Merkel Cell Carcinoma: What you need to know about the rare form of skin cancer behind Jimmy Buffett’s death
The news of Jimmy Buffett’s death may of came as a shock to many people, but even more surprising was the cause of his death. The iconic singer, long known for his love affair with the sun and beach bum culture, had a form of skin cancer called Merkel cell carcinoma, which ultimately led to his death. Dr. Jason Miller, a board-certified dermatologist in our Freehold, New Jersey office, discusses this rare form of skin cancer, warning signs and treatment options.
What is Merkel cell carcinoma?
Dr. Miller: Merkel cell carcinoma is a rare, potentially aggressive form of skin cancer of neuroendocrine origin. It primarily affects older male patients (>50 years old) with lighter skin and has a high rate of spread/metastasis. MCC is thought to originate after a specific virus (Merkel cell polyoma virus) infects cells in the lower portion of the epidermis. It most commonly is found in the head and neck area but can be found almost anywhere on the skin.
What are the symptoms of Merkel cell carcinoma?
Dr. Miller: Enlarging nontender lesions on the head/neck of an older patient (often with a suppressed immune system). Firm, shiny, 1-2cm blue/red bumps under the skin that are rapidly enlarging. It can be asymptomatic in many cases, which can lead to a delay in diagnosis. The crusting and bleeding that is seen in many other forms of skin cancer is less common in Merkel cell carcinoma.
What are the treatment options for Merkel cell carcinoma?
Dr. Miller: The early-stage treatment options include surgical (excision, lymph node biopsy to check for spread) along with imaging to see if the cancer has spread to other areas of the body; radiation may also be used to treat an area after surgery. For later stages of Merkel cell carcinoma, if the cancer has spread, immunotherapy has become the new standard of care. These medications can utilize the immune system to target cancer cells, leading to improved survival in many cases with fewer side effects compared to traditional chemotherapy. Clinical trials remain ongoing for the best management strategies for advanced MCC, and patients should be following with an oncology team familiar with managing this condition.
What else is important for people to know about Merkel cell carcinoma?
Dr. Miller: Even with treatment advances such as immunotherapy, survival rates after three years from diagnosis are still poor. MCC is one of the most aggressive and deadliest forms of skin cancer. Any rapidly changing lesion in the head/neck area, especially in someone over 50, should be evaluated by a dermatologist as soon as possible to allow early diagnosis and treatment.