Title: Merkel Cell Carcinoma: Understanding the Rare and Deadlier Form of Skin Cancer
Introduction:
Skin cancer is a well-known and prevalent disease, with basal cell carcinoma, squamous cell carcinoma, and melanoma being the most commonly heard of forms. However, there is a lesser-known but deadlier variant called Merkel cell carcinoma. Recently, the passing of singer-songwriter Jimmy Buffet at the age of 76 from Merkel cell carcinoma has brought this form of skin cancer into the spotlight. In this article, we will dive deeper into understanding Merkel cell carcinoma, its warning signs, distinguishing characteristics from other skin cancers, and its impact on mortality.
Unveiling the Secrets of Merkel Cell Carcinoma:
To shed light on this rare skin cancer, we reached out to Dr. Paul Nghiem, a prominent expert in the field. Dr. Nghiem, a dermatology professor at Washington University School of Medicine and director of the Clinical Oncology Program at Skin at the Fred Hutchinson Cancer Center, shared valuable insights into Merkel cell carcinoma.
The Importance of Increased Awareness:
Dr. Nghiem emphasizes the significance of raising awareness about Merkel cell carcinoma. While melanoma is widely recognized, squamous cell carcinoma remains the most common, often overshadowing Merkel cell carcinoma. Shockingly, research suggests that Merkel cell carcinoma is four times more likely to be fatal than melanoma. This highlights the urgency of understanding this rare form of skin cancer.
Diagnosing Merkel Cell Carcinoma:
Detecting Merkel cell carcinoma is challenging even for experienced dermatologists, making it nearly impossible for the average person. However, a skilled physician can notice the unusual signs and symptoms and order a biopsy. Merkel cell lesions may appear similar to insect bites, sores, cysts, or pimples. However, they grow rapidly, are insensitive to touch, and follow the AEIOU mnemonic: Asymptomatic, Expand rapidly, Immune system compromised, Older individuals, and UV-exposed skin. Roughly 90% of patients with Merkel cell carcinoma exhibit three or more of these factors.
The Viral Link:
One crucial aspect that sets Merkel cell carcinoma apart from other skin cancers is its viral cause. Approximately 80% of cases are associated with a virus, while the remaining 20% are linked to sun exposure. Although the exact relationship between the virus and sunlight in triggering this cancer is not fully understood, the importance of their interaction is evident. People with darker skin tend to have a lower risk, indicating the significance of the sun-virus interplay.
Unraveling the Complexity:
The development of Merkel cell carcinoma involves a complicated series of genetic mutations, along with the entry and fragmentation of the virus’s DNA in cancer cells. This complexity acts as a barrier to the cancer’s prevalence, as nearly everyone is exposed to the virus and sunlight. The rarity of the cancer, affecting only 1 in 130,000 Americans, raises questions about its progression and true causes.
Growing Cases and Importance of Specialized Centers:
Although Merkel cell carcinoma is relatively rare, its diagnosis has been increasing faster than other types of cancer, including melanoma. The aging population, along with sun exposure without sufficient sun protection, is believed to be contributing factors. In case of a suspected diagnosis, seeking care at specialized centers familiar with Merkel cell carcinoma management is crucial. Survival outcomes have been proven to be better at such centers.
Newer Therapies Offering Hope:
Early detection and prompt treatment significantly improve the prognosis for Merkel cell carcinoma patients. Radiation therapy, preferred over surgery due to the cancer’s tendency to jump locally and distantly, has shown promising results. Additionally, immunotherapy, based on a person’s genetic mutations, is proving to be more effective than chemotherapy. The chances of survival have increased tenfold, with multi-year survival rates rising from 5% to around 50% today.
Research Support and Importance:
The advancement in survival rates for Merkel cell carcinoma would not have been possible without the dedicated support of research institutions such as the National Institutes of Health and the National Cancer Institute. These institutions play a vital role in addressing rare conditions like Merkel cell carcinoma, which collectively contribute to a significant portion of illnesses.
Conclusion:
Merkel cell carcinoma is a lesser-known and deadlier form of skin cancer. Increased awareness about this rare cancer is essential for early detection and effective management. Understanding its distinctive features, such as the viral link and complexity of development, can aid in further research and treatment advancements. With newer therapies like immunotherapy and radiation treatment showing promise, the survival rates for Merkel cell carcinoma patients are steadily improving. By supporting research institutions and prioritizing federal funding, we can continue making significant strides in combating rare and life-threatening conditions like Merkel cell carcinoma.
Source: WebMD – ‘Understanding Merkel Cell Carcinoma: The Rarer and Deadlier Form of Skin Cancer’ (September 5, 2023)
—————————————————-
| Article | Link |
|---|---|
| UK Artful Impressions | Premiere Etsy Store |
| Sponsored Content | View |
| 90’s Rock Band Review | View |
| Ted Lasso’s MacBook Guide | View |
| Nature’s Secret to More Energy | View |
| Ancient Recipe for Weight Loss | View |
| MacBook Air i3 vs i5 | View |
| You Need a VPN in 2023 – Liberty Shield | View |
September 5, 2023: You may have heard of the three most common forms of skin cancer (basal cell carcinoma, squamous cell carcinoma, and melanoma), but there is a rarer and deadlier form known as Merkel cell carcinoma.
The passing of popular singer-songwriter Jimmy Buffett, who passed away on Friday at the age of 76 from Merkel cell carcinoma, has brought this form of skin cancer into the spotlight. But what is it exactly? What are the warning signs, how is it different from other skin cancers, and how does it cause death?
WebMD reached out to one of the leading experts on Merkel cell carcinoma for answers: Paul Nghiem, MD, PhD, professor of dermatology at the Washington University School of Medicine and director of the Clinical Oncology Program at Skin at the Fred Hutchinson Cancer Center, both in Seattle.
Increased awareness of this type of skin cancer is important, Nghiem said.
“In addition to melanoma, there is another skin cancer, squamous cell carcinoma, basically the most common and you hear a lot about it. This cancer is four times more likely to kill someone than a melanoma.”
not obvious cancer
When asked how easy or difficult it is to diagnose Merkel cells, Nghiem replied: “I would say that for the average person it is impossible. For an excellent dermatologist, very difficult. But a good doctor will know that something unusual is going on and will order a biopsy.”
A Merkel lesion on the skin can easily be mistaken for a insect bite, sore, cyst, or pimple. However, Merkel cell carcinoma usually grows rapidly and is not sensitive to touch.
Consider the AEIOU mnemonic:
- A is for Asymptomatic (does not hurt)
- E is for expand (grow quickly)
- I is for immunity (impaired immunity can mean increased risk)
- Or is it for people over 50 years of age.
- U is for skin exposed to UV rays
About 90% of Merkel cell patients have three or more of these factors.
a viral cause
The reason that people with compromised immunity may be at higher risk is that Merkel cell carcinoma is, in about 80% of cases, caused by a virus. That’s another way it differs from other skin cancers. The remaining 20% of cases are associated with sun exposure. In many cases, it is the combination of these two factors that somehow leads to the Merkel cell.
“The virus is crazy because it is on most of our normal skin most of the time. So it’s a very, very common virus and a very rare cancer,” Nghiem said. “That’s an unusual combination.”
It is not fully understood how sun exposure and the virus work together to cause this cancer. But people with darker skin tend to be at lower risk, and “that tells us very clearly that there is an interaction between the sun and this virus,” she added.
It’s complicated
Researchers know that a complicated series of steps is necessary for Merkel cell carcinoma to develop.
“There are genetic mutations that need to occur and we now understand them quite well. The DNA of the virus needs to enter the cancer cell and fragment in a very specific way, and that leads to cancer,” Nghiem said.
That could be a silver lining. “If it wasn’t so complicated, this would be so much more common because basically everyone gets some sun and everyone is exposed to this virus,” she added.
The Skin Cancer Foundation estimates that 1 in 130,000 Americans You will be diagnosed with Merkel cell carcinoma. In addition to immunocompromised people, people at highest risk include those with a history of sun exposure, those with fair skin, and those over 50 years of age.
Although relatively rare, the number of Americans diagnosed with Merkel cell carcinoma is growing “much faster than other types of cancer, and melanoma in particular,” Nghiem said. The aging of the American population, including many who rarely used sunscreencould be behind the rise in cases, the American Academy of Dermatology says on its website.
Merkel cell carcinoma often spreads to other parts of the body if it is not found early. If it appears on the head or neck, for example, it tends to go to the liver. Merkel cell lesions on the legs and other parts of the body usually spread to lymph nodes around the intestine.
If a biopsy shows results that indicate this rare cancer, seek care at one of the dozen or so specialized centers around the country, if you can, Nghiem suggested.
“There is clear evidence that survival outcomes are better if you go to a center that is familiar with how to manage it.” The Merkelcell.org site offers a list of specialists nationwide.
Although the cancer is relatively rare, “if you’ve had other skin cancers and are immunocompromised after an organ transplant, for example, it’s very important that you’re monitored carefully,” Nghiem said. “Not just for this, but for all skin cancers.” For people who receive lifelong immune suppression, the risk of Merkel cell carcinoma increases 30-fold, she added.
Newer therapy offers hope
If caught early, before it spreads to other parts of the body, Merkel cell carcinoma can be successfully treated in many cases.
Another tip is to make sure your health care provider suggests radiation treatment. Unlike many cancers that “grow into a ball” and can be removed with surgery, Merkel cell carcinoma jumps locally and distantly around the body, known as “microscopic spread.” Therefore, radiation is the preferred treatment in many cases because it can treat a larger region than surgery. Radiation also kills Merkel cell carcinoma tumor cells more effectively than other types of cancer.
A newer treatment strategy, immunotherapy, is a more specific treatment based on a person’s unique genetic mutations. It may be more effective than traditional treatments such as chemotherapy because chemotherapy tends to turn off the immune system, which again increases the risk of Merkel cell carcinoma.
“Immunotherapy is making a big difference. The chances of survival are now about 10 times higher,” said Nghiem.
Multi-year survival has increased from about 5% to about 50% today, he said. The American Cancer Society provides estimates of 5-year survivalThey vary depending on whether the cancer is local or has spread throughout the body.
Improved survival rates would be unlikely without research support from the National Institutes of Health and the National Cancer Institute, Nghiem said. “That made a big difference and it’s important for the public to know that.”
For rare conditions like this and many others, federal and national funding is particularly essential. Although a rare condition might affect relatively few Americans, together they account for about 40% of illnesses. And he added: “When you look at the big picture, they are a big problem.”
—————————————————-