Posts for tag: merkel cell carcinoma

                The basal cell carcinoma is the most common of all skin cancers,accounting for 80 percent of

non-melanoma skin cancers while the squamous cell carcinoma accounts for nearly 20 percent. 

And,non-melanoma skin cancers are more common in men with squamous cell carcinoma affecting

2 to 3 times as many men as women  while basal cell carcinoma occurs at a rate of 1 1/2 times of

men to women.

                 The American Cancer Society estimates that in 2019 an approximate 57,000 cases of

melanoma will be diagnosed in men and about 39,000 cases in women.And,the incidence of

melanoma is higher among men across most racial/ethnic populations.

                Since most cases of skin cancer link to sun exposure ,it naturally follows that the

incidence increases with age.And,the incidence of melanoma  increases after age 19 and peaks

for individuals older than 85. between 2011 and 2015 the median age for the diagnosis of melanoma

was 64.

               In addition, the incidence of specific types of skin cancer varies according to race and

ethnicity.Consequently, the risk is more than 20 times higher for the white population than for people

with darker skin such as black,American Indian/Alaskan natives,Hispanic and Asian/pacific islander populations.

And,this is due to the photoprotection provided by increased melanin in the epidermis(outer skin layer) 

of individuals with darker skin,which can filter twice as much  UV radiation as the epidermis of white 


              As is true for the white population,basal cell carcinoma is the most common skin cancer  among

Hispanic and Asian populations . In contrast,squamous cell carcinoma is the most common skin cancer

in the black population and melanoma is the third most common skin cancer  among all racial/ethnic


             And, the highest rate of melanoma is found amiong white men and the lowest is among black

women. Although melanoma is predominate among white men compared to white women,the incidence

of melanoma in men and women is similar in black,Hispanic, and Asian/pacific islander population.

            In addition to sun exposure and radiation exposure,the risk of skin cancer is also inluenced

by co-morbid or other conditions such as non-healing ulcers and tatoos as well as arsenic in the

well water . People whose immune systems are compromised either

by cancer or the drugs used to treat it are also at increased risk for skin cancer.

            Also, skin cancer can develop in 30 to 70 % of  organ transplant patients-with a 100 fold

increase for squamous cell carcinoma ,a 24 fold increase for a very dangerous type of skin cancer

called merkel cell carcinoma(please see my previous articles on merkel cell carcinoma),a six fold

increase for basal cell carcinoma and a two fold increased risk for melanoma.

Please see my previous article entitled: Skin Cancer-not just from the sun.

           In addition, the prevalence of skin cancers is also high among individuals infected witrh

HIV (human immunodeficiency virus) and lesions in this population tend to be more aggressive.

Also,  there is a high risk of squamous cell carcinoma  associated with seropositivity  for the

human papilloma virus (HPV)  type 16 and 18 but a direct causal relationship has not been


           Individuals with a history of skin cancer are at increased risk for another skin cancer and

people living in areas where the sun's rays are most intense such as the equator have an

increased risk for melanoma skin cancer.


          I saw a new patient in my office this week who came in for another problem but complied

with my request to take his shirt off when I promptly diagnosed a melanoma on his back.

         A few years ago I diagnosedf 6  patients with  melanomas in about 6 months.

        In conclusion, if you see a change in the size,shape,color or behavior of spots on your

skin,get checked by your healthcare provider.









By Robert J Weiss, M.D.,FAAD
March 02, 2018
Category: Uncategorized

            Merkel cell carcinoma (MCC) is a very aggressive skin cancer(please see my two previous blogs:

"Merkel Cell Carcinoma,"and Merkel cell carcinoma-a blood test to predict spread" posted on 04/13/2014.

           The incidence of MCC has increased markedly by 95 % during the past decade as compared to

malignant melanoma (57 %) and all solid tumors (15 %).

          Current estimates are for about 2500 new cases in the USA yearly and increase to 3250 cases

annually by 2025. Much of this increase is attributed to an older population,especially the aging of the

Baby Boomers.

          MCC is not only very prone to spread internally(ie,metastasize) but can be very difficult to diagnose

even by astute clinicians since it can appear simply as a firm red,purple or even skin-colored lump or

bump which could easily be mistaken for a cyst or blocked pore or hair follicle.

          Merkel cell carcinoma is caused in part by exposure to the sun and is found on the head or

neck in about 50 % of cases and on the extremities in about 40 % of patients.

         And, merkel cell carcinoma is aggressive and has a strong tendency to recur,to spread

to regional lymph nodes  and to metastasize.

           So,early detection is vital since when caught early the chance of cure increases dramatically

and is better than 90 %.

           An exciting new development in the treatment of metastatic MCC is the first FDA approved

treatment for adults and pediatric patients 12 years of age and older,including those who have not

yet received chemotherapy. 

           The medication called Avelumab is another advance in cancer treatments called biologics

or. monoclonal antibodies which help the body's immune system to fight the cancer.





By Robert J Weiss, MD PC
March 17, 2017
Category: Uncategorized


       Did you know that non-melanoma skin cancer is the most common malignancy in the United States ?

       Breast cancer followed by lung cancer rank # 2 and # 3 respectively.

       And primary lung cancer,or bronchogenic carcinoma,is the leading cause of cancer deaths in both

men and women. 

       About 85 % of lung cancers of all types are linked to smoking.

      The majority of the other 15 % of lung cancers not related to smoking are found in women for 

reasons not clearly known,although exposure of the chest cavity to radiation as well as exposure

to environmental toxins such as asbestos and radon are also linked to an increase risk of developing

lung cancer.

       Now,getting back to skin cancer,I find it extremely interesting that a type of skin cancer called the

Merkel cell carcinoma and, which is extremely aggressive, is of neuroendocrine origin(please see my previous

post on merkel cell carcinoma) as is a type of lung cancer,previously known as oat-cell)and now called

small cell cancer which has an eighty percent rate of metastasis at the time of diagnosis.And,is obviously

also extremely aggressive.

      In my opinion,a diagnosis of merkel cell skin cancer is one of the most serious diagnoses in

dermatology- in many cases more so than malignant melanoma,depending on the latter's depth and

staging at the time of diagnosis.

     The FDA has recently approved the drug Bavenicio( known chemically as avelumab) to treat metastatic

merkel cell carcinoma(which means it has spread to other parts of the body). And,about 1600 people in

the USA are diagnosed with merkel cell carcinoma annually.