MERKEL CELL CARCINOMA
INTRODUCTION
Merkel cell carcinoma (MCC) is a highly aggressive, yet rare type of skin cancer which is associated with a very poor prognosis [1]. The tumor is neuroendocrine and originates from the Merkel cells. ‘Tastzellen’, or touch cells, in the skin which were first described by Friedrich Sigmund Merkel in 1875 [2]. These cells were later renamed as Merkel cells. They are oval shaped receptor cells found in the basal layer of the epidermis of vertebrates. They possess synaptic contacts with various somatosensory afferent nerve fibers and are associated with the sense of touch discrimination of different shapes and textures [3]. In 1972, Toker described five patients with uncommon skin tumors which he named
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The American Cancer Society predicts the incidence of MCC to soon exceed that of cutaneous T-cell lymphomas and melanomas [13, 14].
The etiology of MCC development is likely multifactorial. Major risk factors include –
• Infection – Evidence of infection with the MCC polyomavirus (MCV) [15].
• Immunosuppression – It’s more seen in people who have undergone organ transplants or people infected with HIV (12 cases of MCC/100,000 people/year) [16-19].
• Old age - The mean age of patients at the time of initial diagnosis ranges from 60-80 years, with an average of 70 years.
• Overexposure to natural or artificial sunlight – People who get high exposure to UV-B radiation naturally (sunlight) or artificially (tanning beds) are more susceptible to this disease. The role of UV-B light in the development of MCC is thought to be due to immunosuppressive action than any mutagenic/carcinogenic effect.
• Fair skin color - Caucasians are most affected by this disease.
• Male gender – Men are more likely than women to develop MCC.
CLINICAL FEATURES AND SYMPTOMS
The presentation of MCC is as a painless, enlarged, rapidly growing, dome-shaped reddish, bluish or purple nodule in a sun-exposed area of the skin of the head and neck or upper extremities [19-21]. Initial size of the nodule is usually less than 2 cm [23]. The simple acronym of the vowels of the English language
There are also people with various factors that increase the risk of a person becoming affected by the disease. Age plays a large role in acquiring the disease. Since the disease is largely found in elderly people, the general age for onset is around age 65. After that, the number of people affected continues to increase with age. Another risk factor is
Skin cancer is a disease that can affect any one. Skin cancer includes many types that can be classified as severe or superficial. Consequently, treatement of skin cancer depends on the degree of severity a person has. In the following paper, we will shed lights on the types of skin cancer and its causes. Finally, we will investigate how to treat the different types of cancer and how to avoid it.
Unlike other cancers which we can develop, melanoma can often be detected on the skin which allows doctors to treat it at its early stages resulting in less complications and lower death rates to patients, again if left undetected at its early stages this can easily spread to distant areas and distant organs. Once melanoma has spread to other areas of the body which is classified as stage IV it is diagnosed as
Although there are several types of skin cancer, the most aggressive form is melanoma. This cancer of the skin involves mass replication of the pigment producing melanocyte cells, which are located in the epidermis, below the basal layer. There are several factors involved with the onset of melanoma including, exposure to ultraviolet rays, genetic predisposition, numerous nevi (moles), immunosuppression, and environmental exposure to carcinogens.
Patients who underwent this procedure had to remain on immunosuppressive drugs for about 6 months to prevent the recipient’s immune system from destroying the donor cell. One out of seven patients that had this procedure done had a relapse because they stopped taking their immunosuppressant drug during the critical stage of treatment. This treatment has proven successful, but there still remains the concern of tissue rejection and other complication. Nevertheless, this approach still provides encouragement for people suffering with the disease.
As many as ninety percent of melanomas are estimated to be caused ultra violet (UV) exposure. This includes UV exposure from artificial sources, such as tanning beds. “Strong evidence now links tanning beds to melanoma, a deadly form of skin cancer that afflicts nearly 69,000 Americans a year.”—USA Today. The more one tans and the younger one is your risk for melanoma increases. However, melanoma is increasing faster in women 15-29 years old, than in men the same age. Furthermore, 10,000 people die from melanoma. This is mainly caused because of tanning beds. As a matter of fact, a person dies every fifty minutes from melanoma, the second most common cancer. Tanning beds triple the risk of one getting melanoma. In fact, every time one goes and tans, the risk gets higher and higher. Following this further, more people get melanoma because of tanning beds than developing lung cancer because of
Melanoma is the most dangerous type of skin cancer. It develops when unrepaired DNA damage to your skin cells trigger genetic defects that lead you skin cells to multiply at a fast pace and form tumors. Melanoma can often resemble moles and some can come from previous moles. These melanoma moles can range in color from pink, red, brown, purple, white, blue and skin-colored, but more mostly seen as black or brown. It’s said that consumers who use indoor ultraviolent tanning devices are seven-four percent more likely to develop melanoma compared to someone who has never used a tanning bed before. Melanoma is usually caused from intense and over exposure to UV radiation. It has be estimated to kill around 10,000 individuals in the U.S. each year. The lifetime risk of melanoma is 1.5 times higher in males than in females. Melanoma is curable, if it is recognized early and
Mayo Clinic. (2011, April 21). Surgical oncology and melanoma - Mayo Clinic [Video file]. Retrieved from https://www.youtube.com/watch?v=dL4dIlfWUI4
Sometimes its associated with HIV infection resulting in multicentric form of Castleman disease which can be considered life-threatening. The Multicentric Castleman disease is also associated with other cell-proliferation disorders,
Exposure to abnormally high frequencies of light can potentially alter the DNA of a cell and turn it cancerous, the resulting cancerous cells are known as skin cancer. The most common cause is ultraviolet light emitted by the sun although it has been known to be caused by tanning booths, unusually high levels of x-rays, exposure to some chemicals and in rare cases the abnormal genes that cause skin cancer can be inherited by children from their parents.
Although the disease often occurs in adolescent or young women, it more commonly appears between 30 and 50 years of age.
The average age of onset tends to be in the late teens to the early 20s for men, and the late 20s to early 30s for women.
all other cancers combined. This includes breast cancer, colon cancer and lung cancer (Skin Cancer Foundation).
Thesis: Skin cancer is the most common type of cancer in the United States but is highly curable if detected early and treated properly.
Cancer is one of the leading causes of death worldwide as it can develop in almost any organ or tissue. Significant advances in understanding the cellular basis of cancer and the underlying biological mechanisms of tumour has been vastly improved in the recent years (Jiang et al. 1994). Cancer is a genetic disease which requires a series of mutation during mitosis to develop, its characteristics can be associated with their ability to grow and divide abnormal cells uncontrollable while in the mean time invade and cause nearby blood vessels to serve its need. Even though many people are affected by cancer today, the abilities which cancer cells have make it hard to find a single effective treatment for cancer. The focus of research now lies