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Jimmy Buffett, best known for tropical, beach-inspired hits like Margaritaville and Changes in Latitudes, Changes in Attitudes, died of a rare type of skin cancer called Merkel cell carcinoma at the age of 76, according to his website.

While fewer than 3,000 people are diagnosed with Merkel cell cancer in the US each year, this type of cancer tends to be much more aggressive than other skin cancers and can spread to other parts of the body quickly. Learning what early signs of Merkel cell skin cancer look like can be a crucial step in early detection and treatment for improved outcomes.

What Does Merkel Cell Carcinoma Look Like?

Merkel cell carcinoma often appears as a flesh-colored, red, or bluish lesion on the skin and is usually painless. In fact, it is often mistaken for other minor skin conditions such as an insect bite, cyst, or pimple. The telltale sign of Merkel cell carcinoma, however, is that it typically grows very quickly. Therefore, if you notice a new red spot or nodule on your skin that appears to be quickly growing in size in a matter of weeks, see your dermatologist as quickly as possible.

The most common areas of the body for Merkel cell cancer to develop are the head, neck, and other areas that are often exposed to the sun.

What Is a Merkel Cell?

Named for German anatomist Friedrich Sigmund Merkel, Mercel cells are oval-shaped, specialized cells in the basal epidermal layer of your skin that play a key role in light touch sensations. They are dense in areas such as your fingertips, which are highly sensitive to sensory touch. In fact, Merkel cells were first referred to as “touch cells,” due to their close relationship with sensory nerve endings, now called Merkel nerve endings.

Is Merkel Cell Cancer More Aggressive than Melanoma?

While Merkel cell carcinoma and melanoma are both aggressive types of skin cancer, Merkel cell carcinoma has a higher rate of metastasis, or the growth of cancerous cells in other areas outside of the initial site, making it more difficult to treat. However, if caught early before spreading to lymph nodes and other areas of the body, a Merkel cell cancer prognosis can be more favorable than late-stage Merkel cell cancer.

What Causes Merkel Cell Carcinoma?

Merkel cell carcinoma is believed to be caused by a combination of UV exposure, a weakened immune system, and mutations in a specific type of virus called Merkel cell polyomavirus (MCP).

Scientists have long linked accumulated unprotected sun exposure with all types of skin cancer, including Merkel cell carcinoma. However, this type of skin cancer appears to also be linked with mutations in the MCP virus, leading to the formation of cancerous cells. This may be why a weakened immune system appears to play a role in the development of Merkel cell cancer, as the body is less equipped to clear the virus. More research is needed to determine the exact link between Merkel cell skin cancer and MCP.

Risk Factors for Merkel Cell Carcinoma

There are a number of factors that can increase a person’s risk for developing Merkel cell carcinoma, including:
Age. 97% of all Merkel cell cancer patients are over the age of 50, and 75% of patients are over age of 65.

  • Sex. Merkel cell carcinoma most frequently occurs in fair-skinned males.
  • Ethnicity. Merkel cell skin cancer is more prevalent in people with fair skin tones. However, in rarer cases, it can also occur in those with darker skin tones, though often on the legs rather than the head and neck, as seen in fair-skinned patients.
  • Geographical location. More people are diagnosed with Merkel cell cancer in both Hawaii and Australia than in other parts of the world. Both of these locations receive some of the strongest UV rays in the world.
  • Medical conditions or medications that weaken the body’s immune system.

How Is Merkel Cell Skin Cancer Treated?

A proper diagnosis from a dermatologist experienced with Merkel cell carcinoma is the first step in creating a treatment plan. Mercel cell cancer can be diagnosed through a biopsy of the lesion. Your doctor may also recommend other diagnostic tests such as an MRI or PET scan to determine how far the cancer may have spread.

Once diagnosed, the stage of the Merkel cell carcinoma will largely determine the treatment plan. If detected early before spreading, Mohs surgery may be an appropriate treatment option. Mohs surgery involves the removal of thin layers of skin until no more cancer cells can be detected. Other treatments that may be recommended following a Merkel cell carcinoma diagnosis include lymph node dissection, radiation, and immunotherapy.

Merkel cell carcinoma has a higher recurrence rate than other types of skin cancer, so it is imperative to maintain all follow-up appointments with your doctor.

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How to Lower Your Risk of Skin Cancer

While not all instances of skin cancer are entirely preventable, there are many things you can do to minimize your risk of Merkel cell carcinoma, melanoma, and other skin cancers:

  • Avoid prolonged sun exposure and deliberate tanning.
  • Wear sunscreen of SPF 30 or higher and sun-protective clothing when outdoors, even on cloudy or rainy days.
  • Take steps to promote healthy immune support.
  • Work with your doctor to help manage existing medical conditions that may weaken your immune system.
  • See your dermatologist for an annual or biannual skin exam.
  • Perform self-exams in between visits with your dermatologist, noting any new moles, changes to existing moles or lesions, or swollen lymph nodes.

In Summary

Although Merkel cell carcinoma is rare, it can be particularly aggressive, making early detection that much more important. Make note of any quickly changing moles or lesions on your skin, letting your dermatologist know promptly if you suspect signs of skin cancer.

To schedule an appointment with one of our Delray Beach board-certified dermatologists, give us a call at (561) 692-6422 or fill out our secure online contact form.