Different types of treatment are available for patients with Merkel cell carcinoma. The treatment option depends on the stage of cancer, overall health and preferences about treatment. Patients have time for second opinions and to talk through all of their option with their doctors and develop a treatment plan that best fits their needs.

Surgery

Surgery is the main treatment for most Merkel cell carcinoma. There are several types of Merkel cell carcinoma:

• Initial skin biopsy

Skin biopsy is surgery to remove a suspicious spot event before the doctor suspects it might be merkel cell carcinoma. If MCC is diagnosed from the biopsy, a wide excision is used to remove more skin and other tissue in the area.

• Sentinal lymph node biopsy(SLNB)

Sentinal lymph node biopsy is typically a very important part of determining the stage of cancer. SLNB be done before a wide excision is used to remove more skin and other tissues from the tumor site. Other than that, it can help ensure the results of the SLNB are accurate. If the SLNB is negative, no more lymph node surgery is needed because the cancer would have spread beyond this point. If cancer cells are found in the sentinel node, the remaining lymph nodes in this area are often removed and looked at, too.

• Wide excision

By this treatment local anesthesia is injected into the area numb it before the excision. Then the surgeon cut out the tumor site, along with a small amount of normal skin at the edges. The normal, healthy skin around the edges of the cancer is called the margin. After then, skin is carefully stitched back together afterwards. This will leave a scar.

• Mohs micrographic surgery

Mohs surgery is used when the goal is to save as much healthy skin as possible, such as with cancers around the eye. It will removes a very thin layer of the skin and then checks the sample under a microscope. If cancer cells are seen the next layer is removed are examined. This step will repeat until skin sample cells are found to be free of cancer cells.

• Lymph node dissection

Merkel are often spread to nearby lymph nodes. In this surgical, the surgeon removes all of the lymph nodes in the region near the primary tumor. For example if the merkel cell carcinoma found on an arm, the surgeon would removes the nodes in the underarm region on that side of the body which is where cancer cells would most likely travel to first.

• Skin grafting and reconstructive surgery

It may be possible to stretch the nearby skin enough to stitch the edges of the wound together. Besides, healthy skin may be taken from another part of the body and grafted over the wound to help it heal and look better after surgery.

Radiation therapy

Radio therapy might be used in some situation such as to treat the area of the main skin tumor after surgery to try kill any cell cancer, to treat lymph nodes near the main tumor, to help treat MCC that has come back after surgery and to help treat MCC that has spread to distant parts of the body.

Surgeon will take careful measurements to determine the correct angles for aiming the radiation beams and the proper dose of radiation. The procedure itself is painless. Radiation is usually given 5 days a week for about 5 or 6 weeks.

Chemotherapy

Chemotherapy is treatment that is uses anti-cancer drugs that are typically injected into a vein or given by mouth. Then, this drug will travel through the bloodstream to all parts of the body. Usually chemo is likely to be helpful for MCC that has spread to other organs. Other than that, these drugs are given intravenously usually once every few weeks. They can shrink MCC tumors.

MERKEL CELL CARCINOMA TREATMENT

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