Merkel cell carcinoma is a rare and potentially aggressive form of skin cancer that arises in Merkel cells, which are cells on the outer layer of skin involved in the touch sensation. Though the cancer can grow and spread rapidly, it is highly treatable and curable if caught in the early stages. The University of Michigan Merkel Cell Carcinoma Program, part of the U-M Health System’s Dermatology Department, was one of the first and remains one of the few multidisciplinary programs in the country created solely to treat patients with this rare disease. Merkel cell carcinoma is best managed with the collaboration of multiple specialties. At U-M, our physicians offer experience and expertise in treating the disease at all stages.
Merkel cell carcinoma typically presents as a reddish or purple bump that can occur anywhere on the body, but is predominantly found in sun-exposed areas such as the head, neck, arms and legs. The risk of having the disease increases with age, with 95 percent of patients being over the age of 50. Being fair-skinned or immunosuppressed also increases your risk. Merkel cell carcinoma is rare, accounting for much 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. The U-M Merkel Cell Carcinoma Program treats approximately 70-100 patients annually from all over the world.
All new patients who come to the clinic with a confirmed biopsy diagnosis receive a complete evaluation and exam and are staged, counseled, and educated about the disease. Each patient’s case is discussed at a multidisciplinary tumor board conference devoted exclusively to Merkel cell carcinoma, including such specialties as dermatology, surgical oncology, radiation oncology, medical oncology, head and neck surgery, oculoplastic surgery, pathology, and nursing. The best course of treatment and overall management for each patient is determined by this group of collaborative colleagues.
Treatment will usually include surgery to remove the tumor and biopsy of a lymph node (sentinel lymph node biopsy) to find out whether the cancer has spread. This is typically done under general anesthetic 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 may need chemotherapy. No matter the treatment, U-M’s multidisciplinary specialists and medical team are dedicated to giving patients the highest level of care available, delivering it with compassion and taking into account your and your family’s needs.
Once treatment is complete, you will continue to receive follow-up care at the U-M Merkel Cell Carcinoma Program. This will include exams of the skin and lymph nodes, and may include further testing.