Recurrent melanoma
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What is recurrent melanoma?
Melanoma is a cancer that usually starts in the skin. It can start in a mole or in normal-looking skin. About half of all melanomas start in normal-looking skin.
Sometimes melanoma can come back in the same area after treatment (recurrent melanoma). This can be months or years later. This can happen if cancer cells are left behind after treatment. The cells are too small to be seen with the naked eye or on scans. Over time, these cancer cells can begin to grow again.
Sometimes, melanomas come back as ‘clusters’ of melanomas. The clusters are near where the original melanoma (primary) first started. Doctors sometimes call these satellites or in-transit metastases.
The most common place for melanoma cells to spread is to the lymph nodes closest to the melanoma. When melanoma comes back in a different part of the body, it is known as advanced melanoma.
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Diagnosis of recurrent melanoma
After your initial treatment, your specialist will see you regularly. They will check your skin for signs and symptoms of melanoma to see if it has come back (a recurrence). They may also check the rest of your skin to see if you have any other changes.
Tell your specialist if you have any symptoms of recurrent melanoma. For example, this might be a small lump under the scar. Your doctor or specialist nurse can tell you what to look for.
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Biopsy
Your specialist will take a sample of cells (biopsy) from the abnormal area. A doctor, called a pathologist, looks at the sample under a microscope and checks for any cancer cells.
If the melanoma has come back, your specialist will remove it with an operation called a wide local excision.
Further tests
You may have further tests to check if the melanoma has spread to another part of the body. These tests may include:
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Tests to check your lymph nodes
To check if the melanoma has spread, your doctor may suggest you have tests to check your lymph nodes.
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CT scan
A CT scan takes a series of x-rays, which build up a three-dimensional picture of the inside of the body.
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PET scan
A PET scan uses low-dose radiation to check the activity of cells in different parts of the body.
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MRI scan
An MRI scan uses magnetism to build up a detailed picture of areas of your body.
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Stages of recurrent melanoma
The results of your tests helps your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging.
Treatment for recurrent melanoma
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).
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:
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Surgery
Surgery is the main treatment for a melanoma that comes back in the same area (recurrence). If melanoma has come back in more than one area, it may be hard to remove it with surgery.
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Immunotherapy
Immunotherapy drugs use the immune system to find and attack cancer cells.
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Targeted therapy
Targeted therapy drugs work by targeting something in or around the cancer cell that is helping it grow and survive.
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Chemotherapy
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. If the recurrences are only on one arm or leg, your specialist may advise you to have chemotherapy into an arm or leg.
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Laser therapy
Carbon dioxide (CO2) laser therapy can be used to treat small melanomas that come back in the same area.
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Electrochemotherapy
Electrochemotherapy is used to treat cancers on the skin. It can help control symptoms when other treatments are no longer working.
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Radiotherapy
Radiotherapy uses high-energy rays to destroy the cancer cells. It is sometimes used to treat melanoma that cannot be removed with surgery.
You may have some treatments as part of a clinical trial.
After recurrent melanoma treatment
Follow-up
After the melanoma has been removed, you will have regular check-ups. How often you see your cancer team will depend on the stage of your melanoma and type of treatment.
We have more information on follow-up care after treatment for melanoma and staying safe in the sun.
Well-being and recovery
Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.
Making small changes such as eating well and keeping active can improve your health and wellbeing and help your body recover.