Merkel Cell: What It Is and How It’s Treated

Discovering a fast-growing bump on your skin can cause immediate worry. You're right to feel concerned, especially in Florida, where the strong sun raises the risk of skin cancers like Merkel cell carcinoma (MCC).

MCC is rare, but it can spread quickly. The good news? Early attention helps you make safer decisions.

Our goal is to replace fear with understanding, so here's what you need to know today:

• MCC is serious, but many options exist.
• A clear plan reduces anxiety.
• Timely action improves outcomes.

Let's start with the basics—what exactly is Merkel cell cancer?

What is Merkel Cell?

Merkel cell carcinoma is a rare, fast-growing skin cancer named after Merkel cells - touch-sensitive cells in the skin’s lower layer - even though it may not actually start in those cells.

It often appears as a painless, firm bump on sun-exposed areas like your head, neck, or arms. The bump’s biology and stage, which includes tumor size, help determine risk.

Unlike some cancers, Merkel cell carcinoma can quickly spread to nearby lymph nodes and other parts of your body if left untreated. Many people mistakenly believe that small tumors aren't dangerous, but even small MCC tumors can be serious, and side effects vary widely.

Who is at Risk of MCC?

Major risk factors for MCC include:

• Years of sun exposure
• Older age
• A weakened immune system
• A common virus (Merkel cell polyomavirus)

Understanding your risks helps guide your next steps.

Tests and Staging for Merkel Cell Carcinoma

The first step to diagnosing MCC is usually a skin biopsy, a minor procedure where a doctor removes a tiny piece of the skin lump to examine under a microscope.

Special stains are used to confirm MCC, clearly distinguishing it from similar skin conditions. After confirming the diagnosis, your care team typically performs additional tests like CT or PET/CT scans, looking closely to see if the cancer has spread beyond the skin.

Another important step is a sentinel lymph node biopsy, or a "first-draining node check," to detect microscopic spread.

Understanding MCC stages helps your doctors develop your treatment plan:

With a clear picture of the stage, doctors can tailor your treatment carefully.

Treatment Options at ACTC

At ACTC, we use a coordinated, team-based approach involving surgery, radiation oncology, and medical oncology.

Complex cases benefit from multidisciplinary tumor board reviews, where our specialists collaborate closely to develop your personalized treatment plan.

Surgery

For most MCC cases, surgery is the first step, removing the tumor along with a margin of healthy skin around it to reduce the chances of recurrence.

Surgeons may also perform a first-draining node check to determine if any lymph nodes contain cancer cells.

Radiation Therapy

After surgery, radiation therapy is often added to the treatment plan to further reduce the chance that cancer returns locally.

Radiation is highly targeted and aimed precisely at the area where the tumor was removed, minimizing impact on surrounding healthy tissue.

Medical Oncology

When MCC has spread or can't be removed entirely by surgery, immunotherapy medicines—which help your immune system recognize and attack cancer cells—are usually recommended.

Chemotherapy, once the standard treatment, is now a second-line option if immunotherapy isn't suitable. No matter your situation, we aim to provide clarity and calm at each step. Our care also includes coordination, education, and practical help.

Support and Guidance at ACTC

Facing cancer can feel overwhelming, so we offer specialized nurse navigation to guide you through each part of your treatment. Your nurse navigator can make organizing your care easier and keep you informed.

Here’s a quick checklist for your first visit:

• Bring your photo ID, insurance card, and current medication list.
• Collect any prior medical records, biopsy results, or imaging scans.
• Write down your top questions about diagnosis, treatment, and side effects.
• Consider bringing a support person to take notes and offer comfort.

Your nurse navigator will also share information on managing side effects like wound care after surgery, protecting your skin during radiation, and recognizing symptoms that require urgent attention—like unusual swelling or signs of infection.

Regular follow-ups will be scheduled to monitor your health closely, especially during the early months after treatment.

Your Next Steps

Small actions now can ease anxiety later. Here’s how to take control:

• Gather your medical records and imaging studies.
• Write down your three most important questions for your doctor.
• Ask clearly about timelines for scans, surgery, radiation, or immunotherapy.
• If possible, bring a trusted friend or family member to your appointments for extra support.

Call 352-345-4565 or book an appointment now.