“I once made a million dollars a year with my career,” Dale reminisced to the Los Angeles Times magazine in 2001. “I made $10,000 for three minutes’ work on the ‘Ed Sullivan Show’ in 1963.”

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But Dale’s time in the spotlight came to a sudden end in 1965. That year, when he was only 28, he was diagnosed with rectal cancer. As the Times magazine reported, doctors told the guitarist that without aggressive surgery, he could be dead in a matter of months. He survived, but the cancer bout whittled Dale from 158 pounds to 98 pounds, and also drained his bank account of his pop star proceeds. He moved to Hawaii and stayed away from music for a number of years.

Dale passed away on Saturday night, his longtime drummer Dusty Watson confirmed to NPR. The guitarist was 81. No cause of death has been released.

Tributes have begun popping up online, with many celebrating his distinctive sound. But the musician’s life story was also a constant struggle against health problems — and to pay medical bills. After his first cancer diagnosis in 1965, Dale continued to battle the disease. Up until the end of his life, Dale was explicit that he toured to fund his treatment.

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“I can’t stop touring because I will die. Physically and literally, I will die,” he told the Pittsburgh City Paper in 2015. “Sure, I’d love to stay home and build ships in a bottle and spend time with my wife in Hawaii, but I have to perform to save my life."

Dale’s signature guitar style was the result of a happy accident. Most guitars are strung for a right-handed player. Dale, a lefty, originally picked up the guitar upside down so he could play naturally — without restringing the instrument, leaving the thicker strings on the bottom of the fret board. “[N]obody told me I was holding it wrong,” Dale explained to the Orange County Register in 2009. “I just taught myself to play it like that. It was hard at first.”

Dale’s playing was also heavily inspired by his bloodline. Born in Boston to Lebanese parents, Dale’s father spent most of his childhood in the family homeland. Dale grew up around instruments from the region, such as the tarabaki drums and the oud, a stringed instrument.

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“My uncle taught me how to play the tarabaki, and I watched him play the oud,” Dale told Washington Files, a website run by the U.S. State Department, in 2006. The staccato guitar playing that defined surf rock came directly Middle Eastern music. Dale’s best known song from the 1960s — “Misirlou” — is an electrified revamp of a Mediterranean folk tune.

After his near-death cancer experience in the mid-1960s, Dale reinvented himself as a club owner in Southern California. But bad business decisions and a divorce eventually pulled his lifestyle out from under him. According to the Times magazine, Dale was evicted from his dream house in 1986.

The next year, when he recorded a version of “Pipeline” with Stevie Ray Vaughan that would earn a Grammy nomination, the guitarist was living in an RV parked in his parents’ driveway.

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Dale’s career got an unexpected boost in 1994, when director Quentin Tarantino used “Misirlou” in the opening credits of his Academy Awards-nominated film, “Pulp Fiction.”

But health problems continued to dog Dale, and although various medical conditions made touring difficult, they also made life on the road a financial necessity.

Twenty years after his first diagnosis, Dale’s rectal cancer returned. The second bout left him without parts of his stomach and intestines, and he was outfitted with a colostomy bag. The bag created problems for the left-handed player.

“The bag used to be on my right side, then the doctors took it out of there because there was so much scar tissue and put it on the left side of me,” he told Billboard in 2015. “I told them, ‘Don’t put it there because my guitar lays against it. It’ll break it.’ But they did.”

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The life of a two-time cancer survivor (even one who never smoke, drank, or did drugs) does not exactly mesh with a touring musician. As Dale explained to Billboard, once during the 2010s, when he was set to perform at the Viva Las Vegas festival, his colostomy bag began leaking.

“My fecal matter went down my legs, up my pants, my beautiful cowboy shirt — everything,” he said. “We didn’t have a backup pair of pants, because it was a one-off. Lana [his wife] took everything off and washed my jeans, my stockings, my shoes, my shirt, every part of me. Then we wrung them out wet, and I did the concert with wet pants and shirts. After that, I sat at the merch table, and signed for five and a half hours, me still in my wet clothes. You can only laugh at the whole damn thing.”

Dale continued grinding out concerts on the road despite his health problems — which also included diabetes, renal failure and vertebrae damage that made being onstage excruciatingly painful — because of medical bills. Even with insurance, the cost of buying bags and patches for his colostomy bag and other treatments required Dale to perform live. Touring was his only source of income.

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“I have to raise $3,000 every month to pay for the medical supplies I need to stay alive, and that’s on top of the insurance that I pay for,” Dale told the Pittsburgh City Paper. “The hospital says change your patch once a week. No! If you don’t change that patch two times a day, the fecal matter eats through your flesh and causes the nerves to rot and they turn black, and the pain is so excruciating that you can’t let anything touch it."

However, Dale approached the painful hamster wheel of playing live with an optimistic philosophy.

By opening up about his problems and the financial concerns keeping him on the road, Dale felt he was connecting with his audience in a unique way. Up on the stage, Dale was not some billionaire rocker who had a bank account deep enough to keep the effects of aging at bay, like a Paul McCartney or Mick Jagger.

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Dale was fighting to keep going, just like his fans.

“It’s not ‘Oh, I’m suffering down here and you’re having a good time up there.,' " Dale told Billboard. “I can tell ‘em how much g------ pain I’m going through ‘up there.’ I let them know: I’ve got the same crap you’ve got.”

True to form, Dale had concerts scheduled well into 2019.