Sometimes there is a higher risk that a melanoma will come back. For example, this may be more likely if the melanoma was thick. Or if it was in an area that was difficult to treat with surgery.
The melanoma may come back in:
Why does melanoma come back?
For many people who have surgery to remove a melanoma, the cancer never comes back. The aim of surgery is to prevent melanoma coming back by removing all the cancer cells.
Your team plan your treatment carefully to try to make sure this is done. But it is possible that a small number of cancer cells will be left behind in the body. If cancer cells are left behind, the melanoma may come back.
The cancer cells may be left in the area where the melanoma started. Or they may already have started to spread away from this area.
The cells are too small to be seen with the naked eye or on scans. It may be months or years before they develop into a tumour that can be seen on a scan or that causes symptoms.
Worrying about cancer coming back is common after treatment. Many people struggle to cope with feelings of uncertainty. It can be hard to deal with these feelings if you have them. But they often get better with time.
If you are finding it difficult to cope, talk to your specialist doctor or nurse or your GP. They can give you advice on ways to manage anxiety. They can also refer you to any extra support you may need.
After your initial treatment for melanoma, your specialist doctor or nurse will explain your risk of melanoma coming back. They will give you information about finding any recurrence as early as possible so it can be treated. This may include:
Your doctor or nurse will check for signs of recurrence at any follow-up appointments you have.
Some people will have regular scans if there is a higher risk of melanoma coming back.
Symptoms to be aware of
Your doctor or nurse will explain how to check your scar, the surrounding area and other areas of your body for signs of melanoma.
If there are any signs the melanoma might be coming back, your doctor will arrange tests to find out more.
You may get anxious between appointments. This is natural. It may help to get support from family, friends or a support organisation.
Macmillan is also here to support you. If you would like to talk, you can:
The following organisations also offer information and support:
Melanoma Focus provides information, guidance and support for patients, carers and healthcare professionals. It has a free helpline answered by expert skin nurses. It also has a Melanoma TrialFinder for melanoma trials in the UK.
Treatment for recurrent melanoma depends on:
- where the melanoma has come back
- the treatments you have already had
- your general health and your preferences.
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).
Your specialist doctor 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 can then decide together what treatment is best for you. You may be offered some treatments as part of a clinical trial.
Treating melanoma that comes back in the same area
Treating melanoma that comes back in nearby skin or lymph nodes
Melanoma can come back in another area of skin or in the closest lymph nodes. Areas of melanoma that have spread to nearby skin are called:
- satellite metastases, if they are less than 2cm away from where the melanoma started
- in-transit metastases, if they are more than 2cm away from where the melanoma started but closer than the nearby lymph nodes.
Your doctor may talk to you about one of the following treatments instead. Some of these treatments are specialised and may only be available at certain hospitals. Your doctor or nurse can give you more information.
Targeted therapy and immunotherapy
Chemotherapy into a limb
You may have chemotherapy directly into a limb to treat clusters of melanoma. You have it in the same limb where the melanoma started. Chemotherapy into a limb is also called isolated limb perfusion (ILP) or isolated limb infusion (ILI).
Radiotherapy uses high-energy rays to destroy the cancer cells. Sometimes you have it to treat cancer in the lymph nodes or nearby skin. It is used if it is not possible to remove affected lymph nodes or skin with surgery.
Treating melanoma that comes back in another area of the body
Melanoma that has spread to other parts of the body is called advanced or stage 4 melanoma. The main treatments are:
Targeted therapy and immunotherapy
Other treatments are sometimes used. We have more information about advanced melanoma.
Below is a sample of the sources used in our recurrent melanoma information. If you would like more information about the sources we use, please contact us at email@example.com
Michielin O, van Akkooi ACJ, Ascierto PA, et al. Cutaneous melanoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2019; 30, 12, 1884-1901 [accessed May 2022].
Keilholz U, Ascierto PA, Dummer R, et al. ESMO consensus conference recommendations on the management of metastatic melanoma: under the auspices of the ESMO Guidelines Committee. Annals of Oncology. 2020. 31 (11): 1435-1448 [accessed May 2022].
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Samra Turajlic, Consultant Medical Oncologist.
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We want our information to be as clear as possible. To do this, we try to:
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