Merkel Cell Carcinoma

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 Merkel cell carcinoma is a very rare but highly aggressive form of skin cancer. Although uncommon—about 40 times rarer than melanoma—it carries a high risk of spreading and coming back, often within 2 to 3 years after diagnosis. Because of its aggressive nature, early detection and prompt treatment are especially important.

 This cancer begins in Merkel cells, which are located in the deepest part of the epidermis (the outermost layer of skin) and within hair follicles. Merkel cell carcinomas usually develop on areas of the body that get a lot of sun exposure, such as the head, neck, arms, and legs.

  Merkel cell carcinoma can be tricky to identify just by appearance. It typically presents as a shiny or pearly bump on the skin—similar in look to a pimple—but may also appear red, purple, bluish-red, or flesh-toned. One of the most noticeable signs is how quickly it grows. Patients may see new lumps appear near the original site, and lymph nodes in the area can become swollen and tender. Interestingly, the lumps themselves are often not painful.

Treatment for Merkel cell carcinoma often involves a combination of therapies, depending on the stage and location of the cancer.

• Surgery: Most cases are treated with surgical removal, either through a wide local excision or Mohs micrographic surgery. A sentinel lymph node biopsy may also be done to check if the cancer has spread to nearby lymph nodes.
   
• Radiation Therapy: Radiation is commonly used after surgery to ensure any remaining cancer cells are destroyed and to help prevent recurrence. It may also be directed at nearby lymph nodes or used as a treatment if the cancer returns. In advanced stages, radiation can be used for symptom relief (called palliative therapy).
   
• Chemotherapy: For stage 4 Merkel cell carcinoma, chemotherapy may be used to slow cancer growth, shrink tumors, and ease symptoms. It is typically given through an IV every few weeks and continued as long as the treatment is effective in halting the spread.