Published On:Tuesday, April 12, 2011

Bob Marley the charismatic beloved Jamaican singer, who introduced reggae infused with Rastafarian themes died from a cancerous brain Tumor on May 11, 1981 in Miami. Florida. He was only 36 years old.

It's been 30 years since his death; and there have many rumours and speculation about the cause of death. Did he really die from a brain tumor? Or other nefarious causes? Like the CIA? Poison in his boots etc? Bob Marley's medical records were never made public. However from several sources I managed to piece together the story of his illness and death from Metastatic Skin Cancer (Melanoma). This account I hope is fair, balanced and enlightening.

Bob Marley remains the most widely known and revered performer of reggae music and is credited with spreading Jamaican and the Rastafarian movement worldwide.

HIS LIFE

Born Robert Nestor Marley, Feburary 6, 1945 to an English father Norman Marley, 50 and a Black Jamaican mother Cedella Booker 18 Bob grew up in St Ann's; then Trench Town Kingston, Jamaica.

He recorded his first two singles "Judge Not and "One Cup of Coffee" (1962) but they attracted little attention! He then formed the original Wailers(1963) and they had their first big hit "Simmer Down"(1964). Years later in an interview Peter Tosh one of the original Wailers said he (Tosh) hated the song.

By the 1970's the group was an international success with hits such as "No woman no cry", "Jamming", "On Love" and " Redemption Song" . He married Alpha Rita Anderson in 1966. She became the famous Rita Marley. He became a Rastafarian the same year.

When was the first indication that something was amiss with Bob Marley's health? According to sources this first happened in the summer of 1977. He injured his right great toe during a Soccer game on tour in Paris, France. The toe nail became partially detached and painful. He admitted to his manager that the toe had been injured before and a wound was "on and off" for years! If that was true, could a malignant melanoma (skin cancer) been growing there earlier? A wound or sore that refuses to heal is a classic sign of skin cancer.

The hotel doctor was consulted and the right great toe nail was removed and the toe bandaged. No biopsy was done. The European tour continued and the Right great toe appeared to heal. However, later that summer he hurt the toe again playing soccer. It was painful and a new wound opened up and refused to heal. As Bob Marley went to London for a meeting, late that summer (1977), his manager advised him to see a doctor. According to reports the appearance of his toe shocked the Doctor. It was said to be "eating away". A skin biopsy was done (removal of skin tissue for examination under the microscope).

The shocking diagnosis of a malignant melanoma (Skin Cancer) was given to Bob Marley. He was advised that treatment would be to amputate the toe, to stop the cancer from spreading.

In Miami still in the summer 1977, the British diagnosis of malignant melanoma was confirmed to Bob Marley again. He was advised to get the toe amputated and possibly the right foot. Again he refused.

Why didn't Bob Marley have the amputation? He cited religious beliefs about "not cutting the flesh". However he allowed the famous orthopedic surgeon Dr William Bacon to do a surgical excision to "cut away" cancerous tissue on the toe and do a skin graft at Cedar's of Lebanon Hospital (now University of Miami Hospital). He remained in Hospital one week and spent about three months recuperating in Miami. The procedure was deemed "a success". But sadly it was not. The cancer in it virulent form began to spread through his body (metastasized).

This brings the question, why would Bob Marley get skin cancer on his toe? First we must remember that Bob was diagnosed with an Acral Melanoma. This type accounts for 70 per cent of melanoma in darkly pigmented individual or Asians. It typically occurs on non-sun exposed areas as the palm, the sole and mucosa and under the nails. It is characterised by a dark mole or spot that can turn cancerous.

This can happen by repeated trauma to the area or for no reason at all. Studies have shown that darker skin people are more likely to present with advanced disease stage III -IV than whites who typically appear with stage I. This is exactly what happened in Mr Marley's case. He presented with a skin cancer stage 3-4 on his toe.

He also was fair-skinned of a white father. Being fair-skinned is a risk factor for skin cancer. Melanoma can take years to spread. Most likely he had a pigmented dark mole under his right great toe nail, the continued playing of soccer traumatized the dark mole, which turned cancerous then into a sore. When his cancer was discovered (summer of 1977) the recommendation to amputate his toe would most certainly have saved his life. The surgical excision done and the skin graft (July 1977) was ineffective or simply too late.

As the years went by, his health was deteriorating. He continued to be immersed in his music. In 1976 there was an attempt on his life in Jamaica, Mr Marley narrowly escaped death, He, his wife and manager Don Taylor were shot.

Among the Doctors attending, them was a prominent Bahamian doctor Dr Philip Thompson who was attending U.W.I. at the time.

In 1979, Bob Marley visited Nassau, The trip was opposed by some religious ministers.

It does not appear that he followed up on his doctor's visits.

All appeared well until 1980. He released his last album "Uprising" and the band, the Wailers were planning an American tour with Stevie Wonder for the winter of 1980. However by the summer of 1980 the cancer was metastasizing through his body. According to sources, he did not feel well and saw a doctor who give him clearance to go on tour!

The tour started in Boston followed by New York in September 1980. During the show in New York in Madison Square Gardens Bob looked sick and almost fainted. The very next morning September 21 while jogging through Central Park Bob Marley collapsed and was brought to a hospital. Tests showed a brain tumor, which most likely had spread from the primary cancer on his right great toe. The cancer was now spreading to his vital organs.

How does a malignant melanoma spread? It is generally agreed that melanoma cells spread via the lymphatic, the blood stream or both. Then it can affect the liver, the lungs, the brain or the bones.

A neurologist gave him one month to live. Rita Marley is said to have wanted the remaining tour cancelled, but Bob wanted to continue. He played his last show in Pittsburgh, but was too ill to continue and the tour was finally cancelled. That show proved to be his last.

Convinced at last to seek medical treatment, Bob was admitted to Sloan-Kettering Cancer Center in Manhattan NY. This center is one of the world's leading cancer treatment center. Tests then revealed the malignant melanoma cancer had spread to his lungs and liver. He received a few radiation treatments, but checked out when some New York papers let on that he was seriously ill. He went to Miami, then back to Sloan-Kettering, then Jamaica. Why the back and forth? Some said he hadn't much faith in "Western Medicine".

He was advised to seek further help in Germany. Bob and his entourage then travelled to Germany to the Bavarian Clinic of Dr Josef Issels. He was a specialist in Holistics, or Toxic cancer

treatment. Why leave a world renowned cancer treatment center like Sloan-Kettering to go to a holistic center? That is a mystery to me.

While in Germany Bob Marley celebrated his 36th, and final birthday. While at the center in Germany Bob received such treatments as exercise, ozone injections, vitamins and trace elements. However, as the months went by, he realised that these treatments were not working and his cancer was terminal.

TREATMENT

What is the treatment for Advanced Malignant Melanoma ?

According to the American Academy of Dermatology 2010 "No effective therapy exists at this time for metastatic disease to the internal organs". Until effective therapy is developed the focus must remain on early detection and removal of the primary tumor or mole.

As his metastatic disease progressed, Bob Marley decided to die at home in Jamaica. The group chartered a flight for the trip home. While flying home to Jamaica his vital functions worsened, and the plane was directed to Florida. He was immediately admitted to Cedars of Lebanon Hospital and died May 11, 1981. His wife and mother were by his side. He was said to weigh a shocking 82lbs on the day he died.

He received a state funeral in Jamaica May 21 1981, which combined Ethiopian Orthodoxy and Rastafarian tradition. He was buried with his guitar, a soccer ball, a marijuana bud, a ring and a Bible.

Can we learn anything from the Bob Marley Story?

Yes, no one is exempt from a Cancer diagnosis. Moreover we learn that taking action on anything of concern is imperative.

Shocking statements were made at the time of his diagnosis by a top Rastafarian that "Rasta can't get cancer, it is nothing but a 'Buck toe' and the doctor doesn't know what he is talking about!"

Statements like this have no place in today's world. A malignant melanoma cancer diagnosis must be taken seriously and acted upon immediately.

The amputation of his toe would have certainly prolonged his life or even saved it completely. We also learn that follow up visits are also important especially if one is diagnosed with a malignant cancer.

Some questions still remain about the Bob Marley story.

Why was he given clearance to go "on tour" with an advance malignant melanoma? Did the Doctor really know his condition? Were any medical tests done? Blood, x-rays etc? Was he was a medical specialist?

Also how did he manage to survive so long with an advanced cancer? Was it his marijuana use? This is highly unlikely. According to studies it is difficult to predict outcomes for individual patients with melanoma. We know he was a man of incredible stamina and drive.

Would the FDA approved drug Interferon have helped him? This is the only one approved for Adjuvant treatment of malignant melanoma. Definitely, the amputation would have prolonged his life.

Let's say Mr Marley was diagnosed with an advanced melanoma on his toe in 2011; what would his treatment be? The treatment would be the same, amputation of the toe, maybe even the foot, and the use of adjuvant treatment and follow up visits. However the focus this 2011 is still the same, early detection and surgical excision of the primary tumor/mole.

* (This article expresses the author's personal views on what caused the death of Bob Marley)

Dr Cleland Gooding MD., F.A.A.D. is a physician with a specialty in Skin Diseases. He is employed by the Bahamas Government. He is also an Associate Lecturer at U.W.I. (Bahamas) In the Dermatology Department, and a member of the Voluntary Faculty, Department of Dermatology, University of Miami.

Email: Clegood5@hotmail.com