The Intersection of Medicine, Music, and Personal Triumph

Can resilience and music truly transform lives? Join us in this compelling episode as we sit down with Jason Edwards, MD, an expert in physiology and radiation oncology, to explore the multifaceted journey of improving life’s quality and length. We'll discuss the life and passing of beloved musician Jimmy Buffett due to Merkel cell carcinoma, a rare and aggressive skin cancer. Jason provides in-depth insights into the complexities of diagnosing and treating this disease, underlining the critical importance of early detection and consulting specialists for any suspicious skin lesions.

Prepare to be moved by the poignant story of how Jimmy Buffett’s iconic song "Come Monday" became a beacon of hope during his darkest days. Through his candid interview with David Letterman, Buffett revealed the emotional struggles he faced while working at Howard Johnson's and how this song marked a pivotal turning point in his life. This episode not only highlights Jason’s medical knowledge but also shines a light on the profound influence of resilience and music on our lives. Tune in for an enriching conversation that bridges the worlds of medicine, art, and personal triumph.

Chapters

• 0:00 Improving Life Quality Through Various Topics
• 7:58 Overcoming Tough Times With Music

Transcript

Speaker 1: 0:14

Hello, my name is Jason Edwards and we are starting a podcast here at St Luke's. The podcast will focus on all sorts of things, but the overall theme will be improving the length of your life as well as the quality of your life. I want to talk about everything in this podcast. I want to talk about art, physics, science, medicine, sickness, health and relationships. Let me give you a quick 60-second overview of who I am.

Speaker 1: 0:38

I went to the University of Missouri on a track and cross-country scholarship. I graduated with a degree in biology. I then went on to get my PhD in cardiovascular physiology. Specifically, I studied diet, diabetes, exercise and the effects of those things on the heart and coronary arteries. I then went on to medical school, followed by residency in radiation oncology. Radiation oncologists use subatomic particles to treat cancer in conjunction with chemotherapy and surgery.

Speaker 1: 1:05

I'm married. My wife is also a physician, she's a high-risk OB-GYN. She also completed a trauma surgery fellowship and I'm the father of two children. I enjoy fishing and now powerlifting, as I don't run anymore. I think two of the most interesting things in this world are being with people and learning new things, and this podcast checks both of those boxes. My goal is to learn a lot as we go through this process and enjoy spending time with the guest as we do each show. The one thing that's nice about this podcast is it allows us to stay fairly topical as we go through it. One of the things I want to talk about in this podcast is it allows us to stay fairly topical as we go through it. One of the things I want to talk about in this podcast is Jimmy Buffett. I find him completely fascinating.

Speaker 1: 1:45

He recently passed away from Merkel cell carcinoma. That's a very rare cancer. Merkel cell carcinoma is a skin cancer and it's also a neuroendocrine cancer. It's a very aggressive cancer, somewhat similar to melanoma. Patients with Merkel cell carcinoma typically have a skin lesion and the problem with it is it quickly gets into the bloodstream and spreads to other parts of the body and at that point it becomes incurable. When it metastasizes to other organs, it can be treated, and most commonly now treated with immunotherapies, which are kind of like chemotherapy, but they're a medication that's given through an IV infusion and it turns your own immune system on. It helps your own immune system fight the cancer, and the nice thing about this treatment is not only is it effective, but it doesn't typically cause a lot of side effects. It can have side effects, but they're relatively rare. They can be severe, but they're relatively rare. So most patients on immune therapy have a high quality of life, while it also lengthens your life, which are our two main goals. I don't know specifically what Buffett was treated with, but he was likely treated with an immune therapy.

Speaker 1: 2:57

So what causes Merkel cell carcinoma? Naturally you'd think, well, if Jimmy Buffett got it, it was from you know, all his time in the sunlight and about 20% of cases are caused from sun exposure. But about 80% of cases are caused from a virus called polyomavirus. It's such a rare cancer that when the frequency of the cancer is so few, it's actually hard to attribute it to different things. But that's the best they have so far. It's not typically a genetic cancer when we think of cancers that are passed on from generation to generation through genes, more commonly that things like breast cancer, prostate cancer, can be that way as well. You can have ovarian cancer to some degree as well. But skin cancers things from exposure like skin cancers and lung cancer from cigarette smoke those are very much less common have a genetic component to it where it's passed down through a gene mutation from generation to generation.

Speaker 1: 4:01

I've treated a few patients with Merkel cell carcinoma. The main treatment for it is surgical resection and then it can be followed by radiation if there's high-risk features. I've actually had one patient on treatment right now, or I've treated recently in the past few years who we actually cured it looks like so far from her Merkel cell carcinoma. So that's really positive. But it's an uncommon cancer. It's so uncommon that I can remember the four patients that I've treated in my whole life and I treat a lot of patients um for cancer, and so it's it's just a very rare cancer. In fact, when I first came for my interview here at St Luke's um, they gave me a list of the patients on the tumor board and one of the patients had Merkel cell carcinoma. So when you interview, of course there's no way they're going to ask you medical questions, but you never know, and so I read a bunch about it at that time and so of course that was years ago. But yeah, it's a rare cancer and it's an aggressive cancer and the treatments are getting better, but it's still one of those cancers that's very difficult to beat.

Speaker 1: 5:10

In general, when we talk about skin cancers, the vast majority of skin cancers are going to be squamous cell carcinomas and basal cell carcinomas, and those are kind of flesh colored tumors. They don't look that much different than your normal skin. You could have kind of a pearly aspect to the skin. Sometimes you can see a vessel within the basal cell carcinoma. The squamous cell carcinomas sometimes can bleed or become crusty, but melanomas and Merkel cell carcinomas they don't look like those. They're typically darker, especially the melanomas, they have pigment and of course the thing to do is if you see any lesion on your skin, that's concerning. Even if somebody comes to my office and they have an abnormal lesion that I can't quite identify, although I'm pretty sure it's not cancer, I still say go see your dermatologist because you want to stuff like that, you want to talk to an expert, you want to get it checked out, and so most skin cancers are going to be on the legs and on the back Most of the time. You know we're wearing, you know, shorts and a shirt and so so that's where you're going to see most skin cancers. If you don't have any hair, like me, you can have a cancer on the top of your scalp. The top of the ears is a common spot and, believe it or not, the lower lip has a much higher incidence of skin cancer than the upper lip, and so and that's thought, they don't know for sure, but it's thought to be because the brim of the hat comes over the head and actually provides a little bit more shade to the upper lip than the lower lip. But you know, you never know it's so. You know what do you do? You wear your hat, you wear your sunscreen, you try not to get sunburns and that's how you minimize your risk.

Speaker 1: 6:58

The other thing, when I think about Jimmy Buffett, I actually worked on a boat for a while Between my freshman and sophomore year. My uncle, the world-famous Captain Jack Edwards, had a large boat. It was a 50 by 30 foot catamaran and I was his first mate. There was also Captain Mark as well. It was an ocean-going catamaran and we would take patrons around the lake and raise the sails and sing and dance with them and I would fetch them beers. But it was a wonderful summer and so anytime I hear Jimmy Buffett it kind of takes me back and puts me in a good mood. And although everybody wasn't a first mate on a catamaran, I think most people kind of get this same sensation when they hear Jimmy Buffett songs. It makes them happy, it makes them kind of think about maybe their last vacation to a beach. And you know, that's one of the wonderful things about art you can get leverage with art. You can draw a painting once and millions of people can see it. You can make a song once and millions of people can see it. And so I think Jimmy really made a positive difference in this world.

Speaker 1: 7:58

I heard an interview once with Buffett and he was I think it was David Letterman who was interviewing him, and Letterman was saying you know, you know, tell me about yourself. And he said this song come Monday actually saved my life. And Letterman asked how's that? And he said well, I was working at a Howard Johnson's and I was suicidal and I was having a tough time in life and things weren't really going my way. But all of a sudden the song hit and it changed the course of my life and it just makes me think. You know, sometimes we're all going through a tough time and it's important to realize that good times don't last and neither do bad. We go through phases in life and a lot of times, if you just hang in there, the tide's going to turn Buffett. He hung in there and his song was a hit. And he went on to make hit songs and many people in this world a lot happier for a long time. And so here's to Jimmy Buffett.