Tony, because when you talk about goals and getting through it, what was it like learning you were in remission?

Tony Adams: Well, I mean certainly, I was very, very happy, but my attitude was such that. I wasn't surprised because Dr. Moores said, "This is what we're going to do. We're going to get you better." And I never had a doubt and I work that way. So, we're doing what we're supposed to do. And the remission was just—and I was ready for either way. I mean, I really was. That's the other thing. Is you have to prepare yourself mentally. But I just had so much confidence in the way things were going and I said, "This is going to be a reward at end."

Host: Dr. Moores, how can male breast cancer awareness increase and how can we see better outcomes with this?

Duane P. Moores, MD, PhD: Well, that's the thing is that I don't want anyone to take away that I'm advocating that a male with a mass run to their doctor. Because statistically speaking, it's actually not going to be cancer. But like I said, certain factors: the appearance of the mass, skin retraction, nipple retraction, ulceration, redness, lymph nodes.

The other thing is try to know your family history. patients who have male breast cancer oftentimes have genetic called deleterious mutation. So for example, know if mom had breast cancer, ovarian cancer, dad had prostate cancer, family history of pancreatic cancer, malignant melanoma, then I'm more inclined to say that if you have a strong family history of those certain types of cancers, there may be a mutation that has predisposed you to this cancer. And so, get it checked out. But by and large, I do not want to draw paranoia towards every male breast mass because again, statistically speaking, it is most likely not cancerous. But those aspects, it puts a higher risk that it should get investigated.

So again, in terms of drawing a lot of awareness. I don't want to draw paranoia, but there are certain circumstances where male breast masses should be checked out.

Tony Adams: I'd like to speak to that for just a moment because, going through this, a lot of my male friends, my phone would ring. " Tony, I found a knot. What should I do?" I was like, "Why are you calling me?" And so, from what Dr. Moores says, you can push the panic button, because guys, you know, anybody that had a scar or anything, "What should I do? You think it is cancer?" I was like, "Guys, calm down. It's going to be okay." So yeah, I could see real quickly how men would think, "Oh my gosh, Tony got cancer, breast cancer, so I must have it too," you know, that kind of thing. But what he's saying is very true. My phone rang off the hook. Everybody had nodules and knots.

Host: But on the flip side, Tony, for those that don't know a man that's gone through this and may be thinking breast cancer cannot happen to them, what's your advice to them and do you feel a responsibility or even a calling, if you will, to speak out about this and be so eloquent as you are in doing so?

Tony Adams: Absolutely, because I was that guy. Even when I was getting ready to have surgery, I was like, "This can't be breast cancer. I'm a guy," you know, that kind of thing. So, I tell the guys it can happen. Look at me. It can happen. And to use common sense and I shouldn't have let mine go as long as I did, but I told myself it wasn't breast cancer.

And so, that's where I think I can make a difference is make that awareness out there that it can happen. And just when it's something that's like Dr. Moores described, that's just off the chain, like mine was, I should have checked mine months and months earlier than I did. But there, again, it was not breast cancer, because I'm a guy. So, I think that's where I can help the most by telling guys, "Hey, look at me. I was that guy. But for that, I wouldn't have gone through all this." So, I think that's where I can be the most help. But hey, I'm an overachiever. So, we do what we do.

Host: That's awesome. So in summary here, first for you, Doctor, what's the main message from this case that you want our audience to take away from it?

Duane P. Moores, MD, PhD: First off, when patients get diagnosed with cancer, you envision your own mortality. You think that this is a death sentence. And it's not easy at all, as Tony will tell you, to go through what we put these patients through. But I've been doing this for over 30 years and where we were even in the mid 1990s to where we are now, the number of patients we're curing, the newer, there are breakthroughs in my field on a daily basis, immunotherapy antibody therapy, that it's amazing that just because you're stricken with cancer, it is not necessarily a death sentence. Like I said, it's not fun, it's not easy. And he's got a great attitude because many of my—I'll tell you just very quickly, is most of my male breast cancer patients, they find it embarrassing. When I bring up a mammogram, they say no. The majority, oftentimes, they quit seeing me, way before they finish their endocrine therapy. It, as Tony said, is breast cancer. I'm a man. This can't happen. But it can. It's rare, but it can, but it's not a death sentence. And that's the thing, is just you have to follow through with it and hopefully get in remission.

Host: Wow. That's shocking to hear. And a great point that you make there. Because certainly if you get that news, you don't want to ignore it. Tony, how about your main message? When you boil it all down, you've had this unique experience as we've detailed, what do you want people to know most about you and about it?

Tony Adams: Well, I think when you're faced with something like this, like you say your mortality, once the shock wears off, I think it's so important to embrace it. And if your idea is to fight it, then fight it with everything you've got. And first of all, find you a good doctor like I did, and build you an army around. I felt like I had an army of folks around me. I know I could not have made this journey by myself. And it's still a journey. And I look forward to not the challenges. But I know that whatever comes my way, I'm ready for. I really am. And it's for variety of reasons.

Some being that everything that Moores has told me has come true. And I wasn't surprised by anything. He was brutally honest, like I said, he didn't always tell me what I wanted to hear, but he told me what I needed to hear. And that was so refreshing to me. And that's why I say going forward, I know that sometimes cancer comes back and, God forbid, if we ever have that. I'm ready for it. And I know that every day's a blessing.

And I just want people to be aware of the things that can happen and I want them to look at me perhaps as the good things that can happen. I mean, I didn't have a great, great, great diagnosis. I mean, I could have folded up and curled up in a little ball. But no, I embraced it and we fought through. And Dr. Moores and his team were fabulous. And I don't know that I could have done it with anybody else. But we're here. And come December, I'll be at his party and Santa will be there. That's how we'll measure our success from here on out.

Host: That's great. Beautifully said, Tony. And folks, we trust you are now more familiar with male breast cancer. Dr. Moores, keep up all your lifesaving work. And Tony, continued good health. Such a pleasure to meet you, and we can't thank you enough for sharing your story. You say in your situation, people can't do it alone. Santa needs his reindeer to pull him along, right?

Tony Adams: Amen. Amen.

Host: And for more information, please do visit sghs.org/med-onc. If you found this podcast helpful, please do share it on your social media. And thanks so much again for being part of Health Matters from Southeast Georgia Health System.