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Definition

What is Merkel cell carcinoma?

Merkel cell carcinoma is a rare type of skin cancer that usually appears as a flesh-colored or bluish-red nodule, often on your face, head or neck. Merkel cell carcinoma is also called neuroendocrine carcinoma of the skin.

Merkel cell carcinoma most often develops in older people. Long-term sun exposure or a weak immune system may increase your risk of developing Merkel cell carcinoma.

Merkel cell carcinoma tends to grow fast and to spread quickly to other parts of your body. Treatment options for Merkel cell carcinoma often depend on whether the cancer has spread beyond the skin.

How common is Merkel cell carcinoma?

Merkel cell carcinoma is not common. More than 9 out of 10 people diagnosed with MCC are older than age 50, and more than 2 out of 3 are older than 70. MCC is much more common in whites than in people of other races. More than 9 out of 10 cases of MCC in the United States develop in whites. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of Merkel cell carcinoma?

The first sign of Merkel cell carcinoma is usually a fast-growing, painless nodule (tumor) on your skin. The nodule may be skin colored or may appear in shades of red, blue or purple. Most Merkel cell carcinomas appear on the face, head or neck, but they can develop anywhere on your body, even on areas not exposed to sunlight.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

You should contact your doctor if you notice a mole, freckle or bump that is:

  • Changing in size, shape or color
  • Growing rapidly
  • Bleeding easily after minor trauma, such as washing your skin or shaving

Causes

What causes Merkel cell carcinoma?

It’s not clear what causes Merkel cell carcinoma. Merkel cell carcinoma begins in the Merkel cells. Merkel cells are found at the base of the outermost layer of your skin (epidermis). Merkel cells are connected to the nerve endings in the skin that are responsible for the sense of touch.

Researchers recently discovered that a common virus plays a role in causing most cases of Merkel cell carcinoma. The virus (Merkel cell polyomavirus) lives on the skin and doesn’t cause any signs and symptoms. Just how this virus causes Merkel cell carcinoma has yet to be determined. Given that the virus is very common and Merkel cell carcinoma is very rare, it’s likely that other risk factors play a role in the development of this cancer.

Risk factors

What increases my risk for Merkel cell carcinoma?

There are many risk factors for Merkel cell carcinoma, such as:

  • Being exposed to a lot of natural sunlight.
  • Being exposed to artificial sunlight, such as from tanning beds or psoralen and ultraviolet A (PUVA) therapy for psoriasis.
  • Having an immune system weakened by disease, such as chronic lymphocytic leukemia or HIV infection.
  • Taking drugs that make the immune system less active, such as after an organ transplant.
  • Having a history of other types of cancer.

Being older than 50 years, male, or white.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is Merkel cell carcinoma diagnosed?

The following tests and procedures may be used:

  • Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Full-body skin exam: A doctor or nurse checks the skin for bumps or spots that look abnormal in color, size, shape, or texture. The size, shape, and texture of the lymph nodes will also be checked.
  • Skin biopsy : The removal of skin cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.

How is Merkel cell carcinoma treated?

Treatments for Merkel cell carcinoma can include:

  • During surgery, your doctor removes the tumor along with a border of normal skin surrounding the tumor. If there’s evidence that the cancer has spread to lymph nodes in the area of the skin tumor, those lymph nodes are removed (lymph node dissection).

The surgeon most often uses a scalpel to cut away the cancer. In some cases, your doctor may use a procedure called Mohs surgery.

During Mohs surgery, thin layers of tissue are methodically removed and analyzed under the microscope to see whether they contain cancer cells. If cancer is found, the surgical process is repeated until cancer cells are no longer visible in the tissue. This type of surgery takes out less normal tissue — thereby reducing scarring — but ensures a tumor-free border of skin.

  • Radiation therapy. Radiation therapy involves directing high-energy beams, such as X-rays, at cancer cells. During radiation treatment, you’re positioned on a table and a large machine moves around you, directing the beams to precise points on your body.

Radiation therapy is sometimes used after surgery to destroy any cancer cells that remain after the tumor is removed.

Radiation also may be used as the sole treatment in people who choose not to undergo surgery. Radiation can also be used to treat areas where the cancer has spread.

  • Chemotherapy uses drugs to kill the cancer cells. Chemotherapy drugs can be administered through a vein in your arm or taken as a pill or both.

Your doctor may recommend chemotherapy if your Merkel cell carcinoma has spread to your lymph nodes or other organs in your body, or if it has returned despite treatment.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage Merkel cell carcinoma?

The following lifestyles and home remedies might help you cope with Merkel cell carcinoma:

  • Avoid the sun during peak hours. Avoid sun exposure as much as possible during the strongest sunlight hours of the day — typically from 10 a.m. to 4 p.m. Move your outdoor activities to a time earlier in the morning or later in the day.
  • Shield your skin and eyes. Wear a wide-brimmed hat, tightly woven clothing and sunglasses with ultraviolet light (UV) protection.
  • Apply sunscreen liberally and often. Use a broad-spectrum sunscreen with an SPF of at least 15. Apply sunscreen generously, and reapply every two hours — or more often if you’re swimming or perspiring.
  • Watch for changes. If you notice a mole, freckle or bump that’s changing in size, shape or color, talk to your doctor. Most skin nodules never become cancer, but catching cancer in its early stages increases the chances that treatment will be successful.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: September 14, 2017 | Last Modified: September 14, 2017

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