Patients diagnosed with Merkel cell carcinoma are treated by the Multidisciplinary Cutaneous Oncology Clinic. For more information, please call 734-936-4068.

Healthcare providers: please contact M-LINE at 800-962-3555.

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, and 95% of patients are 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% 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. 

Early detection is key to the successful treatment of skin cancers. We recommend that you pay attention to your skin and do regular self-skin exams from head to toe. It is a good idea to have your physician or dermatologist complete a total body skin exam at least once per year.

If a spot, lesion or mole is concerning to you or your physician, arrange to have it checked out by a dermatologist. A skin biopsy may be needed to confirm a diagnosis of skin cancer, including the type or stage of skin cancer, and to determine a recommended treatment plan. Often, precancerous lesions may be effectively treated in the doctor’s office, while biopsy-confirmed skin cancers may require surgical removal and specialized treatment, including Mohs micrographic surgery for high-risk non-melanoma skin cancers.

Skin Biopsy & Pathology

To provide the most accurate diagnosis, your provider may recommend a skin biopsy. This is a quick and relatively painless procedure that removes a small sample of your skin for microscopic examination and additional testing. 

Skin biopsies are frequently needed to determine if a mole or skin lesion is cancerous, precancerous, or benign. Your skin biopsy is sent to our team of dermatopathologists, who are board-certified specialists with highly-specialized knowledge and skill in the diagnosis of disorders affecting the hair, skin and nails. 

Patients that have been diagnosed through a biopsy with Merkel cell carcinoma will receive a complete evaluation and exam and are staged, counseled and educated about the disease as a new patient. Each patient's case is then discussed at a multidisciplinary tumor board conference devoted to Merkel cell carcinoma, and includes experts from 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 experts. Working closely with the patient, family and their referring doctors, we work to coordinate treatment and follow-up care close to home when possible and to minimize trips to Ann Arbor.

Treatment options

Treatment usually includes surgery to remove the tumor and biopsy of a lymph node (called a sentinel lymph node biopsy) to find out whether the cancer has spread. This is typically done under general anesthesia 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 systemic therapy. No matter the treatment, U-M's Merkel cell 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 through the Multidisciplinary Cutaneous Oncology Program. This will include exams of the skin and lymph nodes, and may include further testing.