What To Know About Recurrent Melanoma

If you have had melanoma, you may wonder if it can return.

The answer, unfortunately, is yes — even if your treatment was successful. That’s why your doctor will want to monitor you closely. They may follow up with you every few months, especially in the first few years after your initial treatment.

“Melanoma can recur at any stage,” says oncologist James Isaacs, MD. “It’s a serious disease, but it’s one that we can cure if it’s caught in time.”

Dr. Isaacs outlines what you need to know about recurrent melanoma.

What are the chances of recurrence for melanoma?

The chances of melanoma coming back depend on its stage.

Those who’ve had melanoma are at greater risk for developing another melanoma. It can return near the original spot or elsewhere on your body.

Some cancer cells may remain inside your body that screening tests can’t detect. If these cells grow into a tumor, it’s known as a recurrence.

Doctors classify melanoma in one of five stages:

• Stage 0: The melanoma is only found on the top layer of your skin. It’s sometimes considered a precancerous lesion.
• Stages I: The melanoma is considered low risk and is typically curable with surgery.
• Stage II: The melanoma is thicker and deeper in the skin and has a higher risk of recurrence, but there’s no indication that it has spread.
• Stage III: The melanoma has spread to nearby lymph nodes or skin.
• Stage IV: The melanoma has spread to distant lymph nodes or internal organs.

The likelihood of recurrence varies by stage. It’s less likely to recur at lower stages, Dr. Isaacs says.

“In general, the recurrence rate increases as the stage advances — even after successful surgery,” he adds.

The stage also affects your prognosis. The lower the stage, the higher the likelihood of curing your melanoma.

“At stage I, more than 90% of patients can be cured,” shares Dr. Isaacs. “As the stage progresses, the likelihood of a cure is less. However, with recent advancements in immunotherapy and targeted therapy for melanoma, even at stage IV, we’re very optimistic that we can cure many patients.”

One exception in the melanoma staging system is that in some cases for stage III melanoma, the risk of recurrence may be quite low.

“This is based on the thickness of the melanoma and the amount of melanoma found in the lymph nodes,” he explains. “Your oncologist can review your pathology report to give you the best estimate of recurrence risk.”

The importance of regular check-ups

The main key to combating a melanoma recurrence is early detection.

After your treatment, it’s vital to continue to see your dermatologist or physician regularly. They will base the need for follow-ups on your specific case. As time goes by without a relapse, the frequency of visits will gradually decline.

“For patients who had melanoma before, we generally recommend seeing your physician every three to six months,” Dr. Isaacs says. “The higher the stage of melanoma you had, the higher your risk is for relapse.”

He recommends seeing your physician every three months for a year. Then, every four to six months for the next year. After that, every six months up to five years.

“If there is no evidence of another melanoma or disease relapse at that point, continue your follow-up once a year,” he advises.

How to protect yourself from melanoma recurrence

Here are the best ways to avoid melanoma recurrence:

• Avoid sunbathing and tanning beds. These are especially harmful to people who’ve had melanoma in the past.
• Cover up outside. Protect your skin by wearing a wide-brimmed hat and sun-protective clothing and by applying sunscreen to exposed skin.
• Monitor your moles. Include self-examination as part of your routine. Conduct regular skin checks with help from a family member if need be. If any of your moles appear irregular, call your physician immediately.

To spot signs of melanoma, keep the ABCDE guidelines in mind:

• Asymmetry
• Borders (irregular or notched edges)
• Color (uneven or mottled)
• Diameter (larger than a pencil eraser’s tip)
• Evolving

Bottom line?

In addition to taking steps to prevent melanoma, remember that early detection is key.

“The earlier we find it, the much higher the chances of curing it,” stresses Dr. Isaacs. “This supports the importance of monitoring your skin and screening for abnormal moles that could signal melanoma.”