Dermatologists say the skin cancer that killed Jimmy Buffett is becoming more common and urge people to look out for a few unique features.
While rare, the aggressive skin cancer pops up most often in skin areas exposed to the sun, such as the face, scalp or neck. People who are fair-skinned, older than 50, and exposed regularly to the sun are at higher risk of developing Merkel cell carcinoma. The key to survival is finding out early, and acting quickly.
People diagnosed and treated for this form of skin cancer while it is still localized have a five-year survival rate of 75%, but once it spreads to a distant organ, the survival rate plunges to only 24%.
What to look for
Dermatologist Steven Hacker says he has many patients he is treating or following that have Merkel cell carcinoma.
“It looks like a very non-specific bump that is flesh-colored or reddish blue and can be the size of an eraser tip on a pencil,” he said. “It needs to be biopsied to make a diagnosis. The sooner it’s caught, the better your chances are.”
If something looks like a pimple or bug bite and doesn’t go away, get checked by a dermatologist, he said. It some cases, the original bump spawns more nearby.
Merkel cell carcinoma can be aggressive, especially when it spreads to distant parts of the body. It is the second most common cause of skin cancer-related death, after melanoma.
“While it’s rare in the U.S., in Florida we actually see a lot of it,” said Dr. Michael Kasper, director of radiation oncology with the Lynn Cancer Institute in Boca Raton. “We see it a couple of times a month.”
And, while it is more common in men, Kasper says they see women with it too. “With the population living in Florida, one of biggest things that sets us apart is the suppressed immune system that happens as we age.”
Kasper said with Merkel, the nodule below the skin’s surface tends to be hard or firm, although not at all painful. “It can grow fairly quickly. Sometimes, doctors who don’t know what it is will try to drain it and nothing will come out,” he said. “It should not be drained. If you know what you are looking at, you know not to drain it. If you find it early and it is localized, most of the time it can be cured.”
A VIRUS called Merkel cell polyomavirus may play a role in causing most cases of the cancer, Kasper said. Just how this virus causes Merkel cell carcinoma is still unknown.
When a biopsy shows Merkel cell carcinoma, doctors will remove the nodule, but also do radiation to completely get rid of cancerous tissue and reduce the chance of recurrence. There also will be a biopsy of the nearby lymph node and a full body PET scan to see if the cancer has spread to organs.
Oncologists recommend immunotherapy if the Merkel cell carcinoma has spread or is inoperable. In 2019, the federal government approved an new immunotherapy to treat people with advanced Merkel cell carcinoma.
Other skin cancers
