Summary about Disease
Merkel Cell Carcinoma (MCC) is a rare and aggressive skin cancer that originates in Merkel cells, specialized cells near nerve endings in the skin that are involved in the sense of touch. It typically appears as a painless, firm, flesh-colored, or bluish-red nodule on sun-exposed areas of the body, such as the head, neck, and limbs. While relatively uncommon, MCC has a high risk of recurrence and metastasis (spread to other parts of the body) if not treated promptly.
Symptoms
The most common symptom of Merkel Cell Carcinoma is a rapidly growing, painless lump on the skin. The mnemonic "AEIOU" is sometimes used to remember the typical characteristics:
Asymptomatic (painless)
Expanding rapidly
Immunosuppression (present in some cases)
Older than 50 years
UV-exposed site Other possible symptoms may include:
A firm, dome-shaped nodule
A reddish-purple or skin-colored lesion
A lesion that bleeds easily
Enlarged lymph nodes near the tumor
Causes
The exact cause of Merkel Cell Carcinoma is not fully understood, but several factors are associated with an increased risk:
Merkel Cell Polyomavirus (MCPyV) infection: This virus is found in the majority of MCC tumors. However, MCPyV infection is common, and most people infected with the virus do not develop MCC.
Ultraviolet (UV) radiation exposure: Chronic sun exposure or tanning bed use significantly increases the risk.
Weakened immune system: People with compromised immune systems due to conditions like HIV/AIDS, organ transplant recipients, or those undergoing immunosuppressive therapy are at higher risk.
Age: MCC is more common in older adults (over 50 years).
Fair skin: People with fair skin are at greater risk.
Medicine Used
Treatment for Merkel Cell Carcinoma depends on the stage and location of the cancer, as well as the patient's overall health. Common treatment modalities include:
Surgery: Wide local excision to remove the tumor and surrounding tissue.
Radiation therapy: Used to kill cancer cells after surgery or to treat tumors that cannot be surgically removed.
Chemotherapy: May be used for advanced MCC that has spread to distant sites.
Immunotherapy: Drugs that boost the body's immune system to fight cancer cells. Examples include pembrolizumab and avelumab.
Targeted therapy: As research advances new agents that target MCC are in clinical trials.
Is Communicable
Merkel Cell Carcinoma itself is not communicable. It is not contagious and cannot be spread from person to person through contact. While the Merkel Cell Polyomavirus (MCPyV) is a factor, infection with the virus is common and does not necessarily lead to cancer.
Precautions
While it's not entirely preventable, you can reduce your risk of developing Merkel Cell Carcinoma by taking these precautions:
Limit sun exposure: Avoid prolonged sun exposure, especially during peak hours (10 AM to 4 PM).
Use sunscreen: Apply broad-spectrum sunscreen with an SPF of 30 or higher daily, even on cloudy days. Reapply every two hours, or more often if swimming or sweating.
Wear protective clothing: Wear long sleeves, pants, a wide-brimmed hat, and sunglasses when outdoors.
Avoid tanning beds: Tanning beds emit harmful UV radiation that increases the risk of skin cancer.
Regular skin self-exams: Check your skin regularly for any new or changing moles, bumps, or sores.
See a dermatologist: Have regular skin exams by a dermatologist, especially if you have a family history of skin cancer or a weakened immune system.
How long does an outbreak last?
Merkel Cell Carcinoma does not have "outbreaks" in the way that viral infections do. It is a tumor that develops over time. The time it takes for a tumor to become noticeable can vary.
How is it diagnosed?
Merkel Cell Carcinoma is diagnosed through a combination of:
Physical examination: A doctor will examine the skin and lymph nodes.
Skin biopsy: A small sample of the suspicious skin lesion is removed and examined under a microscope by a pathologist.
Immunohistochemistry: Special stains are used on the biopsy sample to identify Merkel cell markers.
Imaging tests: CT scans, PET scans, or MRI may be used to determine the size and extent of the tumor and to check for metastasis.
Sentinel Lymph Node Biopsy: To determine if the cancer has spread to nearby lymph nodes.
Timeline of Symptoms
Early Stage: Often begins as a small, painless nodule that may be mistaken for a pimple or cyst. The growth is rapid.
Progression: The nodule increases in size, sometimes becoming ulcerated or bleeding. Nearby lymph nodes may become enlarged.
Advanced Stage: The cancer spreads to distant sites (metastasis), such as the lungs, liver, or bones. Systemic symptoms may develop. Note that the timeline can vary significantly between individuals.
Important Considerations
Early detection is crucial: Because Merkel Cell Carcinoma can be aggressive, early diagnosis and treatment are essential for improving outcomes.
Follow-up care is important: After treatment, regular follow-up appointments with a healthcare provider are necessary to monitor for recurrence.
Immunosuppression: Patients with weakened immune systems should be closely monitored for skin changes.
Multidisciplinary approach: Treatment often involves a team of specialists, including dermatologists, surgeons, radiation oncologists, and medical oncologists.
Clinical Trials: Consider participating in clinical trials to access new and innovative treatment options.