Merkel Cell Carcinoma

Merkel Cell Carcinoma often first appear as a single pink, red, or purple bump that is not usually painful. Sometimes the skin on the top of the tumour might break open and bleed. As it looks like many other types of skin cancers, diagnosis is usually only made after the tumour has been biopsied.

MCC tumours can grow quickly and may spread as new lumps in the surrounding skin. They might also reach nearby lymph nodes, which might grow larger and can sometimes be seen or felt as lumps under the skin in the neck or underarm.

Merkel cell skin cancer is uncommon, which means most doctors may not have seen or treated it before, so it is a good idea to get a second opinion on treatment.

Treatment options available include:

Surgery

Surgery will usually involve an initial biopsy for diagnosis, followed by wide excision where the tumour and a margin of normal skin are cut out. Mohs surgery is sometimes used when the goal is to save as much healthy skin as possible.

About 1 in 3 people diagnosed with Merkel cell skin cancer will have cancer cells in their lymph nodes. Because of this, a sentinel lymph node biopsy is typically a very important part of determining the stage of the cancer. This can be followed by lymph node dissection, where a surgeon removes all of the lymph nodes in the region near the primary tumour.

Chemotherapy

Chemotherapy is most likely to be helpful for Merkel cell cancer that has spread to other organs. So far it’s not clear if it can be helpful for cancers that are still just in the skin or that have only spread to nearby lymph nodes.

Radiation therapy

Radiation therapy may be used to treat the area of the main skin tumour after surgery to try to kill any cancer cells that might remain. It may also be used to treat the lymph nodes near the main tumour.

Radiation therapy may be an option in cases where Merkel cell skin cancer has recurred after surgery or has spread to distant parts of the body. In the latter case, the radiation is used to help shrink or slow the growth of the cancer or to relieve symptoms, but it’s not expected to cure the cancer.