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 vs new primary cancer
The type of skin cancer that can develop again after treatment is considered either recurrent cancer or a new primary cancer. Another skin cancer 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 skin cancer, and is related to the primary (or original) cancer. If another skin cancer develops but it is not in the same location nor is similar histologically, this cancer is considered a new primary cancer.1,2 Individuals with skin cancer can also develop new, non-skin cancer primary cancers after treatment.
What’s my risk of recurrence or developing a new primary skin cancer?
Some researchers have estimated that the rate of recurrence of primary non-melanoma skin cancer post-treatment could be as low as 5%, however, the risk of cancer recurrence or a new skin cancer developing can vary greatly between each individual.1 An individual’s risk depends on the treatment used to treat the original cancer, their personal medical history, the severity, size, or extent of the original cancer, and the type of original skin cancer diagnosed. Further, it has been estimated that squamous cell carcinomas on the ears, nose, and lips are more likely to recur, and can commonly recur within two years of treatment. Conversely, basal cell carcinomas may recur in up to 50% of individuals who have had them, and recur within 5 years of treatment.2,3 It’s important to note that these numbers are just example estimates, and can fluctuate greatly based on an individual’s situation.
Recurrence can be more likely for individuals who had original carcinomas that were larger than two centimeters or that developed several layers deep into the skin. Additionally, those with eczema or dry skin may have a higher risk of recurrence, as well as those who have been exposed to high doses of UV light. High UV exposure is also true for individuals at higher risk of developing a new primary cancer. Environmental exposures or genetic predispositions to developing skin cancer can also contribute to the risk of developing a new primary cancer.4
How do I decrease my risk?
Similar to the amount of variation in recurrence or new primary cancer development rates, there’s also no clear answer on how to prevent 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 then following these instructions, is a great way to help monitor for recurrence or new primary cancer. Your healthcare team or survivorship care plan may also have information on what signs and symptoms to look for at home, between appointments. 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.2,4
If you are concerned about your risk for recurrence or the development of a new, primary cancer after you’ve been treated for a non-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 skin cancer again.
Chen MM, Torres JS, et al. Recurrence after treatment of nonmelanoma skin cancer. Arch Dermatol. May 2011; 147(5), 540-6.
Recurrent Basal Cell Carcinoma. Cancer Treatment Centers of America. https://www.cancercenter.com/skin-cancer/stages/tab/recurrent/. Accessed November 29, 2017.
Recurrence, Prevention, and Early Detection. Skin Cancer Foundation. http://www.skincancer.org/skin-cancer-information/squamous-cell-carcinoma/scc-recurrence-and-prevention. Accessed November 29, 2017.
Living as a Basal or Squamous Cell Skin Cancer Survivor. American Cancer Society. https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/after-treatment/follow-up.html. Published May 10, 2016. Accessed November 29, 2017.