What Leads To Merkel Cell Carcinoma & Can It Be Cured?

Merkel cell is receptors formed of neuroendocrine cells which are connected by nerve endings and these take the sensation of touch to the brain. These, in the uppermost layer of skin known as epidermis[1]. The uninhibited proliferation of these cells is known as Merkel cell carcinoma. It is a rare tumor of the skin especially occurring in head and neck areas.

What Leads To Merkel Cell Carcinoma?

What Leads To Merkel Cell Carcinoma?

The most commonly accounted reason for the development of Merkel cell carcinoma is prolonged exposure to the sunlight, in particular, the ultraviolet rays. Very high-grade exposure to the sunlight can lead to other cancers but high-grade exposure of sunlight for very long periods can lead to it. The UV rays can lead to mutations in the genetics of the skin cells. The commonly encountered gene to be mutated is the Tp53 gene. It is a tumor suppressor gene and its suppression can lead to stimulation of oncogenes which can lead to the rapid proliferation of the cells in a haphazard manner.

Immunosuppression is also an etiological factor for the triggering of the skin cancer. Various patients who have undergone transplantation or are suffering from other immune-suppressing diseases are quite vulnerable to cancer but it is necessary for other factors to also come along for the causation.
Exposure to the ionizing radiation such as X-rays, Gamma rays, etc. can easily propel these mutations in the cells and it could lead to cancerous growth. Various immune

system defects like inability to do DNA repair in a disease known as xeroderma pigmentosum can also lead to accumulation of the mutations in the cells which can trigger the widespread growth whenever they reach a threshold for the same.[1]

Can Merkel Cell Carcinoma Be Cured?

Can Merkel Cell Carcinoma Be Cured?

The Merkel cell carcinoma is curable cancer if detected and diagnosed early in stages 1 and 2. The patient can live absolutely cancer-free after the treatment but later stages carry a poorer prognosis due to its fast metastatic property. It has got a poor survival rate once detected in late stages that is in stage 3 and 4. This makes it a very dangerous cancer as well as it can spread to various body parts rapidly.

The Merkel cell carcinoma treatment depends upon the stage of cancer at which it is detected. Usually, it is detected in early stages and the mainstay of it is surgical treatment. The tumor could be surgically excised completely with excising a margin of about a few centimeters of the healthy tissue along with it.

The lymph nodes involved are to be removed completely along with cancer surgically; if the tumor is a spreading one then the nearby lymph nodes which are draining that area are excised prophylactically to prevent its spreading.

The adjuvant radiotherapy is given in many cases as it is metastatic cancer and there is always risk involved in spreading to other body parts with it. Radiotherapy makes surgical treatment more successful.

If the Merkel cell carcinoma cancer is in late stages and cannot be resected then immune-suppressing and polychemotherapy with anti-cancer drugs can be given with good success of remission in many patients.[1]

Conclusion

The Merkel cell carcinoma is one of the rare cancers of the skin and is generally found on the head and neck regions of the body. It is metastatic cancer with poor prognosis in late stages if left untreated. Surgical resection of cancer and adjuvant radiotherapy can be very successful in curing it in the early stages. Mono and polychemotherapy are given with good success rate even in the late stages. Early detection remains the most important part of its curability. Any nodule of any size on the skin of head and neck regions usually with a property of changing colors like blue, purple, red, etc. should be reported to a doctor as soon as possible and treatment should be sought immediately.

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