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Merkel Cell Carcinoma: Definition, Statistics, Risk Factors and Treatment

  • Date: 2015/02/20 (Rev. 2018/03/16)
  • Thomas C. Weiss - disabled-world.com
  • Synopsis : Information regarding MCC an uncommon form of skin cancer that starts when Merkel cells grow out of control.

Main Document

Merkel cell carcinoma (MCC) is an uncommon form of skin cancer that begins when Merkel cells grow out of control. Merkel cells are a type of neuroendocrine cell and are also sometimes referred to as, 'neuroendocrine carcinoma,' of a person's skin. Another name for MCC is, 'trabecular carcinoma.' MCC is far less common than the majority of other forms of skin cancer, although it is one of the most dangerous ones. It is much more likely than common cancers to spread to other parts of a person's body if it is not caught early and may be very difficult to treat if it has spread.

An uncommon form of skin cancer that begins when Merkel cells grow out of control. Merkel cells are a type of neuroendocrine cell and are also sometimes referred to as, 'neuroendocrine carcinoma,' of a person's skin. Another name for MCC is, 'trabecular carcinoma.' MCC is far less common than the majority of other forms of skin cancer, although it is one of the most dangerous ones. It is much more likely than common cancers to spread to other parts of a person's body if it is not caught early and may be very difficult to treat if it has spread.

Exposure to Ultraviolet (UV) Light

Exposure to ultraviolet (UV) rays is thought to be a major risk factor for most skin cancers, including MCC. UV rays damage the DNA inside skin cells. This can result in skin cancers if this damage affects the DNA of genes that control skin cell growth. There are 3 main types of UV rays:

  • UVA Rays: UVA rays cause skin cells to age and may damage their DNA. The rays are mainly linked to long-term skin damages like wrinkles, although they are also thought to have a role in some forms of skin cancers.
  • UVB Rays: UVB rays can directly damage a person's skin cells' DNA and are the main cause of sunburns. The rays are also thought to cause skin cancers.
  • UVC Rays: UVC rays do not get through Earth's atmosphere and are not present in sunlight. The rays do not usually cause skin cancer.

UVA and UVB rays can damage a person's skin and cause skin cancer. UVB rays are the more potent ones, causing some skin cancers. Based on what is now known - there are no safe UV rays. Sunlight is the main source of UV rays. The majority of MCC's begin in areas of a person's body that have been exposed to the sun such as a person's arms, neck and face. People who receive a lot of sun exposure are at increased risk of Merkel cell carcinomas (MCC's). Even though UVA and UVB rays make up only a small portion of the sun's rays they are the main cause of the damaging effects of the sun on a person's skin.

A Weakened Immune System

A person's immune system defends their body against germs such as viruses. It also appears to help the body to fight some forms of cancers of the skin and other organs. People who have weakened immune systems are more likely to develop some forms of skin cancers, to include MCC's.

For example; people who receive organ transplants are usually administered medications that weaken their immune system in order to prevent their body from rejecting the new organ, increasing their risk of developing MCC. People with autoimmune diseases such as lupus at times take medications that suppress their immune system, something that may also increase their risk of MCC.

People with some forms of blood cancers such as chronic lymphocytic leukemia (CLL) or certain lymphomas also tend to have weakened immune systems. A weakened immune system may be from the cancer itself, or it may be from treatment of the cancer. People with these cancers are at greater risk of getting MCC. MCC's in people who have weakened immune systems tend to grow faster and are more likely to be life-threatening.

Signs and Symptoms of Merkel Cell Carcinoma

Merkel cell carcinomas (MCC's) usually begin on areas of skin that have been exposed to the sun - particularly a person's face, neck, arms and legs. MCC's may also occur anywhere on a person's body. MCC's often times first appear as a single pink, red, or purple bump that is not painful. At times, the skin on top of the tumor may break open and bleed.

MCC's have the ability to grow rapidly. They may spread as new lumps in the person's surrounding skin. MCC's might also reach nearby lymph nodes. If left alone long enough, the lymph nodes grow larger - something that at times can be felt or seen as lumps under the person's skin. Merkel cell carcinoma is not common and may look like a number of other and more common forms of skin cancer or skin issues when it first appears. Due to this reason, doctors do not usually suspect MCC at first and the diagnosis is often times made only after the tumor has been biopsied.

It is extremely important to have any new, growing, or changing bumps, lumps or spots on your skin checked by a doctor as soon as possible so the cause can be found and so they may be treated if needed. The earlier skin cancer is found, the more likely it is the cancer may be treated effectively.

Treatment of Merkel Cell Carcinomas

After a person has been diagnosed as having Merkel cell carcinoma (MCC) and staged, their cancer care team will discuss the treatment options available. Depending upon the person's situation, they might have different types of doctors on their treatment team. The doctors on the team may include:

  • A dermatologist
  • A surgical oncologist
  • A medical oncologist
  • A radiation oncologist

A number of other specialists might be involved in the person's care too, including nurse practitioners, physician assistants, nutrition specialists, nurses, social workers and additional health care professionals. Based on the stage of the cancer the person is experiencing and other factors, their treatment options may also include radiation therapy, chemotherapy, or surgery. At times, more than one type of treatment is used.

It is important for a person with MCC to discuss all of their treatment options, as well as potential side-effects, with their treatment team to help make the decision that best fits the person's needs. If there is anything the person does not understand, it is important to have it explained to them. MCC is not common so most doctors are probably not likely to have either seen or treated people with it. Even at major medical centers where doctors are more likely to have experience with Merkel cell carcinomas (MCC's), not every doctor will agree on the best way to treat MCC. If there is enough time, receiving a second opinion from a team of experts is many times a good idea.




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