Can cancer recur in a different area?

2 answers | Last updated: Jun 22, 2010
A fellow caregiver asked...

I am a melanoma cancer survivor and I'm always scared going to doctor for fear of cancer returning in a different place. Is it possible for cancer to return in a different part of body?

Expert Answers

Dan Tobin, M.D. is the CEO of Care Support of America, a national service providing telephonic and local nurse counsel to adult children caring for aging parents. Dr. Tobin is the author of books and articles focused on the practical and positive aspects of family caregiving.

Hi. It is always possible for cancer to appear in another part of the body but you can schedule regular exams with your doctor and try not to think about the danger of this occurring often. In other words, try and eat well so you get proper nutrition, exercise often if you can and think positively. If you remain concerned try and schedule time to talk with you doctor as well as the nurses in the office. Health counseling can also help you face fears head on at the level you wish. It is a sign of strength to get help with worries and concerns.
Stay well
Dan Tobin

Community Answers

A fellow caregiver answered...

The chances (prognosis) of your melanoma recurring someplace else are a function of the staging of the melanoma. Staging is a function of the depth of melanoma into the skin, measured in mm, or beyond skin, and whether the melanoma was ulcerated. Very superficial melanomas limited to the top layer of skin, called "in situ", have a 99% chance of cure with wide excision under local anesthesia of the lesion alone. The deeper the original melanoma was, which would be indicated on the pathology report, gives a fairly accurate prognosis of what the chances are that that melanoma can spread elsewhere. Usually, melanomas over 1.0 mm depth raise concern about chances of spread and warrant looking for internal spread; ideally with a sentinel node biopsy before re-excision of the first lesion, or a PET scan and brain MRI if after excision. 75% of melanomas that do metastasize spread by lymphatic pathways and 25% by blood pathways, and therefore most metastasis are first found in lymph nodes, before spreading elsewhere such as lung and brain. Melanomas that spread by blood pathways can show up in bone marrow as anemia, spinal lesions, or kidney lesions. Your dermatologist can review your original path report and discuss what your risks actually are of spread elsewhere and what if any additional tests or oncology referral is appropriate. Even if the melanoma was very superficial and with a high cure rate based on depth, the risk of a second, separate or "primary" melanoma is 8-12% after the first one is found, so even if your melanoma was years ago it is important to see a dermatologist for a complete skin exam at least once a year. Also, since about 35% of melanomas are believed to have a genetic component, all first degree blood relatives (parents if alive, siblings, and children) should also be screened by a dermatologist.