Merkel Cell Carcinoma

Merkel cell carcinoma is a rare and potentially aggressive form of skin cancer that arises in the cells on the outer layer of skin. They’re called Merkel cells and make up only a small percentage of skin cells. Though the cancer can grow and spread rapidly, it is generally treatable and often curable if caught in the early stages.

Merkel cell carcinoma is rare, accounting for less than 1 percent of total skin cancer diagnoses, though the number of patients diagnosed with the disease is thought to have tripled over the past two decades. Approximately 1,500 people are diagnosed with the disease each year. These cancers tend to occur in heavily sun-exposed skin and are more common in people with weakened immune systems.

Diagnosis and treatment

If you’ve been diagnosed with Merkel cell carcinoma, your treatment will require the expertise of a multidisciplinary team of cancer specialists. The team may include dermatology, surgical oncology, radiation oncology, medical oncology, plastic surgery, pathology and nursing. At the Melanoma Program, we are fortunate to have access to all of the required specialists. This team will determine the best course of treatment and overall management for you.

Treatment will usually include surgery to remove the tumor along with a biopsy of a lymph node (sentinel lymph node biopsy) to see if the cancer has spread. Radiologic scans may also be recommended prior to surgery. The surgery can almost always be performed on an outpatient basis. Radiation therapy to the skin and/or lymph nodes may also be indicated for patients who have high-risk lesions. Patients whose cancer has spread beyond their lymph nodes into their organs are likely to require other medical treatments.

For Merkel cell carcinoma that has spread but is still confined within the leg or arm, we may recommend local immune therapies or isolated regional perfusion or infusion.