What is Merkel Cell Carcinoma (MCC), Causes, Symptoms, Treatment, Complications, Prevention

Cancer is a disease which occurs when body’s cells multiply uncontrollably. Merkel cell carcinoma (MCC) is a rare and highly aggressive form of primary skin cancer. Carcinoma basically means cancer of the skin or the lining of the internal organs. The incidence of Merkel cell carcinoma (MCC) is rapidly increasing around the world by 8% every year. Merkel cell carcinoma generally appears in sun-damaged regions of skin of the head, neck, mouth, upper and lower limbs, truck and genital lining. It is more common in elderly males. Merkel cell carcinoma can re-occur after treatment.

While the exact causes of Merkel cell carcinoma (MCC) are still not clear, certain possible risk factors have been identified. It is believed that infection with Merkel cell polyomavirus (MCV) and long-term sun exposure may be responsible for triggering this illness. Other risk factors that can trigger or cause Merkel cell carcinoma also include aging. People older than 50 years of age and those with weak immunity are greater risk. Psoriasis patients treated with psoralen, people with light skin color, men, and excessive and prolonged exposure to UV rays, sunlight and tanning beds face greater risk and can be some of the causes of Merkel cell carcinoma.

Merkel cell carcinoma (MCC) spreads rapidly, both locally and also to distant regions of the body. Nearly 66% of people diagnosed with this illness have local cancer, 27% have cancer involving the lymph node and 7% have metastasis disease. Early diagnosis of Merkel cell carcinoma (MCC) is vital for proper treatment and better prognosis.

Merkel cell carcinoma (MCC) is primarily marked by solid painless dermal lesions or nodules which generally appear on those areas of the body which face maximum sun-exposure. Hence, the main symptoms of Merkel cell carcinoma include the presence of lesions on the exposed skin areas. These lesions are often seen on regions of the neck, head, upper and lower limbs and the trunk.

The nodules vary in sizes ranging a few millimeters to 2 cm big. An average lesion is about 1.5 cm in size and can be skin toned or pink, purple, red, blue in color. They are painless and rarely break open to forms ulcers. When the cancer cells spread through the lymphatics in the dermis, satellite lesions appear. These present with more symptoms of Merkel cell carcinoma (MCC). These are subcutaneous or skin lesions within 2 cm of the main tumor. Regional lymph node enlargement is observed in around 30-40% patients.

Diagnosis of Merkel cell carcinoma (MCC) can be made by conducting a physical examination on the patient. They may also conduct skin biopsy, imaging tests like X-ray and CT scan, and certain blood tests to confirm the diagnosis of Merkel cell carcinoma (MCC).

The treatment of Merkel cell carcinoma is done using anti-cancer drugs and radiation therapy. If required, doctors can also consider surgical treatment of Merkel cell carcinoma, to remove the cancerous tumor along with some areas of the skin surrounding the tumor. If the cancer has spread to the lymph nodes in the region affected by skin tumor, treatment of Merkel cell carcinoma (MCC) can also include surgical removal of the relevant lymph nodes. Other options of treatment for Merkel cell carcinoma also include chemotherapy if the Merkel cell carcinoma has spread to the lymph nodes or other organs in their body, or if it has relapsed despite treatment.

Merkel cell carcinoma can spread beyond the skin, i.e. it can metastasize, even with treatment. Merkel cell carcinoma can travel first to the nearby lymph nodes and then spread to the distant areas like brain, bones, lungs or liver and hinder the optimal functioning of these organs. Metastasized cancer is very difficult to treat and can result in fatality.

Although exposure to sunlight is still not a proven cause of Merkel cell carcinoma, it is known to be a risk factor for this type of cancer. To reduce their risk of developing Merkel cell carcinoma (MCC), one should try:

• Avoiding sun exposure during peak hours, i.e. typically from 10 a.m. to 4 p.m. when the sun is the strongest.
• Shielding the skin and eyes by wearing appropriate clothes, a wide-brimmed hat or umbrella and sunglasses with ultraviolet light (UV) protection.
• Applying sunscreen, with an SPF of at least 15, frequently and generously.
• Watching for changes like appearance of a freckle, mole, or bump which are changing in color, shape and size, and then informing the doctor about the same.

While treatment for Merkel cell carcinoma (MCC) is available, knowing the causes, risk factors and early signs can help to detect the problem at early stages.