By Rachel Nania, AARP Sepember 2023
5 Things to Know About Merkel Cell Carcinoma. Older adults are at higher risk for this rare but aggressive type of skin cancer.
The news of Jimmy Buffett’s death has put a spotlight on a rare and aggressive type of skin cancer, known as Merkel cell carcinoma (MCC). The musician was diagnosed with the disease four years ago, according to a statement posted on his website, and he continued to perform throughout his battle with the cancer.
Only about 2,000 cases of MCC are diagnosed in the U.S. each year, mostly in older adults, according to the American Cancer Society. Here’s what you need to know about MCC, including its warning signs and symptoms.
1. It may be easy to overlook at first
Unlike some of the more well-known skin cancers that can appear mole-like, MCC tends to pop up on sun-exposed skin (face, neck and arms) as a painless pink, red or even flesh-colored bump, says William Dahut, M.D., chief scientific officer at the American Cancer Society.
“If you saw it, you might just think it’s like a lipoma [a round lump of tissue that grows beneath the skin] or something, particularly the ones that are flesh- colored,” Dahut says. Some experts say MCC can even look like a pimple at first, making the cancer easy to overlook.
2. It grows and spreads quickly
However, unlike a harmless lipoma or a pimple, MCC spreads quickly, Dahut says. The single lump can grow larger in size, or new lumps on the skin can develop.
The cancer can also spread to other parts of the body, including the lymph nodes, and in doing so may cause them to grow large enough to be seen or felt as lumps under the skin, most often in the neck or under the arms.
Size doesn’t matter when it comes to MCC. “A spot that seems small still can have that risk of spreading to some other part inside the body,” says James Isaacs, M.D., a medical oncologist at the Cleveland Clinic.
3. Some people are more at risk than others
People who have a weakened immune system are more likely to develop MCC, experts say. The same goes for individuals who have a history of skin cancer and who have light-colored skin. Dehut says about 95 percent of patients with the rare cancer are white. Men are also more likely than women to be diagnosed with MCC.
Another risk factor is exposure to ultraviolet (UV) light, so people who use tanning beds, have a history of severe sunburns, or receive light therapy to treat psoriasis or other skin diseases are at greater risk.
And while the cancer can occur at any age, MCC is most common in adults older than 50, making age another risk factor. According to the American Cancer Society, more than 4 out of 5 Americans diagnosed with MCC are over the age of 70.
Interestingly, researchers have found that a common, symptomless virus that lives on the skin, known as Merkel cell polyomavirus (MCV), is found in the cancer cells of 8 in 10 people with MCC. The virus was only discovered in 2008, so researchers are still studying its link to the rare cancer.
4. The earlier it’s treated, the better
Like other cancers, the earlier that MCC is diagnosed and treated, the greater the chances are for remission and survival.
Treatment might include surgery, radiation or chemotherapy. Newer immunotherapy drugs, known as immune checkpoint inhibitors, are also being used to treat MCC, especially if the cancer has spread to other parts of the body.
Dehut says these treatments have resulted in “some very, very promising long responses” and that, overall, “outcomes are better now for people with more advanced disease than they were even a few years ago.”
5. You can lower your risk
Protecting yourself against UV exposure is one of the most important things you can do to lower your risk for MCC and other skin cancers, Dehut says — and that doesn’t just mean lathering up with sunscreen when you’re out in the sun. Covering up with sun-appropriate clothing and seeking shade as much as possible are also important strategies, he adds.
“I tell people there are a lot of risk factors that you can’t control, like having fair skin or aging, which are two big risk factors for Merkel cell. But the one you can control is sun exposure,” Isaacs says.
Finally, if you notice any changes in your skin — any lumps, lesions, moles or sores — make an appointment to see a doctor, experts say.