What is Merkel Cell Carcinoma?

Merkel Cell Carcinoma is a rare type of aggressive skin cancer that usually appears as a flesh colored or red-blue nodule on sun-exposed skin such as the head, face, neck and arms. However, it can occur anywhere on the body including sun-protected areas. Merkel Cell Carcinoma is caused byt he Merkel Cell Polyomavirus. Merkel Cell Carcinoma typically grows rapidly and can spread quickly to other parts of your body.

Who is at risk for developing Merkel Cell Carcinoma?

Risk factors for Merkel Cell Carcinoma include age, gender, skin type, amount of UV/sun exposure over a lifetime. Those over the age of 50 are at risk and the majority of patients I treat are over age 70. Merkel Cell Carcinoma is more common in males than females. Like all skin cancers, people that have lighter skin are at greater risk for developing Merkel Cell Carcinoma. Patients with weakened immune systems are also more likely to develop Merkel Cell Carcinoma.

We often use the acronym “AEIOU” to summarize the combination of risk factors and warning signs for Merkel Cell Carcinoma:

A: Asymptomatic
E: Expanding rapidly
I: Immune suppression
O: Older than 50 years
U: Ultraviolet-exposure

What are some of the common warning signs of this disease?

The first sign of Merkel Cell Carcinoma is usually a fast-growing, painless nodule (bump) on your skin. The nodule may be flesh-colored or may have shades of red, blue or purple. I often tell my patients when in doubt about a new lesion on your skin, get it checked out.

What treatment options are available for patients with Merkle Cell Carcinoma?

Early stage Merkle Cell Carninoma is treated with surgical removal of the affected tissue and local radiation therapy. Later stage disease is treated with systemic therapy. Once a patient is diagnosed with Merkel Cell Carcinoma, we refer to an oncologist for further evaluation. Systemic therapy with chemotherapy was the only treatment option in the past. Today we have immunotherapy that has completely changed the outlook for patients diagnosed with Merkel Cell Carcinoma. Patients treated with immunotherapy drugs such as Bavencio (Avelumab) and Keytruda (Pembrolizumab) are living longer than was possible just a few years ago.

What would you recommend your patients do in order to decrease their risk of developing Merkel Cell Carcinoma?

In order to protect yourself, I recommend practicing SUN-healthy skin habits. When outdoors, make sure that you seek out the shade and use a broad spectrum (UVA/UVB) sunscreen with SPF 30 or higher. You need to apply a shot glass, or 1 ounce, of sunscreen to your entire body. You must reapply your sunscreen every two hours. Most people forget to reapply. Set a timer on your cell phone. Wear a hat, sunglasses, and UPF clothing. Examine your skin once a month. Schedule a complete body exam with your dermatologist. If you notice something new or changing, please have it checked out!


Victoria A. Cirillo-Hyland