Prognosis and Survival Rates

When skin cancer is removed and it does not come back, it is considered to be cured. Recurrence is when the cancer comes back after a period of time when it was not detected.1

Cancer survival is measured in many different ways, including:1

  • Five-year overall survival rate is the percentage of people who are still alive 5 years after diagnosis or treatment. If the 5-year overall survival rate after diagnosis is 85%, that means that 5 years after being diagnosed with melanoma, 85 of 100 people are still alive. Some of those people may still have cancer, others do not.
  • Disease-free survival is how long a person survives after treatment without any sign of that cancer.
  • Median overall survival is the length of time from treatment (or diagnosis) that half the study population is still alive. For example, consider 100 people who are treated with a medication and 3.1 years later, 50 have died and 50 are alive. The median overall survival is 3.1 years.

When looking at a survival rate, it is important to know what group was studied. Survival rates can differ greatly by cancer stage, age at diagnosis, gender, and race/ethnicity. The most accurate numbers about skin cancer survival are about melanoma because cases of melanoma are tracked in cancer registries.

Melanoma

Melanoma is less common than non-melanoma skin cancers, but it is more dangerous. Melanoma is more likely than other skin cancers to invade deeper layers of skin and spread to other body parts.

Can melanoma be cured?

Most melanomas can be treated and removed with surgery if they are caught early.2 Melanomas are removed with a procedure called wide excision. Excision means “cut out.” The surgeon removes the entire tumor, along with some of the healthy skin surrounding it, called the “margin.” The purpose of the margin is to remove any cancer cells that might have spread. This reduces the risk that the tumor recurs.

The risk of recurrence depends on many factors, including:3,4

  • How thick the melanoma was
  • How wide the margin is
  • What type of melanoma it is

Your doctor is the best person to advise you about the risk of recurrence based on your melanoma.

Even if one melanoma is removed, you have a higher risk of another melanoma. Follow-up examinations are very important to check for recurrence of the initial melanoma or development of a new melanoma. Ask your doctor how often and for how many years you should have follow-up exams.

What are the survival rates for melanoma?

The 5-year overall survival rate for melanoma is 91.5%.5 That means that 5 years after being diagnosed with melanoma of any type, about 92 out of 100 people are still alive. This estimate includes people of both genders, all races, and all stages at diagnosis.

Cancer stage. One important factor in estimating survival is how far the cancer has spread by the time it is diagnosed. Local melanoma is melanoma that has not spread beyond the original tumor. About 84% of melanomas are caught at this early stage. The 5-year survival rate for local melanoma is 98.4%.5

If cancer cells have spread to a nearby lymph node, it is called regional metastasis. In 9% of cases, the melanoma has spread to regional lymph nodes at diagnosis. The 5-year survival for regional melanoma is 62.4%.5

Distant spread (metastasis) is when cancer cells have traveled to distant parts of the body. About 4% of melanoma cases have metastasized to distant locations at the time of diagnosis. The 5-year survival for distant metastatic melanoma is 17.9%.5

Gender. Survival rates in women are slightly higher than survival rates in men at all ages and stages of cancer.6 For example, the 5-year survival rate among people diagnosed before age 65 years is 95.3% for women and 90.1% for men. After the age of 65, 5-year survival rates are 90.3% for women and 88.5% for men.

Race. Melanoma is much more common in white people than people with darker skin tones, but survival is lower for people of color who do get melanoma. The 5-year survival rate for melanoma diagnosed between ages 65 and 74 is 91.7% in whites and 62.3% in blacks.6

Basal cell carcinoma

Basal cell carcinoma (BCC) is the most common skin cancer. It grows very slowly and almost never metastasizes.7-9

Can BCC be cured?

Most BCCs can be treated and removed with minor surgery or other local treatment.9 The goals of treatment are to completely remove all cancer cells while preserving the function and appearance of the affected body part.10 Mohs micrographic surgery for BCC has highest cure rate: 99% for a BCC that has never been treated before.9,10

The cure rate when BCC is removed with wide excision can be as high as 98%.10 The cure rate with curettage and electrodesiccation is 91% to 97%.10 Your doctor will recommend a treatment approach based on how likely the cancer is to grow back.

Even when one BCC is removed, your risk of another separate BCC is increased. Ask your doctor how often—and for how many years—you should have follow-up exams.

What are the survival rates for BCC?

Cancer registries do not collect information about BCC because the majority of BCCs are diagnosed and treated easily in a doctor’s office.

Advanced BCC is so rare that there is very little information about survival rates. One study of 100 cases of metastatic BCC between 1981 and 2011 showed that median overall survival is 4.5 years.11 How far the cancer spread made a big difference in survival. For regional metastasis, survival was 7.2 years. For distant metastasis, it was 2 years. These estimates are based on a time when chemotherapy or radiation therapy were the only treatment options.

Survival time with advanced BCC might be improving with newer treatments. In trials for a targeted therapy called Erivedge® (vismodegib), median overall survival was 2.8 years.12 The 1-year survival rate was 84.4% and the 2-year survival rate was 68.0%. Odomzo® (sonidegib), another targeted therapy, has similar survival outcomes. Trials of sonidegib show that 2-year survival is 93% for people with locally advanced BCC and 69% for people with metastatic BCC.13

Squamous cell carcinoma

Squamous cell carcinoma (SCC) is the second most common skin cancer. Most cases are easily treated; however, SCC is more likely than BCC to be invasive and metastatic.

Can SCC be cured?

When SCC is found early—and most are—treatment usually cures this cancer.8 The first choice of treatment is to remove the tumor. Excision or Mohs surgery are used to treat SCC that are higher risk for recurrence. Mohs surgery cures 97% of SCC.14 About 92% of SCC can be cured with excision.14 Curettage and electrodesiccation cures 96% of low-risk tumors.14

Having one SCC increases your risk of another separate SCC, so regular follow-up examinations are important.

What are the survival rates for SCC?

About 5% to 10% of SCC cases are “high-risk” or likely to grow back or spread.8,15 Unfortunately, because cases of SCC are not reported to cancer registries it is difficult to estimate survival rates. It is clear that metastatic SCC is very difficult to treat.16 In large cohorts of people with distant metastatic SCC, about 70% die from their disease.16

Written by: Sarah O'Brien | Last reviewed: May 2017.
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