Diagnosing Merkel Cell Carcinoma at Cleveland Clinic
Everyone has Merkel cells in their outer layer of skin (epidermis). Exposure to ultraviolet (UV) light from the sun or a tanning bed, or having other risk factors like fair skin or a weakened immune system, can make these cells grow uncontrollably. When they do, they can form cancerous growths that can quickly spread (metastasize).
Merkel cell tumors are typically red, purple and shiny or pearly. They most often show up on your face, neck, arms and eyelids. They can be about the size of a dime and get larger quickly. MCC growths can be firm. And they often resemble a pimple or an insect bite. They can even feel tender or sore.
Because Merkel cell carcinoma is rare and resembles other skin conditions, diagnosing it can be tough. It’s often first mistaken for benign (noncancerous) tumors, cysts or infected hair follicles. By the time it’s correctly identified, it may have already reached your lymph nodes.
Accurate and early diagnosis requires the right tests — and skilled healthcare providers with experience treating this skin cancer. Cleveland Clinic’s skin cancer specialists can get you the care you need.
What to expect at your first visit
When you come in for your first appointment, your provider will start by getting to know you. It’s important for them to understand what’s been going on with your skin. Like, when you first noticed the growth, if it’s gotten bigger or changed, and if it’s affected your life in any way. Your provider will also ask you about your personal and family medical history.
Next, you’ll have a physical exam. Your healthcare provider will check out any new or changing skin lesions (growths). We’ll also check for swollen lymph nodes, which could be a sign that cancer has spread. And we might order some tests.
Testing for Merkel cell carcinoma
We may use a few different tests to confirm that your skin growths are MCC. These tests also help us stage the cancer (see how far along it is) and find out if and where it has spread:
Second Opinions for Merkel Cell Carcinoma at Cleveland Clinic
Learning you may have a rare and aggressive skin cancer can be overwhelming. You’ll want to feel confident that you’re working with a team of healthcare providers you trust to give you the best possible care. That’s why we encourage second opinions.
Our expert cancer specialists will dive in and help you better understand your diagnosis and what treatment options might be right for you. We also know that cancer doesn’t wait. That’s why we try to meet with you as soon as possible. Getting a second opinion can help you feel more in control of your care and give you peace of mind knowing you’re in the most capable hands.
Meet Our Merkel Cell Carcinoma Team
Cleveland Clinic believes in a team-based approach to care. This means you may have healthcare providers from different specialties who’ll work together to plan the best treatment for your unique needs. Your care team could include:
0 Providers Who Treat Merkel Cell Carcinoma
Locations
Our healthcare providers see patients at convenient locations throughout Northeast Ohio and Florida.
Treating Merkel Cell Carcinoma at Cleveland Clinic
Your treatment will depend on how big the tumor is, where it is and if the cancer has spread. You may have one treatment or a combination of a few.
Surgery
Removing the tumor through surgery is almost always the first treatment for Merkel cell carcinoma. The chances that surgery will cure the cancer are highest when the cancer is in its early stages, before it has spread.
Your provider may recommend:
- Mohs surgery: We use this very precise procedure to treat high-risk skin cancers.
- Excisional surgery: We remove the tumor and some of the surrounding healthy skin.
- Lymph node dissection: We may remove any lymph nodes (lymphadenectomy) that contain cancer cells if the cancer has spread.
- Reconstructive surgery: Skin grafts and other reconstructive surgery techniques can improve the appearance of the area where a tumor was removed.
You may also receive the following treatments after surgery:
- Radiation therapy: This can destroy any remaining cancer cells where the tumor was removed or where the cancer has spread. It can also shrink tumors to make them easier to remove with surgery.
- Immunotherapy: This treatment triggers your immune system to fight the cancer cells. Cleveland Clinic is at the forefront of the newest immunotherapies for advanced MCC, such as checkpoint inhibitors.
- Chemotherapy: We may use drugs to destroy cancer cells throughout your body. Chemo isn’t as effective as immunotherapy for MCC. We usually recommend it only if you can’t have immunotherapy or didn’t respond to immunotherapy treatment.
Taking the Next Step
Skin cancer doesn’t wait. And neither should you. If you’ve noticed a new growth that doesn’t seem right, you’ll want the expertise of a highly skilled healthcare team to confirm what’s going on and guide you on next steps. Cleveland Clinic’s skin cancer specialists are here to help you understand what it takes to treat your Merkel cell carcinoma. We’ll support you with expertise and compassion, every step of the way.
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Getting an appointment with Cleveland Clinic’s Merkel cell carcinoma experts is easy. We’ll help you get the care you need.
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Survivorship
Learning you have cancer can be stressful, shocking and challenging. From the moment you get the news, you're a survivor. As you face the challenges that go along with cancer treatment and recovery — physical and emotional — we’ll be right there with you.
At Cleveland Clinic, survivorship care is one part of your journey. We offer a wide range of services, resources, clinics and support groups to help with any physical, emotional, financial and spiritual needs you might have related to your cancer diagnosis. Lending a helping hand along the way, we want you to not only survive, but thrive on this journey and beyond.