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Merkel Cell Cancer: Symptoms, Causes and Complications

Merkel Cell Cancer: Symptoms, Causes and Complications
April 02, 2024

Merkel cell carcinoma is an uncommon kind of skin cancer that typically develops on the face, head, or neck as a flesh-colored or bluish-red lump. Another name for Merkel cell carcinoma is neuroendocrine skin cancer.

The majority of cases of Merkel cell cancer occur in elderly adults. Your chance of acquiring Merkel cell carcinoma may be increased by prolonged sun exposure or a weakened immune system. Merkel cell carcinoma has a propensity for rapid growth and body-wide dissemination. Whether the cancer has progressed beyond the skin determines the course of treatment for Merkel cell carcinoma.

How do Merkel cells work?

Deep under your skin’s epidermis, or top layer, are cells called Merkel cells. The cells act both in the neurological and endocrine systems. They are a kind of neuroendocrine cell. They have chemicals that function like hormones and are located close to nerve endings that produce the sense of touch. These cells were initially characterized in the late 1800s by the German physician Friedrich Merkel.

How frequent is cancer with Merkel cells?

This extremely rare kind of skin cancer, known as Merkel cell carcinoma, affects about 3,000 Americans annually.

On the other hand, the number of individuals being diagnosed with Merkel cell cancer is rising significantly. This rise can be the result of better diagnostic procedures. People over 70 are also more likely to be affected by the illness. People may be more susceptible to this cancer as they live longer.

Which other names exist for cancer of the Merkel cell?

The following phrases may also be used to describe Merkel cell carcinoma:

  • Merkel cell cancer
  • MCC
  • Trabecular cancer
  • Neuroendocrine carcinoma of the skin.

Which signs correspond to Merkel cell carcinoma?

Merkel cell carcinoma tumors usually show up on skin regions that have been exposed to the sun. On a skin area that receives a lot of sun exposure, you might detect a pearly or shiny bump.

Usually, the lumps show up on your face, neck, arms, or eyelids. Leg tumors are common in people with darker skin tones. The bump is located on the torso of the younger person. Additionally, the tumor may rupture and become a wound or sore.

The mass could be:

  • Approximately the size of a coin and expanding swiftly.
  • elevated or formed like a dome.
  • Hard.
  • It hurts.
  • like an insect bite or acne lesion.
  • Red, purple, or bluish-red skin tones are possible.
  • painful or delicate.

Symptoms:

The initial indication of Merkel cell carcinoma typically manifests as a rapidly expanding, painless skin nodule or tumor. The nodule could have the color of skin or could have red, blue, or purple undertones. Merkel cell carcinomas can form anywhere on your body, including in locations that are not exposed to sunlight, although they typically affect the face, head, and neck.

What are the causes?

The cause of Merkel cell cancer is unknown. In the Merkel cells, Merkel cell cancer first appears. The base of your skin’s outermost layer, or epidermis, is home to Merkel cells. The skin’s nerve endings in charge of the feeling of touch are linked to Merkel cells. Recent research has revealed that the majority of Merkel cell cancer cases are caused by a common virus. The Merkel cell polyomavirus is a skin-residing virus that exhibits no symptoms or indicators. It is unclear exactly how this virus produces Merkel cell cancer. Since Merkel cell carcinoma is extremely rare yet the virus is highly prevalent, additional risk factors contribute to the formation of this malignancy.

Risk elements:

The following are some factors that could raise your risk of Merkel cell carcinoma:

  • Overexposure to sunshine, whether it be artificial or natural: Exposure to UV light, which includes light from tanning beds and the sun, raises the risk of Merkel cell cancer. Most Merkel cell carcinomas show up on skin surfaces that are regularly exposed to sunlight.
  • An impaired defense mechanism: Merkel cell carcinoma is more common in those with compromised immune systems, such as those with HIV infection, those on immunosuppressive medications, and those with long-term leukemias.
  • Previous history of skin cancer: Merkel cell carcinoma is linked to the emergence of basal cell or squamous cell carcinomas, among other skin malignancies.
  • Older years/ age: As you become older, your chance of Merkel cell cancer rises. Although it can strike anyone at any age, persons over 50 are the ones most likely to have this malignancy.
  • Pale skin tone: Those with light-colored skin are typically the ones that get Merkel cell cancer. This skin cancer affects white people far more frequently than it does Black people.

Complications

Cancer that metastasizes to other bodily organs:

Merkel cell carcinoma frequently spreads (metastasizes) outside of the skin even after treatment. Merkel cell cancer usually starts in the lymph nodes that are close by. Subsequently, it might move to your liver, lungs, brain, or bones, where it could affect how well these organs work. Metastasized cancer can be deadly and is more difficult to treat.

How to prevent it?

Although no concrete evidence links sunlight exposure to Merkel cell carcinoma, it is thought to be a risk factor. Your risk of skin cancer may go down if you spend less time in the sun. Aim to:

  • Stay out of the sun while it is hot.
  • The strongest sun exposure hours of the day are often from 10 a.m. to 4 p.m. Try to avoid being in the sun as much as you can. Postpone your outside activities in the day or early in the morning.
  • Protect your eyes and skin. Put on a wide-brimmed hat, clothes with tight weaves, and UV-protecting sunglasses.
  • Use a lot of sunscreens and do it frequently. Even on overcast days, apply a broad-spectrum sunscreen with an SPF of at least thirty. Use a lot of sunscreens, and reapply it every two hours, or more frequently if you are sweating or swimming.
  • Aim for adjustments. Speak with your doctor if you observe a mole, freckle, or bump that is changing in size, shape, or color. The majority of skin nodules do not progress to cancer, however, early detection of malignancy improves the prognosis.

How does one diagnose Merkel cell carcinoma?

Merkel cell carcinoma is one of the skin conditions that dermatologists identify and treat. It is crucial to consult a skin cancer specialist since Merkel cell carcinoma can mimic benign (noncancerous) cysts, styes, and infected hair follicles (folliculitis).

Your medical professional will conduct a full-body skin examination. They might check for enlarged lymph nodes, which could be a sign of an infection or the possible spread of cancer. A skin biopsy of the tumor will be performed to look for cancerous cells.

What phases does Merkel cell cancer go through?

Cancer staging is a tool used by medical professionals to assess how far cancer has gone. Stages follow diagnosis promptly. The more serious the cancer spread, the higher the stage number. Just the outer layer of your skin is affected by stage 0 Merkel cell carcinoma cancer. Stage IV (4) denotes distant organ involvement in the malignancy.

Which diagnostic procedures identify the Merkel cell cancer stages?

To ascertain the Merkel cell carcinoma cancer stage, you could undergo one or more of the following tests:

  • CT scan.
  • scanning with positron emission tomography (PET).
  • needle biopsy or sentinel node biopsy.
  • Control and Intervention

How does one treat Merkel cell carcinoma?

The cancer stage determines the course of treatment for Merkel cell carcinoma. Treatment-responsiveness of early-stage Merkel cell carcinoma (stages 0 to II [2]) is superior to that of late-stage disease (stages III and IV [3 and 4]).

Merkel cell carcinoma tumors are surgically removed by medical professionals. Options for surgery include:

  • Mohs surgery removes the skin layers and tumor as much as possible while leaving as much healthy tissue intact.
  • Excision of the tumor and some surrounding healthy tissue on a large local scale.
  • Dissection of lymph nodes to surgically remove lymph nodes containing cancer cells that have spread elsewhere.

What follows a surgical procedure for Merkel cell carcinoma?

Following surgery, the treated area can require skin grafting or reconstructive surgery to heal and mend. To eradicate any remaining cancer cells in your body, you could also receive cancer therapies like:

  • Chemotherapy
  • Immune therapy
  • radiation treatment/ therapy.
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