Smiling parents holding young children at beach

Merkel cell carcinoma: a deadly skin cancer on the rise

September 13, 2023 | Heather Shannon
caucasian man with moles on his back being examined by a physician with a magnifying glass
Regular skin exams are an important defense in skin cancer prevention.

Merkel cell carcinoma — the rare but aggressive type of skin cancer that killed singer Jimmy Buffett earlier this month — is the deadliest of all skin cancers. And it’s on the rise.

As with other skin cancers, however, routine screenings and self-checks can increase the odds of early detection and survival.

“An earlier diagnosis greatly improves outcomes,” UCI Health dermatologist Dr. Ling Gao notes. “The surgical procedure to remove it is smaller and has a higher chance of cure."

Merkel cell carcinoma diagnoses rise

This type of skin cancer is cause for concern among experts such as Gao, who notes that diagnoses of the condition are most common in older people and they are increasing as the U.S. population ages.

Although anyone can develop Merkel cell cancer, men over 50 with fair skin are predominant among the 3,000 Americans who are diagnosed each year, she says. In just two years, cases are expected to reach 3,250 annually. While small in total numbers, the percentage jump is concerning.

“Since Merkel cell carcinoma incidence dramatically increases with age, Baby Boomers are expanding the population most susceptible to Merkel cell carcinoma,” says UCI Health skin cancer specialist Dr. Kenneth Linden, noting that it is predicted rise more rapidly than melanoma.

According to the American Cancer Society, 97,610 new cases of melanoma will be diagnosed in 2023. In adults 50 and older, rates have increased among women at a rate of 1% per year, while stabilizing in men.

Protecting your skin from the sun

As with other skin cancers, individuals who have had extensive sun exposure or suppressed immune systems are considered high risk for Merkel cell cancer.

Linden urges vigilance with sun protection, as the rates of all skin cancer types are increasing — particularly in sunny, outdoor-oriented Southern California.

“One can be outdoors and protect oneself very effectively from the sun’s cancer-causing ultraviolet rays,” he points out.

Linden suggests that when going outside, people of all ages should:

  • Use a combination of sun-blocking strategies that involve clothing, sunscreen, shade and timing your activities to avoid the most intense sunlight.
  • Avoid outdoor activities between the peak hours of 10 a.m. and 2 p.m., when 80% of the sun’s cancer-causing ultraviolet (UV) rays are transmitted.
  • Always use sunscreen with a protective factor of at least 30 and blocks both UVA and UVB rays.
  • Use a sunscreen well above SPF 50 if you’ll be in the sun all day, or apply a second layer after several hours.
  • Be generous with sunscreen, applying it in a thick layer.
  • In addition to sunscreen, wear a broad-brimmed hat to protect your scalp and face.

Detecting possible skin cancers

Getting familiar with one’s skin is a crucial strategy for early detection of all skin cancers.

“By doing full-body self-checks every one to three months, the chances of detecting skin cancer at a very early stage increases,” Linden says, noting to watch for suspicious lesions in particular.

Merkel cell carcinoma most often appears as a fast-growing reddish or purplish bump on the skin surface or as a lump under the skin. Although it commonly appears on the head and neck, it can also show up on the arms, legs, torso and buttocks. The Skin Cancer Foundation has more information about the warning signs.

“When a lesion is different from others on your body, when it is growing quickly, bleeding or irregular in shape, seek care from a dermatologist immediately.”

Related Stories