Your best defense vs. another melanoma

Check your skin: Skin self-exams can help melanoma survivors find another melanoma early.

If you’ve been treated for melanoma, you may never get another melanoma. Many people don’t. But it’s important to know that you have a greater risk of getting another one. Anyone who has had melanoma has this risk.

Melanoma can also come back after treatment. The risk of melanoma returning is greater if you had a melanoma that:

• Was thick
• Looked like an open sore (bleeding and forming scabs before it was treated)
• Was surrounded by other melanomas
• Spread to one or more lymph nodes

Why does melanoma return?

Like any cancer, melanoma returns when some cancer cells survive treatment. Your dermatologist or oncologist (doctor who specializes in treating cancer) does everything possible to prevent this. Sometimes, however, cancer cells survive.

If cancer cells survive, they may multiply and grow into a melanoma. The medical term for this is recurrence.

Where does melanoma return?

It may come back in the same place or on the same area of your body. This is most common.

Melanoma can also return far from where you had the first one. For example, if you had a melanoma on your back, it could return on your arm.

It can also show up inside your body. If melanoma appears inside the body, it’s most likely to show up in the lymph nodes, lungs, liver, brain, bone, or gastrointestinal (GI) tract.

How can a returning melanoma appear in a new place?

Melanoma spreads when cancer cells break off from the original melanoma. When the cells break off, they may stay where they are or travel to another part of the body.

Because the cancer cells are from the original melanoma, the cancer is said to have returned. This is true even if the returning melanoma appears far from the original melanoma.

When does melanoma return?

Melanoma is most likely to return within the first 5 years of treatment.

If you remain melanoma free for 10 years, it’s less likely that the melanoma will return. But it’s not impossible. Studies show that melanoma can return 10, 15, and even 25 years after the first treatment. This happens less often.

Best defense: Lifelong skin exams and UV protection

While it can be upsetting to know that you have a higher risk of getting another melanoma, there is good news:

• Skin exams can help you find melanoma early when it can be successfully treated.
• Protecting your skin from harmful ultraviolet (UV) rays can reduce your risk of getting another skin cancer, including melanoma.

Skin exams: Two types of skin exams are essential — 1) Monthly skin self-exams and 2) follow-up exams with your dermatologist. These exams can help find another melanoma early, when it can be treated successfully.

Even when your dermatologist examines you, skin self-exams are important. In one study, patients were the first to find 73% of their returning melanomas.

If you’re unsure of how to check your skin (and lymph nodes), tell your dermatologist. Even if the reason is poor eyesight or an inability to check certain areas of your body, it’s important for your dermatologist to know this. Dermatologist often have ways to solve such problems.

Skin self-exams are so important that they’re recommended for life.

You also want to keep all follow-up appointments with your dermatologist (or oncologist). These exams are recommended every 3 to 6 months for at least the first year after treatment.

After that, your dermatologist (or oncologist) will tell you how often you need to be seen. For many patients, it’s once every 6 or 12 months. These exams are also recommended for life.

UV protection: This means protecting your skin and eyes from harmful UV light, which comes from the sun, tanning beds, and tanning lamps.

You can reduce your risk of getting another melanoma by always protecting your skin from the sun.

If you’re unsure about how to protect your skin from UV light, be sure to ask your dermatologist.

It’s normal to feel anxious

Knowing that you may get another melanoma can leave anyone feeling anxious or worried. In the beginning, any change to your body may convince you that you have another melanoma.

Taking action can help ease your mind. Examining your own skin and keeping all follow-up appointments can help you find signs of skin cancer as early as possible. Protecting yourself from harmful UV rays helps to reduce your risk of getting another skin cancer, including melanoma.

In time, these healthy habits should begin to feel normal and help reassure you that if melanoma returns or you get another one, it will be found early.

References
Benvenuto-Andrade, Oseitutu A, et al. “Cutaneous melanoma: Surveillance of patients for recurrence and new primary melanomas.” Dermatol Ther. 2005 Nov-Dec;18(6):423-35.

Faries MB, Steen S, et al. “Late recurrence in melanoma: clinical implications of lost dormancy.” J Am Coll Surg. 2013 Jul;217(1):27-34.

Francken AB, Shaw HM, et al. “Detection of first relapse in cutaneous melanoma patients: implications for the formulation of evidence-based follow-up guidelines.” Ann Surg Oncol. 2007 Jun;14(6):1924-33.

Paek SC, Sober AJ, et al. “Cutaneous melanoma.” In: Wolff K, Goldsmith LA, et al. Fitzpatrick’s Dermatology in General Medicine (seventh edition). McGraw Hill Medical, New York, 2008: 1156-7.

Uliasz A and Lebwohl M. “Patient education and regular surveillance results in earlier diagnosis of second primary melanoma.” Int J Dermatol. 2007 Jun;46(6):575-7.