Let the Confusion Begin

I continued to research information about Merkel Cell and read every site I could find, some several times just to get an understanding about the information. The information was confusing because of the rarity of Merkel Cell Carcinoma. There didn't seem to be large enough numbers of patients with MCC to study the cancer in any meaningful way. There were different treatment plans, different staging and different opinions about this cancer depending on which hospital you were treated at.

The population of MCC patients in this country increases somewhere between 1000 to 1500 new cases a year. That is a very small number and since we are spread across the entire United States it is difficult for doctors to get a handle on this cancer in any meaningful way.

Stage Primary Tumor Lymph Node Metastasis 0 In situ primary tumor No regional lymph node metastasis No distant metastasis IA Less than or equal to 2 cm maximum tumor dimension Nodes negative by pathologic exam No distant metastasis IB Less than or equal to 2 cm maximum tumor dimension Nodes negative by clinical exam* (no pathologic node exam performed) No distant metastasis IIA Greater than 2 cm tumor dimension Nodes negative by pathologic exam No distant metastasis IIB Greater than 2 cm tumor dimension Nodes negative by clinical exam* (no pathologic node exam performed) No distant metastasis IIC Primary tumor invades bone, muscle, fascia, or cartilage No regional lymph node metastasis No distant metastasis   IIIA Any size tumor (includes invading tumors) Micrometastasis** No distant metastasis   IIIB Any size tumor (includes invading tumors) Macrometastasis*** -OR- In transit metastasis**** No distant metastasis   IV Any size tumor (includes invading tumors) Any lymph node metastasis Metastasis beyond regional lymph nodes

The chart you see here is the most common one that I could find that made sense to me. I fall into the IIIA category.

Stage	5-year Relative Survival Rate
IA	About 80%
IB	About 60%
IIA	About 60%
IIB	About 50%
IIC	About 50%
IIIA	About 45%
IIIB	About 25%
IV	About 20%

By this chart you can see that as a IIIA patient I fall into the 45% survival rate for 5 years after initial diagnosis. More about these topics later