Was Richard Simmons’ death due to a typically non-lethal cancer?
Key Takeaways
Richard Simmons, who passed away on July 13, 2024, reported having basal cell carcinoma (BCC) earlier this year.
This common type of skin cancer is highly treatable if detected early, and deaths are rare. However, BCC can be mistaken for other common skin conditions.
While Simmons’ death was alleged to be due to natural causes, his relative youth and public image of being fit and healthy has sparked speculation about a potential connection to his skin cancer diagnosis.
Basal cell carcinoma (BCC) is common, but deaths from this type of skin cancer are, fortunately, not very common. Yet the recent death of fitness personality Richard Simmons has been linked to BCC.
Simmons, who established himself as a household name and the most popular fitness instructor in the US, died at the age of 76 on July 13, 2024. While it was determined that he died of natural causes, reports of his death cited Simmons’ disclosure earlier this year of undergoing treatment for BCC.[]
Cancer diagnosis earlier this year
In March 2024, Simmons shared that he had been diagnosed with BCC, which first appeared as a blemish under his eye.[] Details on when the lesion arose were not disclosed. Simmons said his dermatologist scraped the area and examined the cells under a microscope, providing the BCC diagnosis within 20 minutes. Simmons’ oncologist informed him he would need to undergo a procedure to burn the skin and remove the cancer cells.
The 30-minute procedure, completed without anesthetic, required two follow-up procedures to remove all of the cancer cells. After this, Simmons said the issue was resolved and he was left without a scar.
"I know some of you reading this have had cancer or have known someone in your life who has had cancer," Simmons shared on his personal Facebook and Twitter pages, at the time. "Promise me you will see your doctor and get a complete checkup."[][]
BCC statistics
According to the American Cancer Society, about 5.4 million cases of the most common types of skin cancer—BCC and squamous cell carcinoma (SCC)—are diagnosed each year in the US, of which 80% are BCCs.[] Along with being the most common type of skin cancer, BCC is also one of the most common types of cancer. Its numbers have been increasing for many years, which may be due to better skin cancer detection, increasing sun exposure, and longer life spans.
BCCs, which develop in areas exposed to the sun—primarily the face, head, neck and arms—are slow-growing and rarely metastasize.[] A BCC can recur if not removed completely, and a BCC left untreated can become advanced.
Advanced BCCs grow deeply into the skin, enclosing the local nerves and blood vessels, potentially causing disfigurement. Metastatic BCC is rare, but when the cancer spreads, it initially travels to the closest lymph nodes, followed by the blood and bones, the lungs, and other skin areas.
“When found early, this skin cancer is highly treatable,” states the American Academy of Dermatology (AAD). “An early basal cell carcinoma can often be removed during an appointment with your dermatologist.”[]
Unlike most other types of cancer, BCC and SCC are not tracked by cancer registries.[] Still, US deaths from BCC and SCC are thought to be rare, with estimates ranging from around 2,000 to 8,000 per year, mainly from SCC.
“Most people who die from these cancers are older and may not have seen a doctor until the cancer has already grown quite large. Other people more likely to die of these cancers include those whose immune system is suppressed, such as people who have had organ transplants or are being treated for autoimmune diseases such as lupus or rheumatoid arthritis,” the AAD notes.[]
Warning signs
The AAD provides seven warning signs of BCC that could be mistaken as harmless.[] These include a pink or reddish growth that dips in the middle and can be mistaken for a skin injury or acne scar.
A growth or scaly patch on or near the ear can be mistaken for dry skin, a minor injury, or a scar. A non-healing or returning sore that bleeds or oozes may be mistaken for a sore or pimple. A raised, scaly patch of irritated skin may be mistaken for dry, irritated skin. A round growth of the same color as the patient’s skin can be mistaken for a mole or a wart. A scaly spot can be mistaken for an age spot or freckle. Finally, a scar-like mark that looks shiny with tight surrounding skin can be mistaken for a scar.
Current guidelines
The AAD published guidelines on the management of BCC and SCC in 2018.[] The following year, the American Society for Radiation Oncology (ASTRO) released its guidelines, focusing on the indications for radiation therapy. The National Comprehensive Cancer Network (NCCN) updated its skin malignancies management guidelines in 2022.
A review published in the Journal of Skin Cancer compared these US guidelines and found that, while AAD, ASTRO, and NCCN use different methodologies to grade evidence, the three groups agree that surgery is the preferred treatment for curing BCC and SCC.[] For patients ineligible for surgery, definitive radiation therapy is recommended by all three groups, with postoperative radiation therapy (PORT) recommended for patients with positive margins unable to be cleared with surgery and for those with nerve invasion.
For patients with lymph node metastases, the AAD, ASTRO, and NCCN guidelines recommend surgery as the primary treatment to cure the disease. NCCN and ASTRO use lymph node size and number, along with extracapsular extension, for recommending PORT. Both NCCN and ASTRO recommend adding systemic treatment to PORT for patients with extracapsular extension.
The US guidelines provide “contemporary and complementary information” on the management of BCC and SCC, the authors concluded.[] “There are opportunities for research, particularly in the areas of staging, indications for adjuvant treatment in curative settings, extent of nerve invasion and prognosis, and the role of systemic treatments in curative and palliative settings.”
What this means for you
BCC is highly treatable if found early. Was this the case for Richard Simmons? As yet, this is undetermined. BCC is a common skin cancer that can be mistaken for other, non-cancerous skin conditions, and therefore any suspicious skin lesion should be evaluated by a dermatologist. The various US guidelines for the management of skin cancer differ slightly, but surgery remains the primary treatment of BCC.