Merkel Cell Carcinoma Treatment
Fast, expert intervention for one of the most serious forms of skin cancer.
Merkel Cell Carcinoma: Fast-Acting and Often Misunderstood
Merkel Cell Carcinoma (MCC) is a rare but highly aggressive type of skin cancer with a high risk of local recurrence and lymph node spread. Though MCC accounts for a small percentage of all skin cancers, it is considered one of the most dangerous due to its rapid growth and potential to metastasize.
Early detection and proper treatment are essential for achieving the best outcomes. At Phoenix Surgical Dermatology Group, our board-certified dermatologists and surgical specialists provide expert evaluation, diagnosis, and treatment for Merkel cell carcinoma to help ensure the highest chance of cure and long-term success.
What is Merkel Cell Carcinoma?
Merkel Cell Carcinoma is a rare neuroendocrine skin cancer that tends to develop on sun-exposed areas of the skin such as the face, neck, and arms. While the exact cell of origin is still debated, MCC was originally thought to arise from Merkel cells, which are touch-sensitive cells located at the base of the epidermis (the top skin layer).
MCC is often misdiagnosed at first because it may resemble benign lesions like cysts, lipomas, or inflamed hair follicles. This makes
clinical suspicion and timely biopsy critical for accurate diagnosis.
Causes and Risk Factors of Merkel Cell Carcinoma
Although the exact cause of MCC is not fully understood, several risk factors have been strongly associated with its development:
Primary Risk Factors for MCC:
- Merkel Cell Polyomavirus (MCPyV): Found in approximately 71% of MCC cases, this virus is thought to play a key role in the development of many tumors.
- Ultraviolet (UV) Radiation Exposure: Chronic sun exposure is a significant contributor, especially in light-skinned individuals.
- Immunosuppression: MCC incidence is higher in patients with weakened immune systems, including:
- Organ transplant recipients
- HIV-infected individuals
- People with chronic lymphocytic leukemia (CLL)
- Older Age: Most cases occur in people over
50 years old.
- Fair Skin Tone: Lighter-skinned individuals are at greater risk.
Warning Signs of Merkel Cell Carcinoma
MCC typically presents as a rapidly growing, painless bump on sun-exposed skin. It may appear skin-colored, reddish, or bluish and can easily be mistaken for a harmless growth.
Common Features of MCC (Remember AEIOU):
- Asymptomatic (painless): Present in
88% of cases
- Expanding rapidly (significant growth in less than three months):
63%
- Immune suppression:
8%
- Older than 50 years:
90%
- UV-exposed site on fair skin:
81%
Having
three or more of these features significantly increases the likelihood of MCC. If you notice these warning signs, seek prompt evaluation from a dermatologist.
How Serious is Dermatofibrosarcoma Protuberans (DFSP)?
While metastasis is extremely rare in DFSP, the tumor is known for its high rate of local recurrence if not completely removed. The good news is that the 10-year survival rate for DFSP is over 99% when treated effectively.
The best treatment approach is
Mohs micrographic surgery, a technique that allows for the complete evaluation of cancer margins, offering the highest likelihood of cure with the least tissue removal.
How Is Merkel Cell Carcinoma Diagnosed?
Because MCC is rare and can mimic benign lesions, proper diagnosis requires careful clinical evaluation and biopsy.
Diagnostic Process Includes:
- Full skin examination by a board-certified dermatologist.
- Skin biopsy: A tissue sample is collected from the lesion and sent for microscopic analysis.
- Immunohistochemistry (IHC) testing: Used to identify MCC-specific markers.
- Sentinel Lymph Node Biopsy (SLNB): May be recommended to determine whether cancer has spread to nearby lymph nodes.
- Imaging studies (CT, PET, or MRI scans): May be needed to assess lymph node involvement or distant metastasis.
Due to the aggressive nature of MCC,
early and accurate diagnosis is crucial.
Treatment Options for Merkel Cell Carcinoma
Treatment for MCC depends on several factors, including the tumor's size, depth, location, lymph node involvement, and overall patient health. Because MCC is aggressive, a multidisciplinary approach may be required.
- Surgical Excision:
- Complete removal of the tumor with clear margins.
- Often includes
sentinel lymph node biopsy to check for cancer spread.
- Mohs Micrographic Surgery:
- In select cases, Mohs surgery may be used for precise removal, especially in sensitive areas like the face.
- Radiation Therapy:
- May be used as a primary treatment if surgery is not feasible.
- Often recommended
post-surgery to reduce recurrence risk.
- Immunotherapy:
- Considered a frontline option for advanced or metastatic MCC.
- Immune checkpoint inhibitors like
avelumab, pembrolizumab, and
nivolumab have shown promising results.
- Chemotherapy:
- Sometimes used for metastatic MCC, though less commonly employed today due to the success of immunotherapy.
Treatment decisions are individualized and may involve collaboration with
oncologists, radiation specialists, and surgical teams.
Why Early Detection of Merkel Cell Carcinoma Is Critical
Because MCC grows quickly and can spread to
lymph nodes and distant organs,
early diagnosis and treatment significantly improve survival rates. Regular skin exams, especially for high-risk individuals, are key to identifying MCC at its earliest, most treatable stage.
Frequently Asked Questions About Merkel Cell Carcinoma
How dangerous is Merkel cell carcinoma?
MCC is one of the most aggressive forms of skin cancer. It has a high risk of recurrence and metastasis, making early detection and treatment essential.
Is Merkel cell carcinoma curable?
Yes, MCC can be curable, particularly when diagnosed early and treated promptly with surgery and, if needed, radiation or immunotherapy.
How fast does Merkel cell carcinoma spread?
MCC is known for its rapid growth and high likelihood of spreading to lymph nodes and distant organs if not treated early.
What does Merkel cell carcinoma look like?
It typically appears as a firm, painless, shiny bump that may be skin-colored, reddish, or bluish. Rapid growth and location on sun-exposed skin are key warning signs.
Who is most at risk for Merkel cell carcinoma?
- Older adults (especially over 50)
- Fair-skinned individuals with significant sun exposure
- People with weakened immune systems
- Individuals with Merkel cell polyomavirus exposure
Schedule Your Skin Cancer Evaluation Today
If you notice any suspicious growths or rapid changes in your skin, contact Phoenix Surgical Dermatology Group to schedule a professional skin evaluation. Our experienced team provides advanced care and customized treatment plans to help you achieve the best possible outcomes.
Early diagnosis and effective treatment can save your life—don’t wait.
