Skin cancer types: Merkel cell carcinoma self-care

Merkel cell carcinoma (MCC) is called an aggressive cancer because it can:

• Spread quickly

• Return after treatment

For these reasons, dermatologists recommend the following self-care for everyone who is diagnosed with MCC.

1. Keep all follow-up appointments with your doctors. Your doctors will tell you how often to return. Typically, for the first 2 or 3 years after treatment, a patient returns every 3 or 4 months.

During these appointments, your doctor will check for signs of cancer. To do this, your doctor will carefully examine your skin and lymph nodes. You may also need testing, such as an MRI, CAT scan, or blood test.

2. Protect your skin from the sun. Every time the sun’s ultraviolet (UV) light hits your skin, it can damage your skin more than it already is. To prevent further damage, which can increase your risk of developing all types of skin cancer, dermatologists recommend the following:

   • Wear protective clothing, such as a lightweight long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, when possible.
   • Seek shade, especially when the sun’s rays are strongest, which is between 10 a.m. and 2 p.m. You also want to seek shade when your shadow is shorter than you.
   • Apply sunscreen every day (even on cloudy, rainy, or snowy days) before going outside. To get the protection you need, use a sunscreen that offers all the following:
   • Broad-spectrum protection
   • SPF 30 or higher
   • Water-resistance
   Apply sunscreen to all skin that clothing will not cover, making sure that you apply it to your neck, face, and ears.

   Protect your skin from the sun

   Wearing a wide-brimmed hat, sunglasses, long sleeves, and pants when outdoors helps to protect your skin from the sun’s harmful rays.

   

3. Learn to examine your skin and lymph nodes for signs of cancer, and perform these exams as often as your doctor recommends. These exams can be lifesaving. If you find any sign of cancer during your exam, call your dermatologist’s office and tell the person who answers the phone that you’ve been treated for MCC. If you’re unsure how to examine your skin for signs of skin cancer, the following can help:

   • Skin self-exam: How to do (video)
Video shows how a partner can help you examine your skin
   • Body mole map
Diagram gives you a place to draw the moles and other spots on your skin so that you can spot early changes

4. Do not use indoor tanning equipment. Tanning beds and sunlamps are not safer than the sun. The amount of the radiation produced by them is similar to that of the sun, and in some cases might be stronger.

5. If you notice a new spot or growth on your skin or swollen lymph nodes, which some people call lymph glands, contact your doctor right away. MCC can return suddenly. You also have a higher risk of developing another type of skin cancer. The sooner skin cancer is diagnosed and treated, the better your outcome.

6. If you want to connect with others who have MCC, look into the online support group for patients who have MCC. Open to patients, family members, and caregivers, this online support group was created to help people coping with MCC.

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References
American Academy of Dermatology. “Indoor tanning fact sheet.” Last accessed February 28, 2019.

Tello TL, MD, Coggshall K, et al. “Merkel cell carcinoma: An update and review Current and future therapy.” J Am Acad Dermatol 2018;78:445-54.