02 9911 7322 amigos@masc.org.au

What is Merkel Cell Carcinoma?

What is Merkel Cell Carcinoma

At enis sunt reperfe rferum re volorestem nonesti re doluptatur sendit facersp elluptas cus sendis eum erum voluptature estio ventur, si cume dignatecuptain nis sam elit facim qui nus volorionsera que evel erchilia venia sequate mporenim aut ad mos mos eumenda con nonsequi consedit modi ut audae volorepernat prat volesto taspedi is et excesequodi to comnimi nvenduc iandita sinvent que pellaut restend iatent quat eos deliquam, et a culliquis molutem desed quas dolest aboristotam del id expelitaerum dolut eles eario magnatet esequo molor accaectatiis ut aut rest, que nullabo reperum doluptatquia non nonseque vendit, conseque la incilitianis adit laccabo. Vitat.

How is it Diagnosed

At enis sunt reperfe rferum re volorestem nonesti re doluptatur sendit facersp elluptas cus sendis eum erum voluptature estio ventur, si cume dignatecuptain nis sam elit facim qui nus volorionsera que evel erchilia venia sequate mporenim aut ad mos mos eumenda con nonsequi consedit modi ut audae volorepernat prat volesto taspedi is et excesequodi to comnimi nvenduc iandita sinvent que pellaut restend iatent quat eos deliquam, et a culliquis molutem desed quas dolest aboristotam del id expelitaerum dolut eles eario magnatet esequo molor accaectatiis ut aut rest, que nullabo reperum doluptatquia non nonseque vendit, conseque la incilitianis adit laccabo. Vitat.

Stages of Merkel Cell Carcinoma

At enis sunt reperfe rferum re volorestem nonesti re doluptatur sendit facersp elluptas cus sendis eum erum voluptature estio ventur, si cume dignatecuptain nis sam elit facim qui nus volorionsera que evel erchilia venia sequate mporenim aut ad mos mos eumenda con nonsequi consedit modi ut audae volorepernat prat volesto taspedi is et excesequodi to comnimi nvenduc iandita sinvent que pellaut restend iatent quat eos deliquam, et a culliquis molutem desed quas dolest aboristotam del id expelitaerum dolut eles eario magnatet esequo molor accaectatiis ut aut rest, que nullabo reperum doluptatquia non nonseque vendit, conseque la incilitianis adit laccabo. Vitat.

Treatment Options

At enis sunt reperfe rferum re volorestem nonesti re doluptatur sendit facersp elluptas cus sendis eum erum voluptature estio ventur, si cume dignatecuptain nis sam elit facim qui nus volorionsera que evel erchilia venia sequate mporenim aut ad mos mos eumenda con nonsequi consedit modi ut audae volorepernat prat volesto taspedi is et excesequodi to comnimi nvenduc iandita sinvent que pellaut restend iatent quat eos deliquam, et a culliquis molutem desed quas dolest aboristotam del id expelitaerum dolut eles eario magnatet esequo molor accaectatiis ut aut rest, que nullabo reperum doluptatquia non nonseque vendit, conseque la incilitianis adit laccabo. Vitat.

Helpful Resources

At enis sunt reperfe rferum re volorestem nonesti re doluptatur sendit facersp elluptas cus sendis eum erum voluptature estio ventur, si cume dignatecuptain nis sam elit facim qui nus volorionsera que evel erchilia venia sequate mporenim aut ad mos mos eumenda con nonsequi consedit modi ut audae volorepernat prat volesto taspedi is et excesequodi to comnimi nvenduc iandita sinvent que pellaut restend iatent quat eos deliquam, et a culliquis molutem desed quas dolest aboristotam del id expelitaerum dolut eles eario magnatet esequo molor accaectatiis ut aut rest, que nullabo reperum doluptatquia non nonseque vendit, conseque la incilitianis adit laccabo. Vitat.

What Is MCC?

Merkel cell carcinoma is a rare but highly aggressive neuroendocrine skin cancer. MCC arises from uncontrolled growth of cells in the skin that share some characteristics with normal Merkel cells of the skin.

The number of cases of MCC is increasing rapidly, having quadrupled in the past few decades.

MCC has the potential to be lethal and appropriate management often should involve several types of therapy such as surgery, radiation, and sometimes systemic medications. Multidisciplinary evaluation of patients with this cancer is critical to determine and carry out a  proper treatment plan.

 

What Are The Symptoms?

MCC usually develops on sun-exposed skin (e.g. head, neck and arms) as a painless, firm lump that can be red-purple or skin-coloured. Patients frequently point out a new MCC to their doctor because a lump is growing rapidly and looks unusual.

Although these cancers typically arise on sun-exposed skin it can occur anywhere on the body, including sun-protected areas such as the buttock or scalp under hair.

What are the Risk Factors?

Factors strongly associated with the development of MCC include age over 65 years, fair skin, history of extensive sun exposure, chronic immune suppression (e.g. kidney or heart transplantation or HIV), and the Merkel cell polyomavirus.

Age relation to MCC

The risk of developing MCC increases with advancing age. 75% of MCC patients are over the age of 65 years at time of diagnosis, with the average age for developing MCC being 74. MCC is slightly more common in men than women for each age group

Sunlight

It is believed that ultraviolet radiation from the sun plays a significant role in the development of MCC. MCC is most commonly found on sunexposed areas of the body (e.g., head, neck, arms) in older Caucasian individuals, who may also have other sun-induced skin cancers. There are more MCC cases in sunny climates.

While extensive sun exposure is a risk factor for MCC, MCC can also occur on sun-protected skin, such as a hair-covered scalp.

Immune function

Patients with weakened immune systems are at significantly higher risk of developing MCC. Long-term suppression
of the immune system (for many years) appears to be a risk factor for MCC in some patients. Conditions associated with weakened immunity include HIV/AIDS, kidney or heart transplantation, and autoimmune diseases requiring medications that suppress the immune system, chronic lymphocytic leukaemia (CLL) and certain types of lymphoma. The risk of developing MCC is 8 times greater in HIV patients, 10 times greater in organ transplant patients, and about 40 times greater in CLL.  While patients with profound immune suppression are at a higher risk of developing MCC, over 90% of all people who develop MCC have no known immune deficiency.

Merkel cell polyomavirus

The Merkel cell polyomavirus (MCPyV) was discovered by the University of Pittsburgh laboratory of Drs Patrick Moore & Yuan Chang in 2008 and found to be frequently present in MCC tumours. The virus was found in 8 of 10 tumours tested, and was associated with the DNA of the tumour cells in such a way to suggest that it is involved in the development of MCC.

Since then, many studies have validated this initial report, finding MCPyV in the vast majority (about 80%) of MCC patients. Studies now show that the majority of people have been exposed to MCPyV by adulthood, but it appears that the virus does not cause any symptoms except in the very rare situations in which it leads to MCC.

MCC in Australia

The incidence of MCC is highest in Australia and approximately twice that of Europe and US.

While most MCC cases (approximately~80%) in Europe and North America are associated with the MCPyV, much lower rates (24%) of MCC tumours with the virus were reported in Australia.

In cases where MCPyV infection is not present, MCC is triggered by UV damage causing DNA mutations. Australia has particulary high rates of sun exposed MCC, thought to be due ti its higher UV index compared with other countries and highly sunexposed patient population.