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Merkel Cell Carcinoma Treatment

There are treatments for all patients with Merkel cell carcinoma. Three kinds of treatment are used:

There are several different types of surgery that may be used for Merkel cell carcinoma treatment. These include:

  1. Wide local excision with sentinel lymph node biopsy: removal of the tumor and sampling of the sentinel lymph node (see below).
  2. Cryosurgery freezes the tumor and then removes it.
  3. Micrographic surgery (Mohs surgery) is a tissue-sparing technique that removes only the tumor.

Advanced therapies include:

Sentinel Lymph Node Biopsy for Merkel Cell Carcinoma Treatment

The removal of the sentinel lymph node (the first lymph node to which the cancer is likely to spread) of sometimes conducted for Merkel cell carcinoma treatment. A radioactive tracer and/or blue dye is injected near the tumor before surgery in a process called lymphatic mapping (or lymphoscintigraphy) The radioactive tracer or dye flows through the lymph ducts in the skin to first draining lymph nodes in the region(s) around the melanoma. The injection of the radioactive tracer is performed in the Radiology Department either the evening before surgery or several hours before surgery. A body scan is then performed to help the surgeon localize the sentinel lymph node before beginning the operation. This first lymph node(s) to receive the tracer is removed for biopsy. A pathologist then views the tissue under a microscope to look for cancer cells and often uses additional tissue stains to determine whether microscopic evidence of melanoma is evident in the regional lymph nodes. If the sentinel lymph node is positive then additional surgery (i.e., lymphadenectomy, or the removal of additional lymph nodes) and/or radiation therapy may be performed.

Radiation Therapy for Merkel Cell Carcinoma Treatment

Radiation therapy for Merkel cell carcinoma treatment uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy).

Chemotherapy for Merkel Cell Carcinoma Treatment

Chemotherapy for Merkel cell carcinoma treatment uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells throughout the body.

If a doctor removes all the cancer that can be seen at the time of the operation, a patient may be given chemotherapy after surgery to kill any cancer cells that are left. Chemotherapy given after an operation to a person who has no cancer cells that can be found is called adjuvant chemotherapy. There are no proven adjuvant chemotherapy protocols in the care of Merkel cell carcinoma.

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