Jimmy Buffett famously sang about “growing older but not up,” a line that became somewhat of a philosophy for millions of Parrot Heads who tuned in to his sunny, salt-rimmed soundtrack to life. But when Buffett died two years ago from Merkel cell carcinoma (MCC), a rare, aggressive skin cancer, a cloud crossed in front of the sun.
Most people had never heard of the disease their musical hero died from, and when Tim LaGue was diagnosed around Thanksgiving last year, he felt blindsided. The diagnosis itself was overwhelming but receiving it as the holiday season began amplified the emotional stress.
MCC is one of the rarest and deadliest skin cancers, known for spreading early – often before a patient realizes anything is wrong. Only about 3,000 cases are diagnosed in the U.S. each year, but one in three of those patients will die from the disease.
“This typically affects older individuals, and sun exposure is the main risk factor,” explained Dr. Ellis Ziel, a radiation oncologist at the Scully Welsh Cancer Center at Cleveland Clinic Indian River Hospital. “There’s also an association with the Merkel cell polyomavirus, which is present on the skin of most adults but usually remains harmless.”
The cancer often begins as a firm, painless, rapidly growing nodule that can easily be mistaken for a benign cyst, bug bite or pimple. Its subtlety is part of its danger.
“MCC can present as a localized lesion, a lesion that has spread to lymph nodes, or it can already be metastatic when diagnosed,” Dr. Ziel said. “Because it spreads so quickly, most patients need a combination of therapies depending on the stage.”
For early-stage, localized cancers, surgeons typically remove the lesion with wide margins of healthy tissue to ensure no microscopic cells remain. Lymph node dissection may follow, and radiation therapy is often added to reduce recurrence risk by up to 65 percent.
Since LaGue’s cancer was in the head and neck region and had a deep margin, his risk of recurrence was high. “We gave him adjuvant radiation, five days a week for five weeks,” Dr. Ziel said.
Through it all, LaGue’s wife, Darlene, provided crucial support. A cancer survivor herself, she understood what it meant to lean on someone you love. Now it was her turn to offer that same steady care.
“He had a little growth on his forehead that just kept growing until it was the size of a quarter,” she said. “I pushed him to get it checked, and the diagnosis was not good. We were lucky to get in with a surgeon quickly. All the tests confirmed Merkel cell carcinoma, and they scheduled surgery right away. We wanted it done before Christmas.”
“They took a graft from his leg and put it on his forehead with a device that pressed the skin down. He looked a little like Frankenstein.” Darlene said. “Honestly, I think he had more pain in his leg than his face, but he was heavily medicated and handled it well.”
Holidays can magnify emotional distress, especially during illness. Energy drops, comfort fluctuates, and what once felt joyful can suddenly feel sad or overwhelming. Patients often try to keep traditions intact but letting go of expectations can be a relief. Simplifying celebrations, relying on others and limiting gatherings can make a world of difference for patients and caregivers.
While Darlene handled day-to-day care like changing dressings, managing medications and getting Tim to radiation, the entire LaGue family stepped in to help. Her daughters organized a meal delivery schedule and helped with chores so the couple could focus solely on healing.
Crowded holiday rooms and long visits can overwhelm someone undergoing intense treatment.
Limiting both the number of visitors and the duration of visits protects the patient’s energy and immune system. And as Darlene reminded family members: “I told them they were coming to see me, and Tim might or might not feel like interacting. He was in a lot of discomfort but grateful to see them.”
The LaGues are far from alone in facing disease during the Thanksgiving and Christmas season.
Cancer doesn’t pause for the holidays. When the world expects joy, many patients and caregivers instead feel waves of fear and grief. Tears are normal. Plans may need to change. A celebration may have to be postponed. Sometimes the most meaningful holiday moments are the quiet ones, like a favorite movie, a few Christmas songs, or simply holding hands.
Most importantly, joy can still be found. It just may appear in smaller, gentler ways.
“Honestly, we were just so thankful Tim made it through surgery and was still alive,” Darlene said. “We scaled down our traditions and filled our hearts with gratitude.”
Caregivers can feel forgotten during the holiday rush. Small gestures like running an errand, dropping off a treat, or sitting with the patient for an hour so the caretaker can regroup, can lift a tremendous weight from their shoulders.
“This year’s Thanksgiving was the best ever with Tim fully recovered,” Darlene said excitedly.
“We had the entire family over and Tim cooked the best Thanksgiving dinner ever! We are already preparing for a huge Christmas gathering.”
Tim and Darlene’s difficult 2024 holiday taught them that even in a season shadowed by cancer, love still found a way to shine through. They discovered the kind grace and gratitude that Jimmy Buffett might have called the simple gift of “growing older but not giving up.”
Dr. Ellis Ziel received his medical education at the University of Alabama School of Medicine and completed his internship in Preliminary Internal Medicine at the University of California, Irvine.
His residency in Radiation Oncology was completed at Rush University Medical Center in Chicago, and his fellowship in Brachytherapy–Radiation Oncology was completed at Ronald Reagan UCLA Medical Center in Los Angeles. His office is located in the Scully Welsh Cancer Center at Cleveland Clinic Indian River Hospital, 3555 10th Court, Vero Beach. The number there is 772-563-4673.
