Merkel Cell Carcinoma
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Description
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What is Merkel cell carcinoma?
Merkel cell carcinoma, also called neuroendocrine cancer 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.
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Stage Explanation
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Stages of Merkel cell carcinoma
After Merkel cell carcinoma has been diagnosed (found), more tests will be done
to find out if cancer cells 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:
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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.
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Stage II
The cancer has spread to nearby lymph nodes, but has not spread to other parts
of the body.
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Stage III
The cancer has spread beyond nearby lymph nodes and to other parts of the body.
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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.
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Treatment Option Overview
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How Merkel cell carcinoma is treated
There are treatments for all patients with Merkel cell carcinoma. Three kinds
of treatment are used:
- Surgery (taking out the cancer).
- Radiation therapy (using high-dose x-rays or other high-energy rays to kill
cancer cells).
- Chemotherapy (using drugs to kill cancer cells).
There are several different types of surgery that may be used to remove the
tumor. These include:
- Wide surgical excision takes out the cancer and some of the skin around the
tumor.
- Cryosurgery freezes the tumor and then removes it.
- Micrographic 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.
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Stage I Merkel Cell Carcinoma
Treatment may be one of the following:
- Surgery alone.
- Surgery followed by radiation therapy to the tumor site and regional lymph
nodes.
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Stage II Merkel Cell Carcinoma
Treatment may be one of the following:
- Surgery alone.
- Surgery followed by radiation therapy to the tumor site and regional lymph
nodes.
- Surgery with or without radiation therapy followed by adjuvant
chemotherapy.
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Stage III Merkel Cell Carcinoma
Treatment will probably be chemotherapy.
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Recurrent Merkel Cell Carcinoma
Treatment may be one of the following:
- Surgery alone.
- Surgery followed by radiation therapy to the tumor site and regional lymph
nodes.
- Surgery with or without radiation therapy followed by adjuvant
chemotherapy.
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Changes to This Summary (06/06/2003)
The PDQ cancer 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.
This information is provided from the PDQ® database in collaboration with the NCI.
