Dermatologists in Florida are warning that the same type of skin cancer that killed Jimmy Buffett is becoming more common in the Sunshine State and residents should be on the lookout for symptoms.
Although aggressive skin cancers are rare, they usually occur on areas of skin exposed to sunlight, such as the face, scalp, or neck. People over 50 years of age with fair skin and regular sun exposure are more likely to develop Merkel cell cancer. The key to survival is to anticipate the situation and act quickly.
People with this type of skin cancer who are diagnosed and treated have a 5-year survival rate of 75%, but if the cancer has spread to distant organs, the survival rate drops to just 24%.
What to look for
Delray Beach dermatologist Steven Hacker said many of the patients he treats or sees have Merkel cell cancer.
“It appeared to be a very non-specific lump, flesh-colored or reddish-blue and about the size of a pencil eraser,” he said. “A biopsy is important for diagnosis. The sooner he is caught, the better your chances.
If something looks like a pimple or bug bite and it won't go away, see a dermatologist, she says. In some cases, the initial swelling can be seen up close.
Merkel cell carcinoma can be aggressive, especially if it spreads to distant parts of the body. This disease is the second cause of death due to skin cancer after melanoma.
“While this is rare in the United States, we are seeing many similar cases in Florida,” said Dr. Michael Kasper, director of radiation oncology at the Lynn Cancer Institute, part of Baptist Health Boca Raton Regional Hospital. We see him twice a month.
Although it occurs more often in men, Kasper said it also happens to women. “One of the biggest things that differentiates us as Floridians is the suppression of the immune system that occurs with age.”
Kasper said Merkel's lumps under the surface of the skin were hard or firm, although they did not cause pain. “It can grow very quickly. "Sometimes doctors who don't know what it is try to drain it, but don't succeed," he said. “He can't lose. If you know what you're looking at, you know not to waste it. If the disease is caught early and treated, then in many cases it can be cured."
A virus called Merkel cell polyomavirus may play a role in the development of most cancers, Kasper said. It is not yet known how this virus causes Merkel cell carcinoma.
When a biopsy shows Merkel cell carcinoma, doctors remove the lymph nodes and administer radiation to completely remove the cancer cells and reduce the chance of recurrence. A biopsy of nearby lymph nodes and a full body PET scan will be performed to determine whether the cancer has spread to the organs. Oncologists recommend immunotherapy if Merkel cell carcinoma has spread or is inoperable. In 2019, the federal government approved a new immunotherapy to treat people with advanced Merkel cell carcinoma.
Other types of skin cancer
Although skin cancer is the most common cancer diagnosis in the United States, most Americans do not undergo routine screening, according to a January survey of more than 2,000 people conducted by the Cancer Prevention Foundation. The survey found that 70% of Americans aged 21 and over had not had a skin exam in the past year.
The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma. Anyone can get this disease, regardless of skin color, but people with freckles, fair skin, and blonde hair are at risk of contracting this disease.
Basal cell carcinoma grows slowly and does not spread to other parts of the body. However, if this cancer is not treated, the cells can spread deeper into the nerves and bones. Squamous cell carcinoma is usually not life-threatening, but if left untreated, the cancer can grow or spread to other parts of the body. Melanoma is the most common type of skin cancer because it is more likely to grow and spread.
Merkel cell carcinoma is 40 times less common than melanoma. Buffett, the “Margaritaville” singer and famous Florida beachgoer, has been battling the problem for four years.
There are also about a dozen other rare types of skin cancer.
Legendary Jamaican singer, musician and songwriter Bob Marley has died at the age of 36 from a rare form of skin cancer. She had acral lentiginous melanoma, which looked like a black spot under her toenail. ALM usually occurs under the nails, soles of the feet, or palms of the hands and is the most common form of melanoma in people of color.
Charles Dunn, dermatologist at ADCS Orlando, says, “If you have a spot that is growing rapidly or changing over weeks or months, get it checked out immediately. “You can get skin cancer in places that don't even get sunlight. "
For any skin cancer, especially Merkel's, Dunn says, "Time is of the essence." Early diagnosis results in better survival statistics.
Be careful, check
Rajeev Natu, a dermatologist and director of the Advanced General Dermatology and Cosmetic Surgery Clinic in Orlando, said skin cancer is often misdiagnosed and recommends that Floridians get regular skin exams from a board-certified dermatologist. “The general public should be aware of the warning signs and seek medical attention, but skin cancer is a complex disease, and that is why we exist as an industry.” Natsu is in the hospital with Merkel as a patient and now her skin cancer has spread. “This is a big event because of the death statistics. One-third of Merkel cases have already metastasized at the time of diagnosis.
While genetics and a person's immune system play a role, dermatologists recommend wearing sunscreen, avoiding sunburn, and staying home during the hottest parts of the day. According to a report from Harvard Health Pleasing, niacinamide, a form of vitamin B3, reduces skin cancer rates when taken orally, but the benefits are lost if you stop taking it.
“Talk to your dermatologist to make sure niacinamide is right for you,” says Hacker.
Although dermatologists recommend annual skin checks, people over 65 are advised to have them checked twice a year.
“It's important to understand what is normal for you and your skin,” says Heather McKee, senior director of cancer prevention and early detection at the Cancer Prevention Foundation. “If you notice a mole, freckle, or lump has changed in size, shape, or color, tell your doctor and don't wait.”
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