Merkel Cell Carcinoma

Description

What is Merkel cell carcinoma?

Merkel cell carcinoma, also called neuroendocrinecancer of the skin, is a rare type of disease in which malignant (cancer) cells are found on or just beneath the skin and in hair follicles. Merkel cell carcinoma usually appears as firm, painless, shiny lumps of skin. These lumps or tumors can be red, pink, or blue in color and vary in size from less than a quarter of an inch to more than two inches. Merkel cell carcinoma is usually found on the sun-exposed areas of the head, neck, arms, and legs. This type of cancer occurs mostly in whites between 60 and 80 years of age, but it can occur in people of other races and ages as well.

Merkel cell carcinoma grows rapidly and often metastasizes (spreads) to other parts of the body. Even relatively small tumors are capable of metastasizing. When the disease spreads, it tends to spread to the regional (nearby) lymph nodes and may also spread to the liver, bone, lungs, and brain. Lymph nodes are small, bean-shaped structures that are found throughout the body. They produce and store infection-fighting cells.

Treatment of Merkel cell carcinoma depends on the stage of the disease, and the patient’s age and overall condition.

Stage Explanation

Stages of Merkel cell carcinoma

After Merkel cell carcinoma has been diagnosed (found), more tests will be done to find out if cancercells have spread from the place the cancer started to other parts of the body. The process used to find out whether the cancer has spread to other parts of the body is called staging. It is important to know the stage of the disease to plan the best treatment. The following stages are used for Merkel cell carcinoma:

Stage I

The primary tumor has not spread to lymph nodes or other parts of the body. Lymph nodes are small, bean-shaped structures that are found throughout the body. They produce and store infection-fighting cells.

Stage II

The cancer has spread to nearby lymph nodes, but has not spread to other parts of the body.

Stage III

The cancer has spread beyond nearby lymph nodes and to other parts of the body.

Recurrent

Recurrent disease means that the cancer has recurred (come back) after it has been treated. It may come back in the same part of the body or in another part of the body.

Treatment Option Overview

How Merkel cell carcinoma is treated

There are treatments for all patients with Merkel cell carcinoma. Three kinds of treatment are used:

There are several different types of surgery that may be used to remove the tumor. These include:

  1. Wide surgicalexcision takes out the cancer and some of the skin around the tumor.

  2. Cryosurgery freezes the tumor and then removes it.

  3. Micrographic surgery (Mohs surgery) is a tissue-sparing technique that removes only the tumor.

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy).

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells throughout the body.

If a doctor removes all the cancer that can be seen at the time of the operation, a patient may be given chemotherapy after surgery to kill any cancer cells that are left. Chemotherapy given after an operation to a person who has no cancer cells that can be found is called adjuvant chemotherapy.

Stage I Merkel Cell Carcinoma

Treatment may be one of the following:

  1. Surgery alone.

  2. Surgery followed by radiation therapy to the tumor site and regional lymph nodes.

Stage II Merkel Cell Carcinoma

Treatment may be one of the following:

  1. Surgery alone.

  2. Surgery followed by radiation therapy to the tumor site and regional lymph nodes.

  3. Surgery with or without radiation therapy followed by adjuvant chemotherapy.

Stage III Merkel Cell Carcinoma

Treatment will probably be chemotherapy.

Recurrent Merkel Cell Carcinoma

Treatment may be one of the following:

  1. Surgery alone.

  2. Surgery followed by radiation therapy to the tumor site and regional lymph nodes.

  3. Surgery with or without radiation therapy followed by adjuvant chemotherapy.

Changes to This Summary (07/20/2005)

The PDQcancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Editorial changes were made to this summary, and links to the NCI Dictionary of Cancer Terms were added.

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