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How Often Does Melanoma Come Back

What Does This Mean In Terms Of Percentage

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Lets look at the upper end of this: one in 20. A ratio of one out of every 20 is five percent.

If you recall your grade school math, to figure out a percent, divide the out of every number INTO the smaller number.

So one divided by 20 equals 0.05. Move the decimal to the right two places to get 5: five percent.

Using this grade school formula to figure out percentages, youll see that one out of 15 means 6.6 percent.

So if a dermatologist wants a suspicious spot removed, the odds that this will come back as the deadliest skin cancer are 5 to 6.6 percent.

But remember, this percentage pertains strictly to moles that a dermatologist is concerned about.

If the doctor says, upon examining your moles, Id like to remove this one here because its network gets my attention, then there is probably a 5 to 6.6 percent chance that youll get horrible news.

Many moles that are benign are also removed for cosmetic reasons, or because a patient is worried and the dermatologist is not those dont count in that statistic, says Dr. Martin.

A study of over 80,000 skin samples which included lesions other than moles, that were sent out for biopsy, turned up a different percentage rate of melanoma diagnoses. Continue reading

Dr. Martin trained at Mayo Clinic Pathology and has been practicing for 13+ years and is with Dermatology Consultants in St. Paul, MN.

Surgical Management Of Melanoma

The first-line or standard treatment for most melanomas is surgical excision. Thin tumors generally can be removed during an outpatient surgery, with a centimeter of normal appearing skin surrounding the melanoma. Surgery cures the majority of people with early stages of melanoma when they have early, thin tumors that have not spread from the original site.

Surgery for melanomas that are not very thin may require a wider excision of two centimeters of skin around the melanoma. This is usually performed as an outpatient procedure. Simple surgical procedures can still allow for a primary closure of most wounds, but occasionally, a skin graft or more complex reconstruction is required to close the wound. In cases where the melanoma is known to have spread to the lymph nodes, the lymph nodes may also need to be surgically removed.

During surgery, your doctor will remove the tumor along with an area of surrounding skin in order to lower the risk of a recurrence. How much skin is removed along with the tumor depends on the tumors thickness, which helps determine the stage of melanoma. Johns Hopkins surgical oncology faculty have led studies and chair international committees that have determined the following criteria for the margin of tissue removed during surgery and the classification of melanomas, depending on their size, into specific stages.

Treatment For Metastatic Melanoma

When melanoma metastasizes, it may spread not only into lymph nodes but also to internal organs, including the liver, lungs, colon, brain or bones. Surgery may be an option in some cases. A number of other therapies are available to help control the spread of cancer and relieve the symptoms of treatment.

  • Immunotherapy describes specialized medical therapy that boosts the immune system to help the body recognize and fight melanoma.
  • Targeted therapy describes the use of drugs that target the parts of melanoma cells that make them different from normal cells in the body. Genetic testing of melanoma cells that are removed can help to identify which specific targeted therapies might work best for a persons melanoma.
  • Radiation therapy may help by shrinking tumors or treating areas that are at high risk for recurrence after initial treatment. A course of radiation therapy may be given over several days using external beam radiation. There are several types of external beam radiation therapy, most of which use computer analysis to identify, measure and target the tumor, thus sparing healthy surrounding tissue.

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How To Protect Yourself

Here are the best ways to avoid melanoma recurrence:

  • Avoid sunbathing and tanning beds. These are especially harmful to people who have had melanoma in the past.
  • Cover up outside. Protect your skin by wearing a wide-brimmed hat and sun-protective clothing and by applying sunscreen to exposed skin.
  • Monitor your moles. Include self-examination as part of your routine. Conduct regular skin checks with help from a family member. If any of your moles appear irregular, call your physician immediately.
  • To spot signs of melanoma, keep the ABCDE guidelines in mind:

    • Asymmetry.
    • Borders .
    • Color .

    Most Melanoma Does Not Start In A Preexisting Mole

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    Melanoma can develop in a preexisting mole, says Dr. Marghoob, but nearly 70% of skin melanomas do not. Rather, they occur in normal skin. Moles themselves are not cancerous, and it is extremely rare for a mole to transform into a melanoma, says Dr. Marghoob. That said, he adds, having many moles helps identify people who are at an increased risk for developing melanoma somewhere on their skin.

    Since most melanoma develops on normal skin, Dr. Marghoob stresses the importance of protecting the entire surface of the body, including areas with many moles and areas without any moles. Some people use sunblock only where they have moles because they think the moles themselves are dangerous, adds Dr. Marghoob. Stay safe by applying broad-spectrum sunblock with an SPF of at least 30, wearing sun-protective clothing, or using a combination of the two approaches.

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    Treatment Options For Recurrent Scc

    A recurrent skin tumor is treated the same way as a high-risk primary tumor.4 Mohs surgery is the preferred option. Wide excision, radiation therapy, and chemotherapy are alternatives. Your doctor may recommend adjuvant therapy with radiation therapy or additional surgery.

    If the cancer recurs in the lymph nodes or distant organs, treatment options include surgery, radiation therapy, and chemotherapy. Treatment options for advanced SCC are limited. Your doctor may recommend participating in a clinical trial.

    Stop Tumors In Their Tracks

    Every melanoma has the potential to become deadly, but the difference between an in situ melanoma and one that has begun to metastasize cannot be overstated. There is a drastic change in the survival rate for the various stages of tumors, highlighting the importance of detecting and treating melanomas before they have a chance to progress. Its impossible to predict exactly how fast a melanoma will move from stage to stage, so you should be taking action as soon as possible.

    To be sure youre spotting any potential skin cancers early, The Skin Cancer Foundation recommends monthly skin checks, and scheduling an annual total body skin exam with a dermatologist. These skin exams can help you take note of any new or changing lesions that have the potential to be cancerous, and have them biopsied and taken care of before they can escalate.

    Trust your instincts and dont take no for an answer, Leland says. Insist that a doctor biopsy anything you believe is suspicious.

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    Treatment For Recurrent Melanoma

    A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team .

    Your doctor or cancer specialist or nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions.

    You may have one or more of the following treatments:

    • Surgery

      Surgery is the main treatment for a melanoma that comes back in the same area . If melanoma has come back in more than one area, it may be hard to remove it with surgery.

    • Immunotherapy

    Many Melanomas Dont Require Immediate Treatment

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    Many people have this concept that all melanomas are extremely rapidly growing cancers, says Dr. Marghoob. They think that waiting even one day after the diagnosis of melanoma can be fatal.

    While some subtypes of melanoma do grow extremely fast, says Dr. Marghoob, most early melanomas dont require immediate treatment, allowing ample time to detect, treat, and cure them. Dr. Marghoob advises checking your skin on a monthly basis. If you notice a changing spot on your skin, dont delay in getting it checked out by a dermatologist, he says. And if your doctor does think you may have a melanoma, know that for most people its not necessary to rush to treatment. Most people can take the time they need to meet with doctors and understand their options.

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    How Fast Can A Melanoma Grow

    Melanoma is a type of skin cancer that is caused by the overproduction of melanin, which is the pigment that gives your skin its color. While melanoma is not contagious, it is one of the most serious types of skin cancer.

    This skin condition can quickly spread to other parts of your body if left untreated. This article will discuss the causes of melanoma, how fast it can grow, as well as the symptoms and treatment options for this deadly disease.

    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, its most likely to show up in the lymph nodes, lungs, liver, brain, bone, or gastrointestinal tract.

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    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 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.

    Skin self-exams help find another melanoma early

    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 youre unsure of how to check your skin , tell your dermatologist. Even if the reason is poor eyesight or an inability to check certain areas of your body, its important for your dermatologist to know this. Dermatologist often have ways to solve such problems.

    Skin self-exams are so important that theyre recommended for life.

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

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

    UV protection can reduce your risk

    Diagnosis Of Metastatic Melanoma

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    Your care team may use several tests to diagnose metastatic melanoma.

    If theres evidence of a primary tumor, a biopsy may be taken. For this, a small section of suspected cancerous skin is removed with a razor, scalpel or small punch tool. The removed tissue is examined under a microscope to determine whether its melanoma.

    Additional tests are needed to determine whether the cancer is metastatic melanoma, or if theres no visible primary tumor. To test for metastatic melanoma, or melanoma that has spread to lymph nodes or distant parts of the body, your care team may perform the following tests.

    • Lymph node mapping and sentinel lymph node biopsy : Your doctor may perform a physical exam of your lymph nodes and check for swelling or physical masses. If no tumors are found , an SLNB may be done. For an SLNB, a radioactive dye is injected to locate the primary tumor. Then, the doctor will remove the lymph nodes that the dye traveled to and check them for melanoma.
    • Computed tomography scan, positron emission tomography scan, magnetic resonance imaging scan or ultrasound exam: Each of these scans is a noninvasive way to look inside your body and check for tumors.
    • Blood chemistry studies: Cancer may cause elevated or abnormal levels of certain substances in your blood. A laboratory test can identify if your blood chemistry shows signs of a cancerous tumor.

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    The Importance Of The Follow

    Attending regular follow-up appointments with a doctor or dermatologist is key to catching any recurring melanomas early before they have a chance to spread or worsen.

    A doctor will advise follow-up appointment timing based on the specifics of each individual patient, but the frequency of follow-up appointments are usually based on the stage the melanoma was in when it was treated.

    DermNet New Zealand provides an overview:

    · Stage I melanoma follow-up visit every year for the next 10 years

    · Stage II melanoma depending on the severity of melanoma in this stage, follow-up every 46 months for 23 years and then once every year up to 10 years

    · Stage III melanoma every 3 months in the first year, every 4 months in the second year, every 6 months until year 5, and then once a year until year 10

    · Stage IV melanoma as for Stage III but with additional visits as required

    Taking the proper precautions by staying out of the sun and wearing sunscreen and protective clothing is the other key to help prevent melanoma from returning.

    Read more about Skin cancer symptoms what to look out for, with pictures, to help you know what to look out for.

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    Keeping Health Insurance And Copies Of Your Medical Records

    Even after treatment, its very important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.

    At some point after your cancer treatment, you might find yourself seeing a new doctor who doesnt know about your medical history. Its important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment. Learn more in Keeping Copies of Important Medical Records.

    Diagnosis And Staging What It Means For You

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    How is melanoma diagnosed?

    To diagnose melanoma, a dermatologist biopsies the suspicious tissue and sends it to a lab, where a dermatopathologist determines whether cancer cells are present.

    After the disease is diagnosed and the type of melanoma is identified, the next step is for your medical team to identify the stage of the disease. This may require additional tests including imaging such as PET scans, CT scans, MRIs and blood tests.

    The stage of melanoma is determined by several factors, including how much the cancer has grown, whether the disease has spread and other considerations. Melanoma staging is complex, but crucial. Knowing the stage helps doctors decide how to best treat your disease and predict your chances of recovery.

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    What Is Metastatic Melanoma

    Metastatic melanoma occurs when the cancerous cells from the original tumor get loose, travel through the lymph or blood circulation, and start a new tumor somewhere else. Once it spreads, or metastasizes, the disease is known as metastatic melanoma. This type of melanoma may typically occur during stage III or stage IV. Common sites for metastases include the lymph nodes, lungs, liver, bones and brain.

    About 106,110 adults in the United States will be diagnosed with melanoma in 2021, according to the American Society of Clinical Oncology . Approximately 4 percent of people are diagnosed with melanomas that have spread to distant parts of the body, according to the ASCO. This is the most advanced stage of metastatic melanoma.

    The percentage of people diagnosed with melanoma that has spread to nearby lymph nodes is 8.5 percent, according to the National Cancer Institute . These cases have a slightly better prognosis.

    From 2014 to 2018, the incidence rate of melanoma that had spread to distant parts of the body was 0.9 per 100,000 people, according to the NCI.

    Melanoma tumors that have metastasized to other parts of the body are still considered melanoma. For example, melanoma found in the lungs is called metastatic melanoma of the lung or melanoma with lung metastases.

    Treatment Options For Recurrent Bcc

    A recurrent skin tumor is treated the same way as a high-risk primary tumor.3 Mohs surgery is the preferred option. Wide excision or radiation therapy are alternatives.

    Your doctor may recommend adjuvant therapy with radiation therapy or targeted therapy. Adjuvant therapy is an additional cancer treatment that is given after the primary treatment. Adjuvant therapy can help lower the risk that the cancer comes back.

    If the cancer recurs in the lymph nodes or distant organs, treatment options include surgery, radiation therapy, or targeted therapy. The targeted therapies approved for advanced BCC are:

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    Why Melanoma Comes Back

    According to Cancer Research UK, if the melanoma is low risk, meaning it is less than .76 mm thick, then there is very little chance that it will return. But if the melanoma is medium risk or high risk then the risk that it will return is higher.

    If the melanoma reached advanced stages, there is also a higher risk of recurrence or, for some, treatment may never stop completely.


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