Usually, it appears as a flesh-colored or bluish-red nodule on the face, head, or neck. Merkel cell carcinoma is a rare and aggressive type of skin cancer that originates from Merkel cells, nerve cells that sense touch. In order to improve survival and quality of life for people with this condition, early detection and treatment are crucial. In addition to lymph nodes, the lungs, the liver, and the brain, Merkel cell carcinoma can spread rapidly throughout the body.
Causes of Merkel Cell Carcinoma
Several factors may increase the risk of developing Merkel cell carcinoma, including:
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UV radiation from the sun or tanning beds can damage the DNA of skin cells, causing them to grow abnormally.
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Merkel cell polyomavirus (MCPyV), a common virus that lives on the skin of most people without causing any symptoms, but is capable of triggering the growth of cancerous cells in those with an weakened immune system or genetic susceptibility
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HIV/AIDS, organ transplants, or chronic leukemia can weaken the immune system, making it harder for the body to fight infections and abnormal cells.
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A history of other skin cancers, such as basal cell carcinoma or squamous cell carcinoma, may indicate a higher sensitivity to UV radiation or a genetic predisposition to the disease.
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As the risk of Merkel cell carcinoma increases with age, people over 50 are more likely to develop it
Symptoms of Merkel Cell Carcinoma
Symptoms of Merkel cell carcinoma typically include a painless, fast-growing nodule on the face, head, or neck, usually exposed to the sun. The nodules may appear skin-colored or have shades of red, blue, or purple. They may bleed, ulcerate, or become infected. A nodule can sometimes be accompanied by swelling of lymph nodes near the affected area, which may indicate that the cancer has spread. Other symptoms may depend on the stage and location of the cancer, including:
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Cancer that has spread to the lungs may cause difficulty breathing, coughing, or chest pain
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If the cancer has spread to the liver, you may experience abdominal pain, jaundice, or weight loss
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If the cancer has spread to the brain, there may be headaches, seizures, or vision problems
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Pain or fractures in the bones if the cancer has spread to them
Diagnosis of Merkel Cell Carcinoma
An examination of the skin and lymph nodes, as well as a medical history and symptoms, is performed by a doctor to diagnose Merkel cell carcinoma. A small sample of tissue will also be removed from the nodule and nearby lymph nodes and examined under a microscope for the presence of cancer cells by the doctor. The biopsy can also help determine the type and grade of the cancer, which indicate how aggressive and likely to spread it is. The doctor may also order some imaging tests, such as X-rays, ultrasound, CT scan, MRI, or PET scan, to check if the cancer has spread to other organs or tissues in the body. Based on the results of the tests, the doctor will assign a stage to the cancer, ranging from stage I (the cancer is limited to the skin) to stage IV (the cancer has spread to distant organs).
Treatment of Merkel Cell Carcinoma
The treatment of Merkel cell carcinoma depends on the stage, location, and size of the cancer, as well as the person's general health and preferences. As a part of treatment, the cancer cells are removed or destroyed, the recurrence of the cancer is prevented or delayed, the symptoms are relieved, and the quality of life is improved. There are a number of treatment options available, including:
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A Merkel cell carcinoma is treated by surgery, which involves removing the nodule and some normal skin surrounding it (wide local excision) to ensure no cancer cells remain. To prevent further spread of the cancer, the doctor may also remove some or all of the affected lymph nodes (lymph node dissection) if the cancer has spread to the lymph nodes. Mohs surgery involves removing the nodules layer by layer and checking each layer for cancer cells until no more are found. This can help preserve more healthy skin and reduce scarring.
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High-energy rays or particles are used in radiation therapy to kill cancer cells or prevent them from growing. After surgery, it can be used to reduce the risk of cancer returning in the same area or nearby lymph nodes (adjuvant radiation therapy), or before surgery to shrink the tumor and make it easier to remove (neoadjuvant radiation therapy). Alternatively, it can be used as a palliative treatment for people with advanced or metastatic cancer who have symptoms such as pain or bleeding and cannot have surgery.
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By administering drugs by mouth, injection, or infusion into a vein, chemotherapy kills cancer cells or stops them from growing. In addition to treating advanced or metastatic cancer that cannot be removed by surgery or treated by radiation therapy, it can also be used as palliative treatment for people suffering from pain or bleeding. Chemoradiation can also be used in conjunction with radiation therapy to increase their effectiveness.
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A drug is used to stimulate the immune system to recognize and attack cancer cells during immunotherapy. It can either be injected into a vein or infused into a vein. In people with advanced or metastatic cancer that cannot be removed surgically or treated by radiation therapy, it can be used as a palliative treatment. In addition, it can be combined with other treatments, such as surgery, radiation therapy, or chemotherapy, to improve results.
Prevention of Merkel Cell Carcinoma
A number of steps can be taken to reduce the risk or detect Merkel cell carcinoma early, such as:
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Limiting or avoiding UV exposure, especially between 10 a.m. and 4 p.m., when the rays are strongest, from the sun or tanning beds
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When going outside, wear protective clothing such as hats, sunglasses, and long sleeves
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Using sunscreen with a sun protection factor (SPF) of at least 30 every two hours or after swimming or sweating
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Reporting any changes or growths to a doctor as soon as possible if they occur
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A regular skin exam by a doctor is especially important for people with a history of skin cancer, a weakened immune system, or a family history of Merkel cell carcinoma
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It is important to quit smoking, as smoking weakens the immune system and increases the risk of skin cancer.
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Following the doctor's advice on medications and lifestyle changes when treating conditions such as HIV/AIDS, organ transplants, or chronic leukemia that affect the immune system
