What is a Merkel Cell Carcinoma?

  Merkel cell is the rarest and most aggressive form of skin cancer. They have the highest risk of spreading and recurring, with most of them spreading inside the body within 2-3 years after initial diagnosis. They are 40 times rarer than a melanoma. 

 They present within the Merkel cells, which are found in the deepest part of the epidermis, or outer most layer of the skin and in hair follicles. They generally arise in areas of sun exposure, like the head, neck, arms and legs.  

  Merkel cell carcinomas are not as distinct in appearance as other types of skin cancer. They typically appear as a pearly lump, similar to a pimple, but can be red, purple, bluish—red or skin toned in colour. The speed in which they grow is most noted by patients. Additional lumps may appear beside the original and lymph nodes near the area may become swollen and tender. Merkel cells do not tend to be painful themselves. 

One or sometimes multiple therapies are used to treat Merkel Cell Carcinomas. The treatment 

Options include:

Surgery

Depending on the stage and location of the Merkel Cell carcinoma, the options for surgery include local wide excision or Mohs Micrographic Surgery. A Sentinel Lymph node biopsy may be required, depending on the stage of Merkel Cell carcinoma. 

Radiation

Radiation is typically used after surgical removal to ensure all cancer cells are destroyed and reduces the likelihood of the cancer returning. Sometimes radiation will include targeting the lymph nodes that are nearby or used to treat a recurrence of Merkel Cell carcinoma. In advanced cases of Merkel Cell carcinoma, radiation is used to help reduce symptoms (palliative therapy). 

Chemotherapy

Chemotherapy is used for stage 4 Merkel Cell carcinomas to help slow the growth, reduce tumor size and reduce symptoms. Chemotherapy is given by a needle every few weeks and is continued until the cancer doesn’t grow or spread any further