Margaritaville Billionaire Dies from Merkel Cell Skin Cancer
September 8, 2023

Did you know there is an aggressive type of skin cancer that is 40 times rarer than melanoma and just as dangerous? Merkel cell carcinoma can be mistaken for a flesh-colored cyst or bluish-red pimple on the face, neck or head. Without diligence, they are easy to overlook because they usually are not painful.
“Just enjoy this ride on my trip around the sun... Just enjoy this ride.”
Jimmy Buffet
License to Chill
Certain factors can increase your risk of developing MCC, like sun exposure, fair skin, having a weakened immune system, or being over 50. Singer-songwriter Jimmy Buffett, known for his Key West tropical rock music and billion-dollar “Margaritaville” brand, recently passed at age 76 after battling Merkel Cell cancer for four years.
Since Merkel cell tumors are not particularly distinctive in appearance, the rapid growth of a pimple-like lump is what should catch your attention. Since spreading of cancer cells is possible, never wait to have a skin abnormality checked out. Early detection can make all the difference in treating Merkel cell carcinoma.
Risk Factors for Merkel Cell Carcinoma
A key factor that contributes to the development of Merkel cell carcinoma is UV exposure. Since ultraviolet radiation from the sun can play a role in developing MCC, tumors are more commonly found on sun-exposed areas of the body like the head, neck, and arms. This is especially true for older Caucasian men, women with fair skin, and those who have been treated for other sun-related skin cancers. It's important to be mindful of hidden sun exposure, such as your hair-covered scalp.
According to the Skin Cancer Foundation, about one in every 130,000 people in the United States will develop Merkel cell carcinoma. And recent research suggests the number of Merkel cell cases are projected to increase to 3,250 cases diagnosed each year by 2025. Risks for MCC increases with advancing age and 75% of patients seen are over 65 at the time of their diagnosis. The average age for developing MCC is 74.
Another important factor in the development of MCC skin cancer is the Merkel Cell Polyomavirus. This virus was initially discovered by researchers at the University of Pittsburgh. Dr. Patrick Moore and Dr. Yuan Chang found the virus to be present in the majority of MCC tumors they tested during a series of studies. Although you were likely exposed to this virus by early adulthood, it typically does not cause any symptoms. By remembering the age-related link, the impact of sun exposure, and the presence of the virus, we all can better manage our risks.
Merkel Cell Cancer Treatments are Personalized
Since people often don’t catch Merkel Cell early enough, the survival rate for this form of skin cancer is lower than most. But here’s the good news – when spotted early-on Merkel cell carcinoma is often curable with surgical and nonsurgical therapies available. Treatment plans for MCC are highly personalized to each patient, taking into account his or her overall health as well as the size, location, depth, and spread of the cancer. Discussed below are frequently combined treatment options:
1) Surgical Removal: The initial approach to treating Merkel cell carcinoma is surgery to remove the tumor. This includes removing a margin of healthy skin around it to ensure all cancer cells are gone. In most cases, a sentinel lymph node biopsy is also performed to check and see if the cancer has spread to nearby lymph nodes.
2) Sentinel Lymph Node Biopsy: This safe, low-risk procedure involves injecting radioactive material at the tumor site. The material travels to the sentinel node. This allows doctors to identify the first lymph node to where cancer cells may have spread. Examining this node confirms if cancer cells are present.
3) Radiation Therapy: Once the Merkel cell tumor is removed, localized radiation therapy may be prescribed to destroy any and all remaining cancer cells and to treat the surrounding lymph nodes if needed. Radiation delivers powerful beams of energy to target cancerous cells and may be an alternative to surgery for some patients.
4) Medical Therapy: Drugs are also available to treat Merkel cell carcinoma. Immunotherapy has emerged as an effective strategy (particularly for more advanced cases) in combination with surgery or radiation therapy. It can also be used as a standalone treatment for cases where other treatment options are not possible.
The good news is that survival rates for Merkel cell carcinoma are steadily improving thanks to advances in immunotherapy and new medications. However, it's important for former patients to stay vigilant as Merkel cell carcinomas can come back after successful treatment. So closely monitor your skin for changes that indicate an occurrence (or a recurrence) of these dangerous skin lesions. In addition, anyone who has had skin cancer of any type are at higher risk for developing new skin cancers, so keep an eye out for skin changes.
Skin Cancer Foundation – The Big See®
One-in-five Americans will develop skin cancer during his or her lifetime. That's why The Skin Cancer Foundation launched The Big See, a nationwide campaign aimed at empowering individuals to be proactive about their skin health. The Foundation encourages everyone to become more familiar with their own skin. All it takes is a routine approach to detect skin cancer early. Since you can actually see skin lesions, early detection of skin cancer is possible anytime you check. Just remember to consider these three adjectives: New, Changing, or Unusual.
The mission of The Big See is to reduce incidences of skin cancer through education and to help people spot all types of cancers early on before they become a more serious health issue. A new mole or lump that suddenly changes in size, shape, color, texture or anything unusual that stands out from the rest of your skin could be an important warning sign. If you notice something suspicious, schedule an appointment with our dermatologist right away. Unless the disease is left untreated, most skin cancers are highly curable.
Working together, communities across Central Florida have been helping with the fight against skin cancer by hosting events that offered free screenings and helped educate community leaders about sun-safe practices. The Big See is just one part of the Skin Cancer Foundation's multi-year public service campaign to inspire you to take a closer look at your skin and to gain a better understanding as what to look for when performing self-exams. Always seek shade when possible, wear protective clothing when outside, and use a SPF-30 or higher chemical sunscreen or advanced mineral sunblock.
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Our dedicated dermatology providers have saved numerous lives by delivering timely diagnoses and treatments for all types of skin cancers. When detected at an early stage, even rare skin cancers like Merkel Cell Carcinoma can be successfully managed. For those of us living in the Sunshine State, regular self-screenings can save lives. Call 800-877-7546 to schedule your next appointment at one of our seventeen dermatology offices in Orlando, Altamonte Springs, Apopka, Celebration, Clermont, Davenport, Dr. Philips, Hunter's Creek, Kissimmee, Lake Wales, Mount Dora, Ocoee, Poinciana, Sanford, or St. Cloud.
Shutterstock photo courtesy of VIAVAL TOURS