17971 Merkel Cell Carcinoma

Overview

Merkel cell carcinoma is a rare and aggressive type of skin cancer. It starts in Merkel cells, which are tiny cells in the top layer of your skin that help you feel light touch. The cancer usually appears as a firm, painless bump on sun-exposed skin, often on the head, neck, or arms. It tends to grow very quickly, so early detection and treatment are important.

No, it is very rare. Only about 1 to 2 people per million are diagnosed each year in the UK and similar countries.

It most often affects adults older than 60, people with pale skin or a history of sun damage, and those with a weakened immune system.

Symptoms

Common symptoms

• A firm, raised bump or lump on the skin, which is usually painless.
• The bump may be skin-colored, red, blue, or purple.
• It grows quickly, often doubling in size within a few weeks or months.
• It most often appears on the head, neck, arms, or other sun-exposed areas.

Symptoms in children

• Merkel cell carcinoma is extremely rare in children. If your child has a new, rapidly growing bump, it is still important to have it checked by a doctor.

Symptoms in older adults

• The same signs apply, but the bump is often on the face, scalp, or hands.
• It may be mistaken for a harmless cyst, insect bite, or a simple sore that refuses to heal.

Causes

Main causes

• Damage to skin cells from ultraviolet (UV) radiation, from the sun or sunbeds.
• Infection with a common virus called Merkel cell polyomavirus, which usually causes no symptoms but can trigger abnormal cell growth in some people.
• A weakened immune system that is less able to recognize and stop abnormal cells.

Risk factors

• Being older than 60.
• Having fair skin and a history of sunburn.
• Long-term sun exposure or use of tanning beds.
• Having a medical condition or taking a medicine that suppresses the immune system, such as after an organ transplant.

When to see a doctor

See a doctor urgently if:

• If you notice a new bump that is growing quickly or changes in size within a few weeks.
• If a skin spot becomes painful, itches, bleeds, or does not heal after several weeks.

Book a routine appointment if:

• If you have many moles, sun-damaged skin, or a history of skin cancer, consider a yearly skin check by a doctor or dermatologist.

Diagnosis

Your doctor will first look at the bump and ask about your history. If they think it could be skin cancer, they will take a small sample of tissue (a biopsy) and send it to a laboratory to be examined under a microscope.

Tests that may be done

• Skin biopsy – a small piece of the bump is removed and tested.
• Imaging tests such as CT, MRI, or PET scans – used to check if the cancer has spread to other parts of the body.
• Sentinel lymph node biopsy – a test to see if cancer cells have reached nearby lymph nodes.

What to expect at your appointment

If the biopsy confirms cancer, you will be referred to a specialist team, usually a dermatologist or an oncologist. They will explain the stage of the cancer, which tells how far it has grown, and discuss the right treatment options with you.

Treatment

Treatment for Merkel cell carcinoma depends on the size, position, and stage of the cancer. The main goal is to remove the cancer completely and then reduce the chance of it coming back.

Self-care at home

• Protect the treated area from the sun to help it heal and to reduce the risk of another skin cancer.
• Follow any wound-care instructions after surgery, such as keeping the area clean and dry.
• Attend all follow-up appointments, even if you feel well.

Medical treatments

Surgery is the usual first treatment. Your doctor may also suggest radiation therapy, which uses high-energy rays to kill cancer cells, either after surgery or if surgery is not possible. Other options include immunotherapy, which helps your immune system fight the cancer, and chemotherapy, which uses anticancer drugs. The exact treatment plan is tailored to your situation and will be explained by your specialist team.

When is surgery considered?

If the cancer is just one spot, surgery to remove the lump along with a margin of healthy skin is the most common first step. Sometimes nearby lymph nodes are also removed to check for spread.

Living with this condition

After treatment, you will need regular check-ups with your doctor. Check your skin every month for any new or changing bumps, and use sun protection every day. Many people continue to have active, full lives after treatment, but it is important to stay alert and treat any new issues early.

Lifestyle tips

• Wear sun-protective clothing, a wide-brimmed hat, and sunglasses when outdoors.
• Use a broad-spectrum sunscreen with a high SPF on all exposed skin, even on cloudy days.
• Avoid sunbeds and try to stay out of direct sun between 10am and 4pm.

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, and whole grains to keep your immune system strong. Gentle exercise, like walking or cycling, can improve your energy, mood, and overall health. Always check with your doctor before starting a new exercise program.

Mental health and emotional wellbeing

A cancer diagnosis can be emotionally heavy. It is normal to feel anxious, sad, or overwhelmed. Talking to family, friends, or a professional counselor can help. If you ever have thoughts of harming yourself, contact a crisis helpline or your local emergency number right away.

Prevention

You cannot prevent every skin cancer, but you can reduce your risk. The most important step is protecting your skin from ultraviolet radiation, both from the sun and from tanning beds. Also, knowing your own skin and checking it regularly helps you spot problems early.

Vaccines

There is no vaccine specifically for Merkel cell carcinoma. Research is ongoing, but no vaccine is currently available for this condition.

Screening programmes

There is no standard screening test for Merkel cell carcinoma. The best approach is to inspect your skin monthly and have a yearly skin examination by a doctor, especially if you are at higher risk.

Complications

If left untreated

• Without treatment, the cancer can grow deeper into the skin and surrounding tissues.
• The cancer can spread to nearby lymph nodes and then to other organs, such as the liver, lungs, or bones.
• Once it spreads, the condition becomes harder to treat and the outlook is more serious.

Long-term outlook

With early diagnosis and prompt treatment, many people with Merkel cell carcinoma do very well. This cancer can be aggressive, but treatment options such as surgery, radiation, and newer immunotherapy have greatly improved outcomes. Your doctor can give you a more personal outlook based on your exact diagnosis and health.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.