Understanding Merkel Cell Carcinoma: A Rare but Aggressive Skin Cancer
In light of the recent passing of Jimmy Buffett, we see this as a time to educate the public on the rare but serious skin cancer, Merkel Cell Carcinoma (MCC). While most skin cancer deaths are from melanoma, MCC has sparsely ever been heard of in a general sense. Unfortunately, MCC is such a rare and aggressive form of skin cancer that it often catches patients and healthcare professionals off guard due to its rapid progression and potential for metastasis. In this blog, we will delve into the key aspects of Merkel Cell Carcinoma, from its origins to its management, shedding light on the importance of awareness and early detection.
What is Merkel Cell Carcinoma?
Merkel Cell Carcinoma is a rare and aggressive type of skin cancer that arises from Merkel cells, which are specialized cells located in the basal layer of the epidermis. These cells play a role in the sense of touch. While Merkel Cell Carcinoma is uncommon, its incidence has been on the rise in recent years (Mayo Clinic Staff, 2022).
Risk Factors
Several risk factors contribute to the development of Merkel Cell Carcinoma, including:
Ultraviolet (UV) Exposure: Prolonged exposure to UV radiation, either from sunlight or tanning beds, is a known risk factor for various skin cancers, including MCC.
Age and Gender: Merkel Cell Carcinoma is more common in older individuals, typically those over the age of 50. Additionally, it occurs more frequently in men than in women.
Immunosuppression: Individuals with weakened immune systems, such as organ transplant recipients or those with chronic diseases, have an increased risk of developing MCC.
Merkel Cell Polyomavirus (MCV): In some cases, the presence of the Merkel Cell Polyomavirus has been linked to the development of MCC (American Cancer Society, 2018).
Clinical Presentation
Merkel Cell Carcinoma often presents as a painless, firm, and rapidly growing nodule or lump on the skin. The most common locations for these growths include the head, neck, and extremities. Due to its aggressive nature, early detection is crucial for better treatment outcomes (Mayo Clinic Staff, 2022).
Diagnosis
Diagnosing Merkel Cell Carcinoma involves a combination of clinical evaluation, biopsy, and imaging studies.
Treatment Options
Surgery: Surgical tumor removal is a primary treatment option for localized Merkel Cell Carcinoma.
Radiation Therapy: Radiation therapy may be recommended to reduce the risk of local recurrence.
Chemotherapy: In cases where the cancer has spread to nearby lymph nodes or distant organs, chemotherapy may be part of the treatment strategy.
Immunotherapy: Recent advancements in treatment have led to the use of immunotherapeutic agents, such as immune checkpoint inhibitors, to enhance the body's immune response against cancer cells (Tai, 2013).
Prognosis
MCC has a higher risk of recurrence and metastasis compared to some other types of skin cancer. The prognosis depends on various factors, including the cancer stage at diagnosis, the patient's overall health, and the effectiveness of the chosen treatment (Cook et al., 2019).
Prevention
Given the association with UV exposure, practicing sun safety measures, such as using sunscreen, wearing protective clothing, and avoiding tanning beds, can help reduce the risk of MCC. Regular skin examinations and prompt evaluation of suspicious skin lesions are essential for early detection.
Merkel Cell Carcinoma may be rare, but its aggressive nature demands attention and awareness. Understanding the risk factors, recognizing its presentation, and seeking prompt medical attention are crucial steps in managing this skin cancer effectively. Ongoing research and advances in treatment options offer hope for improved outcomes, emphasizing the importance of collaboration between healthcare providers and patients in the fight against Merkel Cell Carcinoma. If you have a suspicious skin spot, download CheckMySpot and have it reviewed by a board-certified dermatologist within 24-48 hours.
Sources
American Cancer Society. (2018). Risk factors for Merkel cell skin cancer. Cancer.org. https://www.cancer.org/cancer/types/merkel-cell-skin-cancer/causes-risks-prevention/ris k-factors.html
Cook, M., Baker, K., Redman, M., Lachance, K., Nguyen, M. H., Parvathaneni, U., Bhatia, S., Nghiem, P., & Tseng, Y. D. (2019). Differential Outcomes Among Immunosuppressed Patients With Merkel Cell Carcinoma: Impact of Immunosuppression Type on Cancer-specific and Overall Survival. American journal of clinical oncology, 42(1), 82–88. https://doi.org/10.1097/COC.0000000000000482
Mayo Clinic Staff. (2022). Merkel cell carcinoma. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/merkel-cell-carcinoma/symptoms-cause s/syc-20351030
Tai P. (2013). A practical update of surgical management of merkel cell carcinoma of the skin. ISRN surgery, 2013, 850797. https://doi.org/10.1155/2013/850797