Buffett dies of Merkel Cell Carcinoma
Merkel cell carcinoma has suddenly entered the public spotlight due to the recent death of music star Jimmy Buffett. Most people have never heard of this type of skin cancer unless they work in the field of dermatology. Honestly, as you read this article you may be thinking that you have never heard of Merkel cell carcinoma either. Studies estimate that roughly 1 out of 100,000 people are diagnosed with Merkel cell carcinoma each year1. This is 0.00001% of people worldwide. Another comparison is that for every 1 Merkel cell diagnosed, 33 melanomas are discovered1.
Merkel Cell Cancer and Basal Cell Carcinoma Look Similar
Personally, as a busy dermatologist in private practice for nearly 10 years now, I have diagnosed only 2 patients with Merkel cell carcinoma. Another patient with a history of Merkel cell carcinoma came to me to establish care. Overall, that is a total of 3 patients out of thousands that I have provided care to over the years. In the two cases I diagnosed, I biopsied the lesions because they looked unusual and mimicked another common type of cancer called basal cell carcinoma. Both Merkel and basal cell cancers can appear as a tender, firm, pink to red bumps on sun exposed areas of the head or neck.
What is Merkel Cell Carcinoma?
What is Merkel Cell Carcinoma? Merkel cell carcinoma is a rare cutaneous malignancy that some researchers believe originates from the Merkel cell located in bottom layer of skin, although this is not known for sure. The Merkel cell’s main function is being involved with the sensory component of skin and are sometimes referred to as the “touch cells” of the skin1. This is why it is referred to as a type of neuroendocrine carcinoma.
Exposure to Excessive UV Light Can lead to Skin Cancer
How a person goes on to develop Merkel cell carcinoma is unknown, however there are a few interesting facts about it. There is a known virus, called the Merkel cell polyomavirus, that is detected in up to 80% of Merkel cell carcinomas2. This virus is thought to be a normal part of the skin microbiome and humans tend to make antibodies to this virus, even more so as people age. Thus, one of the risk factors for developing this type of skin cancer is immunosuppression, which makes sense in this case, as the virus can escape normal defense mechanisms and lead to abnormal cell replication2. Other known facts or trends with this type of cancer is history of excessive ultraviolet radiation, areas typically affected being the head or neck, and most common population being elderly white males >65 years old1.
Merkel Cell Carcinoma Treatment Is Aggressive
After Merkel cell is diagnosed in a patient, treatment is aggressive. The cancer needs to be completely removed surgically along with nearby lymph nodes to make sure it has not spread. Additional treatment may include radiation and immunotherapy depending on lymph node status3. Unfortunately, Merkel cell carcinoma carries a high risk of recurrence, metastasis, and death. And if metastasis occurs, the 5-year survival rate is only 11-20%3.
See a Dermatologist for Unusual Growths on the Skin!
If any good has come from Jimmy Buffett’s death, it increased awareness of skin cancer and the seriousness that can come with it. In general, if you notice an unusual growth on the skin, especially something that is not healing, bleeding, hurting, or seems like it doesn’t belong, it is important to see a dermatologist for a skin check as soon as possible.
I recommend that you follow these tips to reduce your risk of skin cancer:
- Seek shade between 10:00 am and 2:00 pm.
- Wear sun-protective clothing and a wide-brimmed hat.
- Apply a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher.
- Reapply sunscreen every two hours when outdoors; more frequently when swimming or sweating.
- Avoid tanning beds!
- Perform regular skin self-exams.
- Schedule and appointment with our office if you notice new or suspicious spots on your skin, or anything changing, itching or bleeding.
Coggshall K, Tello T, North J, Siegrid S. Merkel cell carcinoma: An update and review: Pathogenesis, diagnosis, and staging. Journal of the Academy of Dermatology 2018; 78: 433-442.
Tai P, Nghiem P, Park S. Pathogenesis, clinical features, and diagnosis of Merkel cell (neuroendocrine) carcinoma. uptodate.com Last update on November 23, 2022.
Tello T, Coggshall K, Yom S, Yu S. Merkel cell carcinoma: an update and review, current and future therapy. Journal of the American Academy of Dermatology 2018; 78: 445-454.