Can Melanoma Cancer Come Back?

What you need to know about recurrence

Can Melanoma Cancer Come Back?

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; he or she may follow up with you every few months, especially in the first few years after your initial treatment.

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“Melanoma can recur at any stage,” says Ahmad Tarhini, MD, PhD, Director of Cleveland Clinic’s Melanoma and Skin Cancer Program. “It’s a serious disease but it’s one that we can cure if it’s caught in time.”

What are the chances of recurrence?

The chances of your melanoma coming back depend on its stage.

Those who have had melanoma are at greater risk for developing another melanoma. It can return in the same spot or elsewhere on your body, even 10 years after initial treatment.

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 four stages:

  • In Stages 1 and 2, it involves the skin only.
  • In Stage 3, it has spread from the skin to the lymph nodes.
  • In Stage 4, it has spread from the skin to other organs.

The likelihood of recurrence varies by stage. It is less likely to recur at lower stages, Dr. Tarhini says.

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“The recurrence rate increases as the stage advances — even after successful surgery,” he says.

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

“At Stage 1, over 90 percent of patients can be cured,” says Dr. Tarhini. “As the stage progresses, the likelihood of cure is less. However, with recent advancements in immunotherapy and targeted therapy for melanoma, even at Stage 4 , we are very optimistic that we can cure many patients.”

Getting regular checkups vital

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. Your doctor will base the need for follow-up 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. Tarhini says. “The higher the stage of melanoma you had, the higher your risk is for relapse.”

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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 says.

How to protect yourself

Here are the best ways to avoid melanoma recurrence:

  1. Avoid sunbathing and tanning beds. These are especially harmful to people who have had melanoma in the past.
  2. Cover up outside. Protect your skin by wearing a wide-brimmed hat and sun-protective clothing and by applying sunscreen to exposed skin.
  3. Monitor your moles. Include self-examination as part of your routine. Conduct regular skin checks with help from a family member. 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  

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

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