Merkel Cell Carcinoma Symptoms, Treatment and Survival
Merkel Cell Carcinoma Symptoms can be easily recognized by a health
professional during medical exam; although its warning signs can be neglected by the patient. The cancer
usually appears on skin areas that are frequently exposed to sunlight.
It appears as a single mass that
- rapidly changing
- firm or raised
- Have one color: red, pink, blue, or
Progression and Complications
As the tumor progresses, Merkel cell carcinoma tends to
spread, most often, to the liver, lungs, bone, the brain, regional lymph nodes, or distant lymph nodes, thus making the
survival more difficult. Presence of any of these metastases decreases considerably the chance of the
patient to heal or survive for more than 5 years.
Merkel Cell Carcinoma treatment depends on the stage or
the evolution of the cancer at
diagnosis. It is therefore necessary for the health care provider
to perform an assessment of the extent of
the tumor before considering a therapeutic approach. This assessment, in addition to a complete physical examination, will include an ultrasound of the lymph nodes, CT scan of the
thoracic and abdominopelvic organs.
Depend on the characteristics of the cancer, brain scans can also be recommended. Some health professionals
go further to envisage bone scan or a PET scan.
Stages I and II – at these
stages, a surgical removal of the lesion,
with very small or medium margins of 3 cm, is performed in most cases. Local radiotherapy can be considered to
reduce the incidence of local recurrence. Conventionally, radiation therapy in the lymph node is often
associated with the surgery in case of metastases in the sentinel node, but there
is no evidence of improvement in terms of
Stage III- in this stage, spreading of the cancer to
regional lymph node is usually confirmed; removal of the tumor and the affected
lymph node is often the ideal therapeutic approach. This surgery is
completed by radiotherapy. If there is
a recurrence, chemotherapy is discussed and recommended, according to
the general condition of the patient.
Stage IV – at this last stage, the
patient can have metastasis in the liver, bone, lung, brain or skin. The treatment is
palliative combining radiation therapy
and chemotherapy. Surgical resection of a solitary metastasis is possible, but barely
Chemotherapy: adjuvant chemotherapy is given
to the patient if the lymph nodes or distant organs are affected. But
the therapy causes side effects which can be permanent and serious. Please see the chemotherapy side effects section for more details.
used in Merkel Cell Carcinoma Treatment include:
- doxorubicin (Adriamycin)
- cyclophosphamide (Cytoxan, Procytox)
- cisplatin (Platinol AQ)
- 5-fluorouracil (5-FU, Efudex)
- dacarbazine (DTIC)
- vindesine (Eldesine)
- etoposide (Vepesid).
Merkel cell carcinoma
causes and diagnosis
1- Toker C.
Trabecular carcinoma of the skin Arch. Dermatol. 1972 ; 105 : 109-110
2- Heath M.,
Jaimes N., Lemos B., Mostaghimi A., Wang L.C., Peñas P.F., et al. Clinical characteristics of Merkel cell
carcinoma at diagnosis in 195 patients: the AEIOU features J Am Acad Dermatol. 2008 ; 58 : 375-381
E.A., Frisch M., Goedert J.J., Biggar R.J., Miller R.W. Merkel cell carcinoma and HIV infection Lancet.
2002 ; 359 : 497-498
4- Heath, M., Jaimes,
N., Lemos, B., Mostaghimi, A., Wang, L. C., Peñas, P. F., & Nghiem, P. (2008). Clinical characteristics
of Merkel cell carcinoma at diagnosis in 195 patients: the AEIOU features. Journal of the American Academy of Dermatology, 58(3), 375-381.