Recurrent melanoma

What is recurrent melanoma?

Melanoma is a cancer that usually starts in the skin. Recurrent melanoma means melanoma that has come back after treatment.

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:

the same area where it started – at your surgery scar
areas of skin near to where it started – called satellite or in-transit metastases
the lymph nodes closest to where it started
a different part of the body – this is called advanced melanoma.

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.

Related pages

What is cancer?

Worried about recurrent melanoma

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:

Follow-up appointments

Your doctor or nurse will check for signs of recurrence at any follow-up appointments you have.
Scans

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.

Getting support

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:

Call the Macmillan Support Line for free on 0808 808 00 00.
Chat to our specialists online.
Visit our melanoma forum to talk with people who have been affected by melanoma, share your experience, and ask an expert your questions.

The following organisations also offer information and support:

Melanoma Focus

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.
Melanoma UK

Melanoma UK provides support and information for patients, carers and healthcare professionals. It provides a skin check toolkit.

Treatment for recurrent melanoma

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.

Related pages

Melanoma treatment overview

Treating melanoma that comes back in the same area

If the melanoma has only come back at your scar or nearby, you usually have surgery to remove more tissue from the area. You may also have targeted therapy and immunotherapy drugs after surgery to help reduce the risk of cancer coming back. This is called adjuvant treatment.

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.

Sometimes surgery can be used to remove an area of skin or to remove the lymph nodes. If melanoma has come back in more than 1 area, it may be hard to remove it with surgery.

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

Targeted therapy drugs target something in or around the cancer cell that is helping it grow and survive. Immunotherapy drugs use the body’s immune system to recognise and kill cancer cells.
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

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.
Laser therapy

Laser therapy can be used to treat small areas of melanoma that comes back in nearby skin.
Electrochemotherapy

Electrochemotherapy uses chemotherapy and a small electrical current to treat small areas of melanoma that come back in nearby skin.
T-VEC

This is a type of immunotherapy. You have it as an injection into an area of melanoma on the skin or in the lymph nodes.

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

Targeted therapy drugs target something in or around the cancer cell that is helping it grow and survive. Immunotherapy drugs use the body’s immune system to recognise and kill cancer cells. Immunotherapy and targeted therapy drugs can help control or shrink the growth of advanced melanoma.
Radiotherapy

Radiotherapy uses high-energy rays to destroy the cancer cells. You may have it to help control symptoms if melanoma has spread to the brain, bones or skin.

Other treatments are sometimes used. We have more information about advanced melanoma.

About our information

References

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 cancerinformationteam@macmillan.org.uk

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].

Reviewers

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, Professor Samra Turajlic, Consultant Medical Oncologist.

With thanks to: Dr Stephanie Arnold, Consultant; Kerry Jane Bate, Advanced Nurse Practitioner; Dr Philippa Closier, Clinical Oncologist; Sharon Cowell-Smith, Macmillan Advanced Nurse Practitioner Skin Cancers; and Dr Benjamin Shum, Medical Oncologist.

Thanks also to the other professionals and people affected by cancer who reviewed this edition, and to those who shared their stories.
Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

use plain English
explain medical words
use short sentences
use illustrations to explain text
structure the information clearly
make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.