Even after successful treatment, an individual’s battle with skin cancer may not be over. Once an individual has been diagnosed and treated for skin cancer, their risk of developing skin cancer again increases greatly.
Recurrent melanoma vs new primary melanoma
Melanoma that occurs after treatment is considered either recurrent melanoma or a new primary melanoma. Another melanoma that develops in roughly the same location as the first cancer, and that has similar histological characteristics (the way the tissue or cancer cells look under a microscope), is considered a recurrent melanoma. Even though it’s not in the same original location, if a melanoma spreads to or recurs in the lymph nodes, it’s still considered a recurrent melanoma.1,2
If another melanoma develops in a different location, and is deemed to be unrelated to the original melanoma, it is called a new primary melanoma. Individuals with melanoma can also develop new, non-skin cancer primary cancers after treatment.
What’s my risk of melanoma recurrence?
An individual’s risk depends on the treatment used to treat the original cancer, their personal medical history, and the severity, size, or extent of the original melanoma. Some studies have found that long-term melanoma recurrence (longer than 10 or 20 years post-treatment) is dependent on the thickness and location of the original melanoma, with thicker tumors being the most likely to recur. Also, having a primary melanoma that is considered ulcerated (where a portion of the epidermis covering the tumor is not intact) is considered to contribute to an increase in the risk of recurrence.3
What’s my risk of developing a new primary melanoma?
As far as developing new cancers, it has been estimated that individuals with melanoma have a 9-fold increase in risk in developing new, primary melanomas, as well as a 28% overall increase in risk of developing a new primary cancer that isn’t melanoma, also referred to as a second cancer. Specifically, individuals with melanoma are at a higher risk of developing second cancers in the prostate gland, breasts, salivary glands, kidneys, and thyroid glands, as well as a higher risk of developing leukemia and non-Hodgkin lymphoma.4
Factors that contribute to the development of a new primary melanoma include gender, genetics, age, and original melanoma location. For example, the younger an individual is at original diagnosis, the greater their risk is of developing a new melanoma. This could be due to a genetic tendency to developing melanomas, since melanoma diagnosed in individuals 30 years old or younger is often due to genetic factors. Also, women who have had an original melanoma on the head or neck region are at a higher risk of developing subsequent primary melanomas. Additionally, the risk of developing a new primary melanoma decreases each year after diagnosis and treatment, however, individuals with melanoma are a higher risk of developing a new melanoma than the general population for up to 20 years.4
How do I decrease my risk?
Similar to the amount of variation in recurrence or new primary melanoma development rates, there’s also no clear way of preventing these events from happening. Creating a survivorship care plan with your healthcare team that includes a set of guidelines and timelines for future follow-up appointments, exams, tests, and screenings, and following these instructions, is a great way to help monitor for recurrence or new primary melanomas. Your healthcare team or survivorship care plan may also have information on what signs and symptoms to look for at home between appointments, as well as tips on how to perform self-exams of your skin and lymph nodes. Additionally, eliminating or reducing cancer risk-increasing behaviors, such as smoking, obesity, lack of exercise, and poor diet, may help reduce your overall risk of developing another cancer, both recurrent or new.1
If you are concerned about your risk for recurrence or the development of a new primary melanoma after you’ve been treated for melanoma skin cancer, contact your healthcare team and ask what your risk profile looks like, and what steps you can do to lower your chances of developing melanoma again.
Living as a Melanoma Skin Cancer Survivor. American Cancer Society. https://www.cancer.org/cancer/melanoma-skin-cancer/after-treatment/follow-up.html. Published May 20, 2016. Accessed November 30, 2017.
Recurrence of Melanoma. Aim at Melanoma Foundation. https://www.aimatmelanoma.org/after-treatment/recurrance-of-melanoma/. Accessed November 30, 2017.
Soong SJ, Shaw HM, et al. Predicting survival and recurrence in localized melanoma: A multivariate approach. World Journal of Surgery. Mar 1992; 16(2), 191-5.
Bradford PT, Freedman DM, Goldstein AM, Tucker MA. Increased risk of second primary cancers after a diagnosis of melanoma. Arch Dermatol. Mar 2010; 146(3), 265-272.