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After a patient undergoes skin cancer treatment and their skin has healed, one question is frequently asked: what are the chances of my skin cancer coming back?
“I hear it all the time,” says Dr. Adam Mamelak, board-certified dermatologist and fellowship-trained Mohs micrographic surgeon. “The anxiety around the medical procedure has passed. Patients feel relieved that they have recovered from the surgery and now wonder the chances of it happening all over again.”
The truth is, different skin tumors have different recurrence rates. “There are a few factors here,” says Dr. Mamelak. “Recurrence rates can dependent on the type of skin cancer a patient has, how it’s treated, and if it’s been treated in the past.”
Localized skin tumors, such as basal cell carcinoma, tend to have lower recurrence rates. “These skin cancers have a contiguous growth pattern. This means all the malignant cells that make up the tumor and its extensions are connected,” explains Dr. Mamelak. “Therefore, because it’s one mass, when these skin cancers are removed with clear margins, the cure rate is exceedingly high.”
Basal cell carcinoma can be treated in a number of different ways, with both surgical and destructive modalities. When the margins of these tumors are examined after the skin cancers are removed, to ensure no malignant cells are left behind, cure rates of over 90% can be achieved. The highest cure rates are achieved with Mohs surgery, where 100% of the tumor’s peripheral margin is examined, ensuring the most complete removal and a less than 1% chance of it ever coming back.
“Skin cancers that have been treated before and then recur are a slightly different animal,” says Dr. Mamelak. “Basically, these tumor cells grow in a mixture of scar tissue left behind from the previous treatment.” Clear surgical margins are harder to obtain in this scenario. While the cure rates for things like basal cell carcinoma are still very high, they’re not as high as treating a ‘new’ skin cancer.
If localized tumors do recur, they tend to recur in the same location. “Again, this has to do with the contiguous growth pattern. The root left behind starts to develop and grow again.”
Recurrence of other skin cancers, like melanoma, are based on other criteria. “A number of these tumor’s characteristics are examined to ‘stage’ these cancers,” says Dr. Mamelak. “By examining these characteristics and comparing them to patient data collected over years of study, we can give a statistical prediction of the chance of these tumors spreading, whether it be within the region they’ve developed or in more distant locations.”
Whether you’re concerned about your skin cancer coming back or not, there is one unfortunate observation that is well-recognized by dermatologists: having one skin cancer puts you at higher risk for developing another, new separate tumor. “I advise all of my skin cancer patients to get their skin checked,” says Dr. Mamelak. Regular skin surveillance ensures skin cancers are caught in their earliest stages of development, when their cure rates are the highest.
Dr. Mamelak treats patients with skin cancer at Sanova Dermatology and the Austin Mohs Surgery Center. If you have questions about skin cancer or has been treated for skin cancer and are worried about recurrence, please contact us today. Our skilled physicians can help you with the detection, diagnosis and treatment of your skin condition.
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