We Ask an Austin Dermatologist about Jimmy Buffett’s Deadly Merkel Cell Carcinoma
When Jimmy Buffett died on Sept. 1, the shock of the death of the 76-year-old singer of “Margaritaville” was palpable.
His Parrot Head fans asked what is Merkel cell carcinoma, the cancer that led to his death.
Why haven’t we heard about Merkel cell carcinoma before?
“Even within medicine there’s not much knowledge for it,” said Dr. Russell Peckham, a Cedar Park dermatologist with U.S. Dermatology Partners.
It’s very rare, compared with other skin cancers. It is 40 times more rare than melanoma, according to the Skin Cancer Foundation. The National Institutes of Health estimates there were 2,800 cases in 2020.
What are the signs of Merkel cell carcinoma skin cancer?
Merkel cell is fairly nondescript, Peckham said. Often it looks like a pencil eraser-size blue or red bump on the skin that is glassy.
With skin cancer, we talk about evaluating a mole or skin area with the ABCDE’s:
- A: Asymmetrical with an irregular shape.
- B: Border, the edges are abnormal and not defined.
- C: Color, the mole has changed colors or it has an uneven distribution of color.
- D: Diameter of more than 1/4 of an inch.
- E: Evolving, it changes over time.
- For Merkel cell carcinoma, only E applies, Peckham said. The skin in that area does change over time, Peckham said.
Merkel cell carcinoma looks like a red or blue glossy bump on the skin.
Who is most at risk for Merkel cell carcinoma skin cancer?
It mainly happens in older men, with fair skin and spend a lot of time out in the sun, Peckham said.
“We don’t understand why men and why age 70 and over,” Peckham said, though he reminds that anyone at any age could get it.
How does Merkel cell carcinoma become deadly?
This skin cancer is very aggressive and has similar survival rates to melanoma, Peckham said.
Those rates depend on when the cancer was caught and if it has spread. If it’s localized, the survival rate is 75%, according to the American Cancer Society, but if it as spread regionally, those rates drop to 61%. If it has spread to a distant area from the initial sight, the survival rate falls to 24%.
“If I had to pick, this would be the last one I would pick,” Peckham said of all the skin cancers.
Like any cancer, the cancer spreads through the lymph system or the blood stream to other areas including the brain and organs.
Merkel cell carcinoma looks like a red or blue glossy bump on the skin.
How is Merkel cell carcinoma treated?
If it is caught early, it can be surgically removed. If it has spread to the lymph nodes or other areas of the body, then like any cancer, treatment could include radiation and immunotherapy.
An oncologist becomes involved in the case after the dermatologist has diagnosed the cancer.
What precautions should you take against skin cancer?
“We really stress the importance of sun protection,” Peckham said.
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Avoid being exposed to the sun in the heat of the day, from 10 a.m. to 4 p.m.
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Cover up skin with sun-protective clothing and a hat if you are going to be outside. Clothing is now made with sun protection factor (SPF) in it.
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Wear sunscreen daily, especially if you are going to be outside. At a minimum it should be SPF 30, but Peckham prefers SPF 50 or higher.
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Reapply sunscreen every 90 minutes when you are outside.
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Get yearly skin checks and watch for changes in your skin in between checks.
