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How is Merkel cell carcinoma treated?

Donna Hill Howes, RN
Family Medicine
There are three types of standard treatment for Merkel cell carcinoma:

Surgery
One or more of the following surgical procedures may be used to treat Merkel cell carcinoma:
  • Wide local excision: The cancer is cut from the skin along with some of the tissue around it. A sentinel lymph node biopsy may be done during the wide local excision procedure. If there is cancer in the lymph nodes, a lymph node dissection also may be done.
  • Lymph node dissection: A surgical procedure in which the lymph nodes are removed and a sample of tissue is checked under a microscope for signs of cancer. For a regional lymph node dissection, some of the lymph nodes in the tumor area are removed; for a radical lymph node dissection, most or all of the lymph nodes in the tumor area are removed. This procedure is also called lymphadenectomy.
Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.

Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Treatment options for Merkel cell carcinoma depend on how far the cancer has spread. Many times, treatment will begin with surgery to remove the growth on your skin. During surgery, doctors remove the tumor and some of the surrounding tissue. Sometimes, the lymph nodes may also be surgically removed. In some cases, doctors may use a procedure called Mohs surgery. In this method, doctors shave of the tumor layer by layer and test each layer for cancerous cells as they go. This way, they can stop removing tissue as soon as there are no more cancerous cells, meaning they can preserve as much healthy skin as possible. If doctors think that there may be cancerous cells left after they've removed the tumor, radiation therapy may be used. If the cancer has spread to other organs, chemotherapy may be recommended. Another option is immunotherapy, using medications to tag cancerous cells and alert the immune system to destroy them.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.