You’ve been cleared of melanoma. Now how do you keep it from coming back?
Most types of skin cancer are unlikely to spread (or metastasize) to other parts of the body, and tumors can be removed by a surgical excision relatively easily. However, melanoma is another story. Melanoma is considered the most rare—yet most dangerous—form of skin cancer.
Of the three main types of skin cancer, melanoma is the most likely to metastasize, according to the American Cancer Society. Metastasis increases the chances of cancer recurrence and requires more aggressive treatment, known as adjuvant therapy.
“Adjuvant therapy is what we add after surgery to decrease the chance that that tumor will return, or relapse,” says Jeffrey Weber, MD, PhD, medical oncologist and melanoma researcher at Perlmutter Cancer Center at NYU Langone Health. Today’s adjuvant therapy options for melanoma cut the risk of relapse by about half, according to Dr. Weber.
Despite the oncologist’s best efforts, it’s possible for some cancer cells to survive after adjuvant therapy. If this happens, they can multiply and lead to melanoma recurrence. The chances of this happening are the highest during the first five years after treatment.
This leads to an important question: If any cancer cells survive the treatment for metastatic melanoma, what can survivors do to lower their risk of recurrence?
Although nothing is a guarantee, there are certain lifestyle habits that may be helpful. A healthy lifestyle may be able to lower the risk of recurrence—and if the melanoma does recur, good habits may help improve treatment outcomes and chance of survival. Self-care is a major component. “That means you’re managing yourself, your psyche, your well-being, in the best way possible,” says Kaveh Alizadeh, MD, a plastic and reconstructive surgeon in New York. “That could be through nutrition, through meditation, through a regular sort of surveillance of yourself as a person.”
The following habits may help lower the risk of melanoma recurrence:
Avoiding tanning beds
Wearing hats and sunglasses
Managing weight (being overweight or obese is linked to a higher risk of recurrence)
Avoiding alcohol or drinking within moderation
Eating a diet rich in fruits and vegetables
Following food safety guidelines to avoid food poisoning
Limiting consumption of red meat and heavily processed foods
Exercising at least 150 minutes per week
And staying hydrated
Although it’s not necessarily a habit for “prevention,” another important habit is doing skin self-checks regularly and attending your follow-up appointments for formal skin checks. This can help relieve anxiety about melanoma recurrence, and if the melanoma does come back, catching it early can help improve treatment outcomes.
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I know it's very confusing for patients
when they first get a diagnosis of
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melanoma because, on the one end,
you think of it as just a skin tumor that,
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potentially, if you remove the skin,
you can, potentially, be cured.
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But the problem is that,
unless you've done the surveillance and
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know whether these tumors
have gone beyond the skin,
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you can potentially end
up with a recurrence.
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And after the surgeon does his or
her thing, and they remove the tumor,
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clinically, it's gone.
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But we all know that melanoma,
depending on how thick it is, and
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how many different qualities it has,
can have a very high risk of relapse,
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even after the surgeon takes it out.
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So adjuvant therapy is what we add after
surgery to decrease the chance that that
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tumor will return, or relapse.
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And I think most people would,
if they had a reasonable thing they could
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do that would cut that risk in half, which
is basically the risk reduction with our
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therapies, the adjuvant therapies,
they would do the adjuvant therapies.
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So once you've undergone your
first set of treatment options and
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have undergone this surgery,
potentially followed by adjuvant therapy,
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you will have the discussion
with your doctor, hopefully,
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in which they'll say, as far as we know,
we have cleared the tumor.
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And now the question
becomes your follow up.
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And, in fact, if you have had a deeper
involvement of the tumor or metastasis,
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you do need to see your
doctor a lot more frequently.
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Self-care after cancer is just as
important as therapeutic care,
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or medical care.
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What does self-care mean?
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That means you managing yourself,
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your wellbeing, in the best way possible.
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And that could be through nutrition,
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through a regular sort of surveillance
of yourself, as a person.
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And I think what we're learning is that,
it's not just medical, and
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it's not just therapeutic, going to
the hospital and going to the doctor, and
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it's not just trying to be
healthy in your lifestyle.
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But bringing these two elements
together for the first time, and
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we're learning more and more,
has a huge impact on your wellbeing.
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Can I do anything to prevent cancer recurrence? Atlanta, GA: American Cancer Society. (Accessed on February 21, 2019 at https://www.cancer.org/treatment/survivorship-during-and-after-treatment/understanding-recurrence/can-i-do-anything-to-prevent-cancer-recurrence.html.)
Living as a melanoma skin cancer survivor. Atlanta, GA: American Cancer Society. (Accessed on February 21, 2019 at https://www.cancer.org/cancer/melanoma-skin-cancer/after-treatment/follow-up.html.)
Melanoma recurs after 10 years in more than 6 percent of patients. Chicago, IL: American College of Surgeons, 2013. (Accessed on February 21, 2019 at https://www.facs.org/media/press-releases/jacs/melanoma0613.)
Nutrition and physical activity during and after cancer treatment: answers to common questions. Atlanta, GA: American Cancer Society. (Accessed on February 21, 2019 at https://www.cancer.org/treatment/survivorship-during-and-after-treatment/staying-active/nutrition/nutrition-and-physical-activity-during-and-after-cancer-treatment.html.)
Your best defense vs. another melanoma. Chicago, IL: American Academy of Dermatology. (Accessed on February 21, 2019 at https://www.aad.org/public/diseases/skin-cancer/melanoma/your-best-defense-against-another-melanoma.)