When is tumour removal surgery recommended for Merkel cell carcinoma?

The surgical team assesses the skin tumour’s size, depth and position, along with whether nearby lymph nodes or other areas may be involved. Surgery may remove the visible growth and a surrounding rim of tissue. A lymph node procedure may also be discussed because Merkel cell carcinoma can spread through lymphatic channels. The planned operation must balance cancer removal with healing and function at the affected site.

Imaging, a biopsy report and examination help the team decide whether an operation should come first or be combined with treatments such as radiotherapy or drug treatment. If the tumour is difficult to remove completely or has spread, another treatment sequence may be more suitable.

Bring the biopsy report and scan results to the consultation if they are available. Ask which tissue would be removed, whether lymph nodes need assessment, and how the wound might be closed. Discuss medicines, smoking, existing health problems and any planned reconstruction before the operation. A specialist team can explain how surgery fits with additional treatment and follow-up.

Arrange prompt medical review for a fast-growing, firm, shiny or unusual skin lump, a sore that changes, or a new swelling near the lesion. After surgery, contact the care team urgently for heavy bleeding, wound separation, spreading redness, fever, worsening pain or new swelling. Sudden breathing difficulty or severe weakness needs emergency help.

Is the tumour in a location where it can be removed with a suitable margin? Will nearby lymph nodes be sampled or treated? Could I need radiotherapy or another treatment before or after surgery? What changes in movement, appearance or sensation should I plan for?