Talk:Merkel-cell carcinoma

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 21 April 2020 and 15 May 2020. Further details are available on the course page. Student editor(s): Cksnowden.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 03:55, 17 January 2022 (UTC)

note

I have started a Merkel Cell Cancer Group here at Google Groups. This is a group dedicated to those that have experienced Merkel Cell Cancer, their family members, or those supporting the care of a patient with MCC.

Please stop by, sign up, and post your experiences with MCC.

• Group name: merkel cell cancer
• Group home page: http://groups.google.com/group/merkelcell
• Group email address merkelcell@googlegroups.com

George Administrator for Group

No evidence for Longley Claim

At the moment, I don't believe that Luc Longley had MCC. I cannot find any online backing for the claim and unless anyone can provide some, I will remove his name from the list in about five (5) days.Jefferson61345 (talk) 01:51, 7 April 2008 (UTC)

A relevant Google search comes up with nothing useful, so I've gone ahead and removed it. If it was true, it would have been mentioned by organisations such as the Australian Broadcasting Corporation, which has online archives going back several years. Graham87 02:17, 7 April 2008 (UTC)

And look at the other edit by the user who added the entry here. I can't believe I fell for it. Graham87 02:24, 7 April 2008 (UTC)

Spanish link

Removed this link as i believe it belongs in the "spanish version" of the wikipedia. If there is no article about this topic in the spanish wikipedia, hopefully you can speak spanish and you can tell them to create this article and place this link in their external link or use it as a reff.... http://www.cancer.gov/espanol/pdq/tratamiento/celulas-de-Merkel/

Now since I can't "read spanish" (i can say the odd word) i cant find it useful? So yeah sorry to be a pain n remove you're good faith.. Calaka 11:03, 17 April 2007 (UTC)

There isn't even an article about Merkel cells in Spanish. I'd like to suggest it to Spanish Wikipedia as an article but I don't know the language - it's hardly taught in Australia. Graham87 11:18, 17 April 2007 (UTC)

Fare enough mate, let it stay Calaka 12:36, 17 April 2007 (UTC)

I hadn't thought of the slippery slope issue before - and that alone is a good reason to remove the link. Therefore I'll leave it out of the article. There will eventually be an article about the topic in Spanish anyway. Graham87 04:09, 14 April 2008 (UTC)

Alternative Medicine Claim

I think the article would be better without this:

Conventional, Western methods have not shown any improvements. Alternative methods may be affective such as Alkaline Therapy and Ozone Therapy.

Apart from the grammar, there should at least be a link to some reason why those therapies 'may be [e]ffective'. I think also that if we keep that reference it would be worth having a link to quackwatch or something similar (e.g. http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/oxygen.html) but probably it is just better without mentioning alternative medicines at all (especially not under the Radiation and Chemotherapy heading) though if conventional therapies are not effective then it might be worth keeping that claim (ideally with a reference). Macbutch (talk) 17:53, 23 November 2010 (UTC)

Also, this:

Merkel cell cancer that has metastasized may respond to treatment with chemotherapy and/or radiation. This therapy is not effective in curing and should not be treated to patients unless all other options have been exhausted.

The second sentence should probably be removed given that the normal treatment seems to be radiation therapy very soon after surgery.

Finally, what about putting the 'Sentinel lymph node biopsy' section above 'surgery' as I think that that would then represent the normal progression. i.e.

1. Sentinel lymph node biopsy
2. Surgery
3. Radiation and Chemotherapy

I think that, in fact, chemotherapy might deserve its own section too as that would be after the cancer has spread and possibly not needed for all patients (whereas I think radiation therapy is recommended for all patients)? If we were to be too picky then a biopsy isn't actually treatment as such - not sure that it is important though. Something like this perhaps (for ordering, not content): http://www.mayoclinic.com/health/merkel-cell-carcinoma/DS00802/DSECTION=treatments-and-drugs

Also that link metnions that 'whether chemotherapy improves the survival rate in people with Merkel cell carcinoma is unclear' which we could use as a reference for the claims I mentioned above about non-efficacy of chemo (though we should probably distinguish there between chemo and radiation as they're not the same and the same warning does not seem to apply to radiation therapy). Macbutch (talk) 18:10, 23 November 2010 (UTC)

Radiation and Chemotherapy -- question on MEDRS

Proposed citation: 10.18632/oncoscience.358

This section reports that physicians treat Merkel-cell carcinoma with radiation therapy but does not cite any evidence that patients who forego radiotherapy typically have a poorer overall survival than those who do not. Is the proposed citation a reliable source? Not a literature review, but a retrospective cohort study of two decades' worth of Merkel-cell carcinoma cases. I'm bringing it up here because of financial disclosure noted at the top of this talk page. Cglife.trummler (talk) 00:20, 15 November 2017 (UTC)

No, it is not WP:MEDRS. If you don't understand MEDRS then ask at WT:MED. Do not waste our time so you can make money. Gr. Jytdog (talk) 06:12, 15 November 2017 (UTC)

--Shuhang1 (talk) 03:36, 7 March 2018 (UTC)

External links modified (January 2018)

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• Added archive https://web.archive.org/web/20080119104822/http://news.theage.com.au/new-virus-linked-to-rare-but-lethal-skin-cancer/20080119-1muc.html to http://news.theage.com.au/new-virus-linked-to-rare-but-lethal-skin-cancer/20080119-1muc.html
• Added archive https://web.archive.org/web/20101221002053/http://www.cancer.gov/cancertopics/pdq/treatment/merkelcell to http://www.cancer.gov/cancertopics/pdq/treatment/merkelcell

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student editing plan - 2018

15:01, 10 March 2018 (UTC)Shuhang1 (talk)

My plan for the edit include 1)add Merkel cell carcinoma prevention part. 2)add prognosis part, 3) add staging part if I find the right format, 4)research some more literatures and edit or expand the existing parts in signs/symptoms, pathophysiology, treatment. May also add a few more clinical images if appropriate.Shuhang1 (talk) 03:36, 7 March 2018 (UTC)

Thanks for sharing your ideas for improving the page. We look forward to your contributions.JenOttawa (talk) 16:45, 7 March 2018 (UTC)

Thanks JenOttawa. I also will add some references since I find some references missing in some sentences. I also may make some changes in the "cause" part of Merkel cell carcinoma since I find this part is quite esoteric and may be confusing to average readers who has no training in either medicine or biological sciences. — Preceding unsigned comment added by Shuhang1 (talk • contribs) 00:23, 8 March 2018 (UTC)

Peer Review UCF COM

Dear article writer,

This is DermMan1 performing a peer review of your article to ensure it is meets the criteria of the course. Criteria is as follows:

Make sure it's understandable to the intended WP audience •Make sure we include appropriate sources, mostly NOT primary literature. But OK to use primary literature when there is no secondary literature •Also OK to use closed-access resources •Look at the workplan and compare/contrast to actual work done •Don't be harsh on your classmate •Spot check a few links to ensure links are not broken •Ensure structure of article flows understandably •Follow readability guidelines (no sentences longer than 26 words) •Lots of periods, few commas or semicolons

My findings are the following:

The lead paragraphs are missing references after every sentence. It is important to please include up-to-date references after each sentence for the lead paragraphs.

Another issue, is the grammar is not consistent across the article. Please make sure the grammar is consistent. For example, one sentence is "The cancer is considered to be a form of neuroendocrine tumor." I believe the word "a" is missing before "neuroendocrine." I also see a link to "ioactiv" at the end of the surgery paragraph which is out of place. Also, there is an unnecessary/uneven spacing between the surgery and radiation paragraph. Please fix.

Also where is the talk page section stating your goals? I could not seem to find it, as I wanted to evaluate if you achieved your goals.

Positives are that I checked 4-5 hyperlinks at random and they all seem to be in working order and the references look up-to-date (one published in 2018 from the JAAD, a reputed dermatology journal). You also included a lot of great review articles, mainly secondary sources. The references are a strong point. Multiple pictures were also included which is great. Maybe you could delete one or two since they seem stacked on each other and a little cluttered however.

Overall, good job, but please work on grammar, flow, presentation, and to show a workplan. Thanks!

Dermman1 (talk) 21:15, 24 March 2018 (UTC)

@Dermman1: You say "It is important to please include up-to-date references after each sentence for the lead paragraphs." but since most of the lead (apart from perhaps the first para) is meant to be a summary of the rest of the article it's not essential (or even desirable) that the lead is fully referenced if the expansion/detail later in the article is adequately sourced. - Rod57 (talk) 11:07, 8 April 2018 (UTC)

Responses to the peer review

I made the changes according to the peer review. For the leading paragraph, I deleted sentences that is overlapping with other part of the article. Most of the overlapping part is about the prognosis of Merkel cell carcinoma. Since I have added a new prognosis heading and covers prognosis in that part, it is wise to remove the overlapping part. After I remove the overlapping part, it becomes more succinct. The remaining sentences in the leading paragraph have appropriate references. I fixed several grammar issues. I also removed a few typos as suggested by peer reviewer. I also fixed minor format issue. My initial work plan is right above the heading “Peer Review”. I didn’t put a new heading for my work plan, so it is buried in other paragraphs. Basically I met my goals of the work plan. The only thing is I didn’t add the staging part since on second thought, I think it is at the level too esoteric for ordinary readers. As for the images, I like all the images currently existed. These are images of clinical presentations or pathology. These images give reader a visual impression of what is Merkel cell carcinoma. I have no intention to delete any of these images. I couldn’t find any images better than current images, so I have no intention to add or replace these images either. Thanks Shuhang1 (talk) 23:27, 25 March 2018 (UTC)

Can we say if the MCV cases have different treatment or prognosis

Can we say if the MCV cases have different treatment or prognosis since the distinction was reported in 2008 ? - Rod57 (talk) 11:16, 8 April 2018 (UTC)

Queen’s University Student Editing Initiative

Hello, we are a group of medical students from Queen’s University. We are working to improve this article over the next month and will be posting our planned changes on this talk page. We look forward to working with the existing Wikipedia medical editing community to improve this article and share evidence. We welcome feedback and suggestions as we learn to edit. Thank you. 14mfm5 (talk) 14:42, 14 November 2019 (UTC)

Due to concerns with the wikipedia page stating a causal relationship between Merkel-Cell Carcinoma (MCC) and Merkel-cell polyomavirus (MCV), whereas scientific evidence does not support such a claim, we will be revising all causal statements. These statements will now correctly state that there is correlational data suggesting that in the presence of MCC there is often a MCV-positive status however the exact relationship between the two in humans is not completely understood. Sweetpete8 (talk) 22:48, 17 November 2019 (UTC)

Thank you for sharing your proposed improvements @Sweetpete8: Do you mind sharing the source to support that “Scientific evidence does not support this claim”?JenOttawa (talk) 02:04, 18 November 2019 (UTC)

drizzlsizzl(talk)(18:42, 25 November 2019 (UTC)) Hi JenOttawa, I am working together with Sweetpete8 to reframe statements claiming a causal relationship between Merkel-Cell Carcinoma (MCC) and Merkel-cell polyomavirus (MCV). The citation that we are using for this is the following:

Kervarrec, Thibault; Samimi, Mahtab; Guyétant, Serge; Sarma, Bhavishya; Chéret, Jérémy; Blanchard, Emmanuelle; Berthon, Patricia; Schrama, David; Houben, Roland; Touzé, Antoine (2019-06-10). "Histogenesis of Merkel Cell Carcinoma: A Comprehensive Review". Frontiers in Oncology. 9: 451. doi:10.3389/fonc.2019.00451. ISSN 2234-943X. PMC 6579919. PMID 31245285.

Due to ambiguity regarding the reported relationship between cancer stage and 5-year survival rate, I will be consulting the AJCC cancer staging manual 8th edition to clarify the staging of MCC. The reported 5-year survival rates are circularly cited and extensive literature review has failed to reproduce the same statistics included in this article. I am looking to remove these statistics and replace them with evidence-based information on the correlation between cancer stage and survival rates specific to MCC.14mfm5 (talk) 20:09, 18 November 2019 (UTC)

Currently the radiation therapy section does not make it clear when radiation therapy should be used, and how that relates to the outcome of the tumour resection. We will be editing the the treatment section to add more details to the surgery section, using the 2018 Merkel Cell Carcinoma Clinical Guideline. Additionally, we will be updating the radiation section to clarify the peri-operative use of radiation therapy and adding details about when radiation therapy is indicated. — Preceding unsigned comment added by Leclairr22 (talk • contribs) 20:11, 18 November 2019 (UTC)

Thank you for including these. Do you mind adding in the exact wording of your proposed improvement (along with the citation). Great work so far!JenOttawa (talk) 23:19, 18 November 2019 (UTC)

Proposed changes:

Surgery:

The goal of surgical excision is to remove the MCC with negative resection margin, meaning the tumour has been excised completely with a surrounding boarder of healthy tissue. Complete excision is associated with significantly higher survival rates. Surgicalmargins should extend 1 to 2 cm beyond the border of the MCC and may include underlaying fascia and muscle if the MCC has invaded deeper than the dermis[1]. Mohs micrographic surgery may also be used to insure more precise histological margins. Surgical excision be coordinated with the sentinel lymph node biopsy (SNLB). Reconstruction may also be needed if the surgical treatment required extensive tissue removal. However, reconstruction should not occur until negative margins and a negative SLNB have been confirmed.

Radiation Therapy:

Evidence on the efficacy of post-operative RT for Merkel cell carcinoma is inconclusive as of 2018. Therefore it is unclear which patients should be receiving post-operative RT. However, it has been recommended that observation is sufficient for patients will small primary lesions (<1cm) that have been excised with clear margins and no lymph node involvement, or immunosuppression. Peri-operative RT is recommended for cases with larger primary lesions, with positive margins indicating the possibility of an incomplete excision, and other risk factors for reoccurrence including positive lymph node involvement and immunosuppression. If the patient is to receive RT, the delay between the surgical treatment and RT should be minimized to optimize the clinical outcome. Leclairr22 (talk • contribs) 22:02, 19 November 2019 (UTC)

References

Thanks for this suggestion. Great use of this clinical practice guideline. JenOttawa (talk) 01:17, 21 November 2019 (UTC)

Drug therapy - Original Text
As of 2013 there had been hope that new targeted anticancer therapy for patients with distant and systemic MCC disease would be available in the near future, particularly to target the MCV either to prevent infection or to inhibit viral-induced carcinogenesis.[34] In March 2017, the U.S. Food and Drug Administration granted accelerated approval to avelumab to treat adults and children above 12 years with metastatic MCC. Avelumab, a checkpoint-inhibitor targets the PD-1/PD-L1 pathway (proteins found on the body's immune cells and some cancer cells) to help the body's immune system attack cancer cells.[35] In December 2018, the U.S. Food and Drug Administration granted accelerated approval to pembrolizumab(KEYTRUDA®, Merck & Co. Inc.) for adult and pediatric patients with recurrent locally advanced or metastatic Merkel cell carcinoma. Keytruda (pembrolizumab), is another checkpoint-inhibitor targeting the PD-1/PD-L1 pathway.[36]

Drug therapy - Revised Text
Immunotherapies, namely PD1-PDL1 checkpoint inhibitors, are novel anticancer agents that have shown benefit in advanced-stage MCC or chemotherapy-resistant MCC. These checkpoint inhibitors reactivate the immune response, enabling the immune system to target cancer cells for destruction. In March 2017, the U.S. Food and Drug Administration granted accelerated approval to avelumab, a PD1-PDL1 checkpoint inhibitor, to treat adults and children above 12 years with metastatic MCC. In December 2018, the U.S. Food and Drug Administration granted accelerated approval to pembrolizumab (KEYTRUDA®, Merck & Co. Inc.) for adult and pediatric patients with recurrent locally advanced or metastatic MCC. Keytruda (pembrolizumab), is another checkpoint-inhibitor targeting the PD-1/PD-L1 pathway.[36] Yung Pharaoh (talk • contribs) 22:00, 19 November 2019 (UTC)

Thanks for sharing this @Yung Pharaoh:. Your citations did not come through in this. Do you mind confirming what citations you plan to use for your new improved paragraph. I see this list in your sandbox:

• 1) Becker, J., Stang, A., DeCaprio, J. et al. "Merkel cell carcinoma." Nat Rev Dis Primers 3, 17077 (2017).
• 2) Harms PW, Harms KL, Moore PS, DeCaprio JA, Nghiem P, Wong MKK, Brownell I; International Workshop on Merkel Cell Carcinoma Research (IWMCC) Working Group. “The biology and treatment of Merkel cell carcinoma: current understanding and *research priorities.” Nat Rev Clin Oncol. 2018 Dec;15(12):763-776.
• 3) Topalian, S. L., Drake, C. G. & Pardoll, D. M. "Immune checkpoint blockade: a common denominator approach to cancer therapy." Cancer Cell 27, 451–461 (2015).
• 4) Paulson, K. G. et al. "Systemic immune suppression predicts diminished Merkel cell carcinoma-specific survival independent of stage." J. Invest. Dermatol. 133, 642–646 (2013).

JenOttawa (talk) 01:17, 21 November 2019 (UTC)

Student editing plan

Hi there,

I am editing this page for a class and would like to propose the following edits, in addition to some copy-editing:

1) Changing the title from Merkel-cell carcinoma to Merkel cell carcinoma (no hyphen). I have found the hyphenated form of the disease name in hardly any other sources, and it results in the Wikipedia page being hard to find for those searching for it.

2) Re-working of the pathophysiology page. First, I plan to add a section discussing the origin of MCC, since the cell type of origin has been debated. Second, I plan to include more information about the biology of this virus's involvement in the disease, since many studies have elucidated more about this and several review articles have discussed this process in depth. Finally, I think that the RNA modifications section can be removed, since it cites only one primary study of a phenomenon not as extensively discussed elsewhere in the literature.

3) Re-working the treatment section: This part has been flagged by the Wikipedia page for work, saying that it leans too heavily on primary sources. I plan to augment the sources used. I also plan to separate the chemotherapy and radiation therapy segments and to correct the claim that MCC should be managed through radiation therapy alone. I also plan to expand the segment on immunotherapy, explaining more clearly the role of PD-1 inhibitors and providing citations to review papers discussing other research avenues.

Please let me know your thoughts. My sandbox can be found here: https://wiki.riteme.site/wiki/User:Cksnowden/sandbox. Thank you!

Cksnowden (talk) 16:43, 14 May 2020 (UTC)

Section organization

Should the "Epidemiology" and "History" sections be moved before the "Signs and symptoms" section to make it more consistent with standard medical article format? — Preceding unsigned comment added by Daspj (talk • contribs) 19:49, 31 January 2022 (UTC)

Is Merkel cell hyphenated?

The article uses both, but the cell links to 'Merkel cell' with no hyphen. Darcourse (talk) 10:57, 3 September 2023 (UTC)

Predominant usage is without a hyphen. Doremo (talk) 03:55, 6 June 2024 (UTC)