A Merkel cell carcinoma is a rare form of skin cancer. It is often presented as a rapidly enlarging and painless lump on the skin. The tumour tends to be flesh coloured or sometimes a mixture of purple and blue.
Merkel cell carcinoma tends to occur on sun exposed areas such as the head and neck (80% of all Merkel cell carcinomas). It tends to affect elderly patients or those with immune systems weakened by diseases such as HIV or drugs related to organ transplantation.
Merkel cell carcinomas tend to grow rapidly and have the ability to metastasise at an early stage. It can behave very much like melanoma in that it can spread to the surrounding skin, the lymph nodes or to other organs from the bloodstream.
Merkel cell carcinoma is usually diagnosed by excision biopsy. Often the diagnosis presents as a surprise to both the patient and the doctor who performed the biopsy. Sometimes the Merkel cell carcinoma spreads to the lymph glands without a lump on the skin ever being detected.
The treatment of Merkel cell carcinoma depends on the stage of cancer and whether it has spread to other parts of the body or not. Furthermore, since Merkel cell carcinoma is rare, opinions differ from cancer centre to cancer centre regarding the best treatment options for the disease. Treatments offered at the Norfolk & Norwich University Hospital include the following:
- Wide Surgical Excision and Reconstruction,
- Excision and Radiotherapy,
- Sentinel Lymph Node Biopsy,
- Radiotherapy to the Lymph Glands,
- Surgery to the Lymph Glands,
- Systemic Immunotherapy.
The treatment plan for each individual patient would be discussed at the specialist multidisciplinary meeting. A treatment plan would be agreed only after discussion with the patient and, where appropriate, their relatives.