Dolly Parton’s cancer diagnosis was, by every account from those closest to her, a closely guarded secret — one she managed to keep even as she was admitted to Vanderbilt-Ingram Cancer Center in Nashville.

Until the night her death was announced, the public understanding of her health struggles extended only to an autoimmune condition and recurring kidney stones.

According to reporting from CBS’s Megan Alexander, Parton was surrounded by family, friends, and her physician, Dr. Najib Abumrad, when she died — and the news that she had been battling cancer came as a genuine shock even to people in her inner circle.

Dr. Abumrad, speaking about the diagnosis, noted the layered difficulty of her case: cancer risk rises steadily with age, and Parton’s existing autoimmune disease and kidney issues would have made treating any cancer considerably more complicated.

Signs of decline had been visible for months, even if their cause wasn’t. Roughly two months before her death, Parton appeared at the grand opening of her Tennessee truck stop, visibly needing her manager’s arm for support while navigating the event in heels, and requiring additional ᴀssistance during the ribbon-cutting itself.

She had spoken candidly, in the time since losing her husband Carl Dean, about neglecting her own health during his illness and afterward — saying plainly that she’d let a lot of things go that she should have been taking care of while he was sick, and then continued to do so once he was gone.

The response to her death was immediate and visible well beyond Nashville. Outside her home in Brentwood, Tennessee, fans gathered to leave flowers, cards, and personal mementos, described by reporters on the scene as a display marked by quiet reverence rather than spectacle.

The property, purchased and built by Dolly and Carl in the 1970s, includes a small chapel where the couple renewed their vows on their 50th wedding anniversary.

Trish Shields, Parton’s former personal ᴀssistant, described her as consistently kind and good to everyone she worked with, and said that despite awareness of some ongoing health problems, no one close to her fully grasped how sick she truly was.

Tributes came from across entertainment and public life. Kathie Lee Gifford wept openly discussing her friendship with Parton, saying she’d touched not just her personally but everybody.

Country singer Randy Travis, who has been unable to speak since a stroke, had his wife Mary deliver a message describing the special bond between the two performers, noting that Parton was already a dominant force in country music when Travis was first coming up.

Miley Cyrus, whose godmother relationship with Parton mirrored her role playing “Aunt Dolly” on Hannah Montana, said she felt she had an angel by her side and would always love her.

Both CBS and ABC aired hour-long primetime specials honoring Parton’s life. The tributes extended internationally.

A drone show at Dollywood illuminated the night sky with her image. The Empire State Building in New York shimmered pink in her honor.

Outside Buckingham Palace, the King’s ceremonial guard performed “9 to 5.” Details of her funeral arrangements have also emerged: she will be placed in a mausoleum beside Carl Dean, dressed, according to her own wishes, in a comfortable cotton dress and her signature high heels.

She had previously said she wanted the gospel hymn “If We Never Meet Again This Side of Heaven” sung at her service — the same song she performed at her own father’s funeral in 2000, and one that had been his favorite.