Merkel Cell Carcinoma Explained
While far from a card-carrying Parrothead, I certainly appreciated the magic of a Jimmy Buffet song to transport a person to paradise even in the gloomiest conditions. Like so many, I was saddened to hear of the passing of this cultural icon.
What killed Jimmy Buffett?
Jimmy Buffett died from a rare cancer that starts in the skin called a Merkel cell carcinoma (MCC). There are only about 1500 cases in the United States each year.
Merkel Cell is primarily a tumor of the elderly, with the average age of about 75 years at the time of diagnosis. Unfortunately, the tropical lifestyle can also put one at risk for MCC, with sun exposure being a major risk factor and 90% of tumors occurring on sun exposed skin. Tumors are also more common in individuals with a suppressed immune system.
MCC is usually present on the skin as a rapidly growing, painless red nodule with a shiny surface. Because of their rapid growth, by the time a patient presents to a physician for a biopsy, up to 1/3 of the cancers have already spread within the body, or metastasized, most commonly to the lymph nodes. MCC’s ability to spread so quickly makes it one of the most dangerous types of cancers, with only 65% of those diagnosed living more than 5 years.
Treatment for Merkel Cell Carcinoma
Treatment is typically surgery and radiation. While traditional chemotherapy has been largely ineffective, there is hope with clinical trials of newer targeted immunotherapies.
Perhaps one of the most fascinating things about MCC is the discovery in the past decade that 80% of the tumors contain a newly discovered virus, called the Merkel cell polyoma virus (MCPV). The virus is present in up to 80% of the population over the age of fifty and its transmission pattern is unknown.
Similar to the well-established association of the HPV virus with cervical cancer, MCPV’s presence may be necessary, along with more traditional cancer risk factors like immunosuppression and UV light exposure, for Merkel cell carcinomas to form.
Insights such as this also give us hope that like HPV, the MCPV could be a future target for a vaccine to drastically reduce the risk of this very dangerous cancer.
If you have any suspicious lesions or haven’t been in for a skin check in the last year, schedule your skin check today!