Let’s talk about something important – Merkel Cell Carcinoma, or MCC for short. This rare type of skin cancer is caused by the rapid and uncontrolled growth of specialized skin cells known as Merkel cells. While it’s not as common as some other skin cancers, MCC can be quite aggressive, quickly spreading to other parts of the body, a process referred to as metastases.
MCC stands as the second most common cause of skin cancer death after melanoma. Sadly, in recent news, legendary “Margaritaville” singer Jimmy Buffett passed away on September 1, 2023, after four years of battling MCC. Early detection is key to improving outcomes, making it vital to be able to recognize the signs and distinguish MCC apart from other common skin conditions.
What does MCC look like?
Some common signs of MCC include:
- A single firm, dome-shaped or raised lump
- A pink, red, or purple lump or bump on the skin
- Typically painless lumps that may turn into ulcers or sores, with the possibility of the skin breaking or bleeding.
- It is fast-growing – about 63% of MCC’s have grown significantly over the past 3 months.
- Enlarged nearby lymph nodes.
- Most MCC (88%) are “asymptomatic” meaning that they are not tender or painful.
Despite these signs being common indicators of MCC, It is essential to have any new, growing, or changing lesions or growths on your skin checked by a physician. Like all cancers, the earlier it is detected, the easier it is to treat. This holds even more significance for MCC due to its rapid growth and high likelihood of spreading.
What Can MCC Be Mistaken For?
MCC can sometimes be mistaken for other skin conditions, causing delays in diagnosis. The information below can be helpful to consider when evaluating suspicious areas on your body. Still, it’s best to see a physician immediately if you notice anything unusual or concerning on your skin. Here are a few skin conditions MCC can be mistaken for:
| Sore | Insect Bite | Cyst |
| A sore is typically a raw or painful lesion of the skin. Unlike a sore, MCC is typically painless. |
Some insect bites can cause large, red inflammation. Most insect bites will go away after a short period of time and are not associated with other signs and symptoms of MCC. |
A cyst can grow rapidly and is often red or purple. However, unlike MCC, a cyst will almost always be tender. |
| Stye | Pimple |
| A stye is a red, sore lump, often on the eyelid, often caused by a bacterial infection. Unlike MCC, stye’s are typically quite painful. | Cystic acne causes painful, pus-filled pimples underneath the skin, which can cause inflammation. Unlike MCC, cystic acne can be very tender and sore to the touch. |
How to Identify MCC
Screening remains the best way for diagnosing MCC and improving patient outcomes. Understanding how to identify MCC and where it’s typically found is essential. While commonly located on sun-exposed areas like the head or neck, MCC can appear elsewhere, including areas like the esophagus and inner nose/nasal mucosa4. For people with skin of colour, MCC often presents on the lower legs, and on the trunk in younger adults. Despite this, it is important to remember that MCC can develop anywhere on the body.
Risk Factors for MCC
The main risk factor for MCC is high exposure to UV radiation from the sun or other forms of UV radiation such as tanning beds or sun lamps. Other risk factors include5;
- Weakened immune systems (e.g., patients on immunosuppressive drugs or people with HIV)
- Older age (those greater than 50)
- Having light skin
- A history of other cancers
- Sex assigned at birth (males are two times more likely to be diagnosed with MCC than females)6.
Prevention and Detection
Did you know that 75% of melanomas are detected by patients themselves? Here are some steps you can take for prevention and early detection:
- Perform monthly self-exams: We encourage you to check your skin every month and report any new spots, sores or changes to your doctor. Follow along with our skin exam guided video to perform your monthly skin exams.
- Full-Body Skin Examinations by a Dermatologist: Schedule routine skin checks with a dermatologist, who can conduct a thorough examination and address any concerns. Find a dermatologist here.
- Avoiding Tanning Beds: Minimize or eliminate the use of tanning beds, as they emit very high levels of harmful UV radiation and increase the risk of developing melanoma greatly.
- Sun Protection: Protect your skin from harmful UV radiation by seeking shade, wearing protective clothing (including wide-brimmed hats and UV-protective sunglasses), and applying broad-spectrum sunscreen regularly.
Always remember, early detection is key! Perform regular skin self-exams, familiarize yourself with the signs and characteristics of MCC, and be on the lookout for any new growth or changes. If you notice something unusual, or if a spot doesn’t heal, it’s time to consult your dermatologist or family doctor.
For an accurate assessment, it is crucial to consult with a healthcare professional, preferably a dermatologist, for a thorough evaluation and proper diagnosis.
Facing a cancer diagnosis, especially a rare form, can be very distressing and isolating. If you, or someone you love, has been diagnosed with MCC, Melanoma Canada’s patient care specialist is available to support you. Please email support@melanomacanada.ca for more information.
- For a personal journey with MCC, read Ryck’s story here
