Life After Treatment
If Melanoma Recurs

When melanoma comes back after it has been treated, it is called a recurrence. Recurrent melanoma may appear locally (at or near the site of the original tumor) or in another part of the body.

The probability that melanoma will recur after appropriate treatment is characterized as low-risk, intermediate-risk, or high-risk.

  • Low-risk: less than 20% risk of recurrence
  • Intermediate-risk: 20-50% risk of recurrence
  • High-risk: greater than 50% risk of recurrence. High-risk melanoma has a high probability of having already spread to local or distant sites at the time of treatment

The risk of recurrence increases with:

  • The thickness of the primary tumor, with thicker tumors carrying greater risk than thin tumors
  • The presence of ulceration in the primary tumor
  • The presence of satellite metastases surrounding the primary tumor

If you have had melanoma in the past, you are at increased risk for recurrence. A significant number of patients with a past history of melanoma develop a second primary tumor after a period of time. A study reviewing the data of 3310 patients with Stage I and Stage II melanoma revealed a 2.8% risk of developing a second melanoma after 5 years, and a 3.6% risk after 10 years.1 Therefore, screening for melanoma recurrence through skin self-examination and regular medical skin examinations is of the utmost importance.

The appearance of a second melanoma does not necessarily carry a poor prognosis, particularly when the recurrence is local and found in an early stage. Research supports the benefits of close physician follow-up and patient education in the early detection of second melanomas. In one study, the thickness of a second primary melanoma was compared to that of the initial primary tumor. In almost 50% of cases, the second melanoma was significantly thinner than the initial melanoma.2 With earlier diagnosis, these thinner, second melanomas can be treated with simple tumor surgery and carry an encouraging prognosis for long-term survival.

References
1DiFronzo LA, Wanek LA, Elashoff R, Morton DL. Increased incidence of second primary melanoma in patients with a previous cutaneous melanoma. Ann Surg Oncol .1999;6:705-711. 2DiFronzo LA, Wanek LA, Morton DL. Earlier diagnosis of second primary melanoma confirms the benefits of patient education and routine postoperative follow-up. Cancer. 2001;91:1520-1524.