Having a skin cancer removed surgically does not mean it cannot return. Recurrence is a recognised possibility with all types of cancer, and understanding why it happens, what it may look like, and what steps can be taken to reduce the risk is an important part of life after treatment. Being informed helps patients take an active role in their own ongoing care.
Why Can Cancer Come Back After Surgery?
Surgical removal aims to take out the cancerous lesion along with a surrounding margin of healthy-looking tissue. This margin is intended to reduce the chance of cancer cells remaining at the site. However, if any cancerous cells are present beyond the margin removed, they may continue to grow and give rise to a recurrence at or near the original site.
A new cancer can also appear in a different area of the skin. This is not the same as the original lesion coming back, but it does show that patients who have had one skin cancer have a higher chance of developing another. This higher risk is linked to past diagnosis and the effects of sun exposure on the skin over time.
Does the Type of Cancer Affect the Risk of Recurrence?
The type of cancer plays a role in recurrence risk. Basal cell carcinoma, the most common type, can return at the original site if the excision margins were not clear or if the lesion had features that made complete removal more complex. Certain subtypes of basal cell carcinoma are known to have a higher rate of recurrence than others.
Squamous cell carcinoma has a higher risk of spreading to nearby lymph nodes or other parts of the body, especially when it is found at a later stage or has higher-risk features. Melanoma is the most serious of these three and needs careful follow-up. The depth of the melanoma at the time it is diagnosed is one factor that can affect the risk of it coming back or spreading.
What Factors Influence the Likelihood of Recurrence?
Several factors can affect whether a cancer returns. One of the most important is whether the tissue removed during surgery had clear edges, meaning no cancer cells were found at the outer border of what was taken out. When the removed tissue shows cancer cells right at the edge, it may suggest that some cells were left behind, and further treatment may be needed.
The location of the lesion also matters. Cancers on the face, especially around the nose, ears, and eyelids, can be harder to treat because surgery in these areas is more complex. Other factors that can affect the outcome include the size and depth of the lesion, the subtype of cancer, and the patient’s immune health.
What Does Recurrence Look Like, and How Is It Detected?
A recurrence may appear as a new growth, thickening, or change in the skin at or near the site of the original lesion. In some cases, it may look similar to the original cancer. In others, it may appear as a small change that is easier to detect during a professional skin check than through self-examination alone.
Changes to watch for include any new lump, sore, or area of skin that does not heal, bleeds without an obvious cause, or changes in size, shape, or colour over time. If anything unusual is noticed, it should be assessed promptly rather than left to see if it resolves on its own.
How Can Patients Reduce the Risk of Cancer Returning?
Reducing ongoing UV exposure is one of the most practical steps patients can take. This includes applying broad-spectrum sunscreen regularly, wearing protective clothing and hats, and avoiding sun exposure during peak UV hours. These measures will not undo past sun damage but can reduce the risk of further UV-related changes to the skin.
Attending regular skin checks is equally important. The frequency of monitoring will depend on the type of cancer that was treated and individual risk factors, and this should be discussed with A/Prof Bish Soliman. Professional skin checks allow for early detection of any recurrence or new lesions at a stage when treatment options are likely to be more manageable.
What Happens if the Cancer Is Found to Have Returned?
If a recurrence is identified, the treatment approach will depend on the type, size, location, and extent of the returning cancer. Surgical removal is again a common option, though the approach may differ from the original procedure. In some cases, additional treatment such as radiation may be considered as part of the management plan.
A recurrent diagnosis is generally assessed and managed with the same level of care as the original. Patients should not delay seeking assessment if they have concerns, as earlier detection of a recurrence is associated with a broader range of treatment options.
Why Choose A/Prof Bish for Skin Cancer Surgery in Sydney and North Shore
A/Prof Bish Soliman is a FRACS-qualified Specialist Plastic Surgeon with specialist registration in plastic surgery, practising across Sydney and the North Shore. He is a member of the Australian Society of Plastic Surgeons (ASPS) and the Australian Society of Aesthetic Plastic Surgeons (ASAPS).
Skin cancer surgery and reconstruction form a significant part of his surgical practice. He holds two consultant positions at major Sydney tertiary referral hospitals and brings experience in complex reconstructive techniques, which are relevant for managing larger, recurrent, or more complex lesions.
A/Prof Bish Soliman’s approach is centred on thorough assessment and clear communication. He takes the time to discuss each patient’s diagnosis, the surgical options available, and what ongoing monitoring may be appropriate, so patients are well informed at every stage of their care.
