Overview
Merkel cell carcinoma is a rare form of skin cancer that typically presents as a flesh-colored or bluish-red nodule, often appearing on the face, head, or neck. It can also develop on other parts of the body, regardless of sun exposure. The exact cause is not clear, but Merkel cell polyomavirus has been linked to most cases. Risk factors include excessive sun exposure, a weakened immune system, and a history of other skin cancers. Merkel cell carcinoma tends to grow and spread quickly. Symptoms include a fast-growing, painless nodule on the skin that may change in size, shape, or color. If you notice any unusual growths, it is essential to consult a doctor.
Understanding the disease
Symptoms
The symptoms of Merkel cell carcinoma typically include a fast-growing, painless nodule (tumor) on the skin. The nodule may be skin-colored or appear in shades of red, blue, or purple. Merkel cell carcinomas most often develop on the face, head, or neck, but they can appear anywhere on the body, even in areas not exposed to sunlight. If you notice any changes in size, shape, or color of a mole, freckle, or bump, or if it grows rapidly or bleeds easily after minor trauma, it is recommended to see a doctor.
Risk Factors
Risk factors for developing Merkel cell carcinoma include excessive exposure to natural or artificial sunlight, a weakened immune system, a history of other skin cancers, and older age. Merkel cell carcinoma is more common in people with light-colored skin, and it tends to appear on skin surfaces frequently exposed to sun. Additionally, the Merkel cell polyomavirus has been discovered to play a role in causing most cases of Merkel cell carcinoma, although other risk factors are likely involved.
Development
Merkel cell carcinoma begins in the Merkel cells, which are found at the base of the outermost layer of the skin (epidermis). These cells are connected to the nerve endings responsible for the sense of touch. While researchers have discovered that a common virus called Merkel cell polyomavirus plays a role in causing most cases of Merkel cell carcinoma, the exact mechanism of how the virus causes the cancer is not yet determined. It is believed that other risk factors may also contribute to the development of this cancer.
Assessment and Diagnosis
Triage
You should see a doctor if you notice a mole, freckle, or bump that is changing in size, shape, or color, growing rapidly, or bleeding easily after minor trauma, such as washing your skin or shaving.
Diagnosis
To diagnose Merkel cell carcinoma, your doctor will typically perform a physical exam to check for unusual moles, freckles, pigmented spots, or other growths on your skin. If a suspicious growth is found, a skin biopsy will be conducted to remove a sample of the tumor or the entire tumor. The sample will be analyzed in a laboratory to look for signs of cancer. Additionally, imaging tests such as a chest X-ray, CT scan, PET scan, or octreotide scan may be used to help determine the extent of cancer spread beyond the skin. In some cases, a sentinel node biopsy may be performed to check for cancerous cells in the lymph nodes.
Management and Treatment
Complications
Complications of Merkel cell carcinoma may include cancer that spreads to other parts of the body (metastasis), particularly to nearby lymph nodes, as well as organs such as the brain, bones, liver, or lungs. Metastatic Merkel cell carcinoma can interfere with the functioning of these organs and is generally more difficult to treat, potentially leading to fatal outcomes.
Prevention
Merkel cell carcinoma is a rare skin cancer that can be difficult to prevent, as its exact causes are not well understood. However, certain steps can be taken to potentially reduce the risk:
- Protect yourself from excessive sun exposure: Limit your time in the sun, especially during peak hours, and use protective clothing, hats, and sunscreen with a high SPF to reduce your exposure to ultraviolet light. Although sun exposure is not proven to be the direct cause of Merkel cell carcinoma, it is a known risk factor.
- Maintain a healthy immune system: A strong immune system might play a role in preventing the development of Merkel cell carcinoma. Eat a balanced diet, exercise regularly, manage stress, and get adequate sleep to support your immune system.
- Regular skin cancer screenings: Conduct regular self-examinations of your skin, and consult a dermatologist for regular full-body skin exams. Early detection can improve the chances of successful treatment. Keep in mind that while these steps can help reduce the risk of Merkel cell carcinoma, it is still a rare cancer, and the exact causes are not yet fully understood. It's essential to consult a healthcare professional if you notice any concerning changes in your skin.
Home Remedies
It is important to consult a healthcare professional for proper diagnosis and treatment of Merkel cell carcinoma.
Treatment
Treatment options for Merkel cell carcinoma depend on whether the cancer has spread beyond the skin. If the cancer is localized and hasn't spread, the primary treatments may include:
- Surgery: The most common treatment is surgical removal of the tumor, along with some surrounding healthy tissue. This helps to ensure that all cancerous cells are removed.
- Radiation therapy: This treatment uses high-energy X-rays or other types of radiation to kill cancer cells. It can be used instead of surgery or in addition to surgery, particularly if the cancer is in a sensitive location or if the patient is at high risk for complications from surgery.
- Chemotherapy: This treatment uses drugs to kill cancer cells. It may be used if the cancer has spread beyond the skin or if the tumor is large and cannot be fully removed with surgery. If the cancer has spread to other parts of the body (metastasized), treatment options may include a combination of surgery, radiation therapy, chemotherapy, and/or immunotherapy. Consultation with an oncologist is crucial to determine the best course of treatment for advanced cases. It's important to note that researchers have recently discovered a common virus (Merkel cell polyomavirus) that plays a role in causing most cases of Merkel cell carcinoma, but the exact mechanism is yet to be determined.
Preparing for medical consultation
To prepare for an appointment for Merkel cell carcinoma, you should:
- Be aware of any pre-appointment restrictions, and follow any instructions provided by your doctor.
- Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for the appointment.
- List key personal information, including any major stresses or recent life changes.
- Make a list of all medications, vitamins, or supplements that you're taking.
- Consider bringing a family member or friend along for support and to help remember important details.
- Gather your previous scans or X-rays (including images and reports) and any other relevant medical records to bring to the appointment. Remember to arrive on time and dress appropriately for a physical exam, if necessary. Be open and honest with your doctor about your concerns and any questions you have. This will help ensure that you receive the most appropriate care and guidance for your situation.