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Merkel cell carcinomas are removed by wide local excision (removal of the cancer and a wide margin of normal skin) or by Mohs surgery. These cancers have a tendency to spread to the lymph nodes or distant sites. Because of this, even if the lymph nodes do not seem enlarged, many doctors recommend a sentinel lymph node biopsy to look for possible spread of cancer to the lymph nodes. When possible, this should be done before surgery to the skin. If the sentinel node contains cancer, a full lymph node dissection is usually done. In either case, radiation therapy to the affected area after surgery is often used to reduce the risk of cancer coming back. If many lymph nodes were found to have cancer, adjuvant (additional) chemotherapy may be recommended as well.
If nearby lymph nodes are enlarged at the time the cancer is diagnosed, a fine needle aspiration (FNA) biopsy may be done to determine if they contain cancer. If cancer is found, treatment options include a lymph node dissection, radiation therapy to the area, or a combination of the two. Adjuvant treatment with chemotherapy may also be considered.
For cancers that have spread to or recur in distant sites, surgery, radiation therapy, chemotherapy, or some combination of these treatments may be used. These treatments may relieve symptoms or temporarily shrink these cancers, but they generally cannot cure Merkel cell carcinoma that has spread beyond the skin.
Overall, the 5-year survival rate (the percentage of patients who live at least 5 years after diagnosis) for Merkel cell carcinoma is about 50%. Last Revised: 06/10/2008
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