How to Treat Merkel Cell Carcinoma

A Merkel cell carcinoma (MCC) is a form of skin cancer that usually occurs on the head and neck. Its origin is uncertain because it has both epidermal and neuroendocrine features. The most likely possibilities are pluripotential cells or neural crest cells. The most common causes of Merkel cell carcinomas are ultraviolet light, especially UV-B and arsenic poisoning. The following steps will show how to treat a Merkel cell carcinoma.

Instructions

• 1

  Determine the treatment for a Merkel cell carcinoma based on its clinical stage. MCC is an aggressive malignant cancer with a strong tendency for recurrence, local involvement and metastasis. Therapeutic options include chemotherapy, radiation therapy and surgery.

• 2

  Perform surgery as the treatment of choice for most Merkel cell carcinomas. The lesion should be surgically excised with a 2 to 3 cm margin of healthy skin to reduce the chances of recurrence. This is not always possible, but a disease-free margin is the single most important factor in the prognosis.

• 3

  Use Mohs micrographic surgery for small Merkel cell carcinomas on the face. This procedure is followed by radiotherapy and is effective in preserving skin in cosmetically important areas.

• 4

  Conduct radiotherapy as the primary treatment when the patient cannot tolerate surgery or the margin would not be wide enough. Radiation is most often used as adjunctive therapy after surgery. The typical dosage is in the 45 to 60 Gy range and is administered to the surgical site and local lymphatic bed.

• 5

  Administer chemotherapy for advanced Merkel cell carcinoma. Most of these cases show some response, but complete cures are rare.