What to do if a mole appears again after removal

Malignant melanoma has a reputation for complete unpredictability, however, in comparison with other cancer processes, quite a lot is known about the patterns of its progression.

• What does relapse of melanoma look like?
• Causes of melanoma recurrence
• Locations
• Signs and symptoms of melanoma
• Relapse groups
• Frequency of occurrence
• Diagnostics
• Treatment
• Prevention
• Why is relapse dangerous?
• Forecast

What does relapse of melanoma look like?

Recurrent neoplasm differs from primary melanoma not so much in appearance as in the total volume of the lesion. Often secondary formations are very similar to the previously removed maternal one, only there are many more of them, they can be larger or smaller.

In domestic oncology, there are four types of melanoma relapses according to Wagner’s classification:

1. local - the tumor is located exactly in the area of ​​the primary operation;
2. transit metastases or satellites - next to the scar, but no closer than 2 centimeters, can be localized not only in the skin, but also in the subcutaneous tissue;
3. regional metastases - damage by a malignant process to the lymph nodes near the operation area;
4. distant metastases - secondary melanoma tumors in other organs and tissues.

The patient can have relapses of any type and in any set, all at once, which is not surprising for such an aggressive tumor.

Mole grows after removal, treatment methods

Mole grows after removal

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There is nothing wrong with the appearance of moles on the body, but sometimes the reason for their occurrence is fraught with many mysteries. The first nevi appear in infancy, and the rest can be acquired throughout later life. Sometimes it happens that you have a mole removed, and it appears again, but why does this happen?

Causes of nevi

Before we talk about why a removed mole grows back, it is necessary to understand why moles appear on our body in the first place. Doctors identify several main factors contributing to this:

1. Genetic predisposition. First of all, moles are passed on to us from our ancestors, so you can observe that in parents and children they are localized in the same place.
2. Prolonged exposure to the sun. Ultraviolet radiation negatively affects the condition of our skin. Despite the fact that there are a lot of tanning enthusiasts, they all understand perfectly well what this can mean. After all, it is the sun that sometimes causes cancer to develop.
3. Hormonal imbalance. Managing hormones is difficult, especially on your own. They can rage in children during puberty, as well as in pregnant women. Sometimes even stress affects this in a negative way.

It's not surprising that new moles start appearing on your body. However, not all moles are the same, which means there are other reasons for their occurrence. For example, the reasons for the formation of red moles are as follows:

1. Malfunction of internal organs, for example, the colon.
2. Failure in lipid metabolism.

Only a doctor can name the exact cause of formations after conducting an examination

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Causes of melanoma recurrence

It is assumed that the source of development of a recurrent or metastatic tumor is a malignant cell preserved in a blood or lymphatic vessel. The likelihood of the disease returning is affected by the aggressive biology of the melanoma cell and its ability to survive for long periods of time.

It has been noted that the relapse process is typical for young people from 30 to 50 years old, and the timing of progression is associated with gender. For example, damage to regional lymph nodes in women occurs in the first year after removal of melanoma, in men - in the second or third, distant metastases in a man are likely in the first 3 years after treatment, in a woman - after 3 years.

The thickness of the first tumor correlates with the rate of progression; with a thickness of more than 2 mm, 8–9 patients out of ten are likely to develop metastases in the lymph nodes. In clinical studies, a standard approach to the distance from the tumor to the incision line has been developed, depending on the thickness of the tumor node, so at least half a centimeter is retreated at a minimum height, with a nodule thickness of more than 2 mm, 2 centimeters are retreated from it.

As we recently found out, the probability of recurrence has little effect on the volume of the primary operation, but if the volume of excision is insufficient, when malignant cells are found in the edges of the removed tissue during histological examination, a repeat operation is performed no later than 8 weeks or radiation is carried out with preventive drug therapy.

What to do if it is not completely removed?

If some time after the mole was removed, it suddenly grows back, do not panic. The first thing you need to remember is how the nevus was eliminated. If it was removed according to all the rules with a histological examination of the tissues, and the tests did not find any pathological (cancerous cells), you can calm down and not worry. Of course, it would be a good idea to show a new (recurrent) mole to a doctor and make sure it is safe.

When is pigmentation dangerous?

A benign nevus, which for some reason appears again, is considered a benign phenomenon. However, there are typical symptoms that require special attention. They are, in principle, similar to similar signs of malignancy of any mole and include:

Locations

Two thirds of relapses are metastases, one third are nodular formations in the area of ​​the first operation. The location of the maternal tumor affects the fate of the patient:

• every third person operated on for melanoma of the scalp and neck develops tumors in the scar, and in women the problem occurs in the first year after treatment;
• transit metastases have the largest percentage in the group of melanomas of the extremity; this type of progression in women develops five years after excision, and in the male population - in the second and third years after surgery;
• with the initial lesion of the skin of the legs most often, in seven out of ten secondary tumors are found in the lymph nodes, in women in the next year, in men a little later;
• The primary process on the trunk in every fourth person is complicated by distant metastases.

Signs and symptoms of melanoma

Signs of recurrent formation in the skin and soft tissues do not differ from those of a primary tumor; the same diagnostic algorithm is applicable to them: asymmetry and uneven coloring, uneven edges and instability of the condition. The sizes are very variable - from tiny to gigantic, “the size of a baby’s head.”

Symptoms of metastases depend on the location, so if the lungs are affected there may be a cough with shortness of breath, if metastases to the brain - blurred vision, headaches, vomiting, convulsions.

Regional metastasis is manifested by an increase in the package of lymph nodes, followed by tumor growth into soft tissues and blocking of nearby passing vessels, which is complicated by swelling of the limb.

Clinical studies have proven that detecting disease progression before symptoms appear significantly improves life prospects. The course of the disease is always individual, so observation after treatment should be based on the biological characteristics of the malignant tumor. Euroonko does everything for early detection and prevention of health problems.

Preventing the appearance of a new mole

Before surgery to remove a mole, it is recommended to undergo a histological examination, which will determine the nature of the neoplasm. This diagnostic method is considered the most accurate. After confirming the benignity of the nevus, you should choose the best clinic and doctor who has sufficient experience in this field. Next comes the selection of the removal method. There are many of them, so it is necessary to choose the safest method that guarantees complete removal of the tumor. To avoid unpleasant consequences after removing a mole, you must follow the recommendations that the doctor must give:

• Do not wet the area where the growth is removed for the first 7 days.
• Properly treat the damaged area of ​​skin. Before handling, wash your hands thoroughly to avoid infection.
• After 1 week, a dry crust will appear on the wound, which under no circumstances should be removed. The dead skin will fall off on its own over time.
• If the operation is performed in the summer, you should avoid prolonged exposure to the sun, do not sunbathe, and do not visit the solarium. If you cannot avoid direct sunlight, the wound should be covered with clothing, and a bactericidal patch can be glued on top. Exposure to ultraviolet radiation can cause the appearance of pigment spots in areas of skin damage.

Compliance with careful care of the affected area after removal of a mole is the key to successful recovery and prevention of recurrence of the tumor. If scars begin to appear on the skin, it is necessary to use ointments and creams, the therapeutic effect of which will help hide such cosmetic defects. Properly done independent and medical work will lead to a good result.

Relapse groups

In 1985, the domestic oncologist Anisimov proposed, for the convenience of describing the clinical picture, to divide recurrent tumors into six groups:

• The first - round and few formations, often outside the scar and mainly subcutaneously - in the fatty tissue, often fall under the criteria of “transit” metastasis according to Wagner.
• The second is multiple irregular cutaneous and subcutaneous infiltration accompanying vessels and nerves; it is assumed that the external picture of relapse is formed by tumor cells that have taken root in small vessels.
• The third is nodules directly associated with the operation area that have grown from malignant cells remaining in the skin.
• The fourth is polycyclic multiple formations.
• The fifth is a lot of bulging nodules, often on a stalk, like morel mushrooms.
• The sixth is a combination of all five options.

Classification is rarely used in clinical practice, because the assessment of treatment results is based solely on the size of the nodes, and not on their appearance.

Frequency of occurrence

For any type and size of melanoma, the most common progression after surgery is metastases to other organs in almost 60% of patients.

The most dangerous period is the first three years after surgery, but in the first year, 60% are more likely to have metastases in regional lymph nodes. In stages 1 and 2, the incidence of lymph node involvement is low - every fifth person, and very rarely - less than 5% are affected by the postoperative scar.

Due to the development of relapses of the disease, only 60% of patients live longer than five years, but the disease can return after 15 years - in 7%, and after 25 years - in 10%. Every fifth person with an unimportant individual prognosis, however, does not experience a relapse in the next 5 years.

What to do if a mole reappears after removal

If a removed mole re-grows on the body, you should carefully monitor the color and size of the mole. Inspect the operated area daily. If a large scar or scar forms, you should seek help from a doctor. After analyzing the patient, the specialist will select the optimal medications. Medicines will remove the crust on the wounds.

If the recurrence of the nevus is malignant, the following signs are observed:

• pain in the area of ​​the new mole;
• the formation of severe itching of the skin;
• the surface of the body peels off and becomes covered with small cracks;
• blood oozes from the growth;
• education takes on a different color and shape.

If you experience the above symptoms, seek help from your doctor. A medical professional will determine the risks of cancer development and select effective therapy. The main task is to neutralize the effect of metastases, which dynamically spread throughout the human body. Otherwise, complete recovery will become unrealistic.

Diagnostics

The examination is similar to the diagnosis of the primary process. A special feature of diagnosing progression is strict adherence to a schedule of regular examinations, which makes it possible to identify the process at the very beginning and before the appearance of clinical symptoms.

In European countries, it is recommended to visit an oncologist every 2 months during the first year after surgery, quarterly in the second year, and then be monitored without reducing intensity, since most often relapses occur in the first three years.

Early diagnosis of melanoma relapse is an objective reality today. In each clinical case, Euroonko clinics use an individual diagnostic search program, eliminating both the redundancy of the examination and its insufficiency.

Treatment

Treatment of local recurrence in the scar, transit metastases and altered lymph nodes is similar to the tactics for the primary tumor - surgery is optimal, including plastic closure of a large tissue defect.

Adjuvant drug treatment after surgery is the norm; drugs that have not previously been used for prevention are used, although the choice is small: alpha-interferon and ipilimumab.

With metastases to other organs, the question of drug therapy arises, and in the first line they resort to immuno-oncological drugs in combination with targeted drugs in the presence of gene mutations.

The choice of drugs is large, therefore, in the absence of results or progression during second-line treatment, they resort to previously unused drugs. Chemotherapy for relapse of melanoma is used as a last resort, not because of pronounced adverse reactions, the problem is the low result. For superficial formations, radiation therapy is possible.

Mole removal

There are moles on every person's body, some have more, some have less. They do not always decorate the body with their presence. Their ability to degenerate into malignant tumors leads to severe cancer. Therefore, when they discover new birthmarks or convex growths, people run to the doctor, demanding that the suspicious mark be removed.

Removing moles is a serious procedure that requires a high level of professionalism from the doctor. A mole needs to be removed if it bothers a person, for example: it has increased in size, hurts when touched, changes color and structure. If the tumor is located in a place that is often subject to friction or clinging, then it is better to remove it too, so as not to damage it or cause infection.

Why is relapse dangerous?

Relapse in melanoma is not only the appearance of a malignant formation in the scar, but also metastases. They most often affect the lymph nodes, lungs, skin, brain and liver. The possibility of removing a recurrent formation opens up prospects for a long life; if the operation is technically impossible, then the present and future will be occupied by drug therapy.

Survival for multiple organ metastases does not exceed six months; the results of drug therapy leave much to be desired, even with the use of innovative immuno-oncological drugs, which rarely promise more than two years of life.

Brown dot - what is it?

Sometimes, some time after the mole has been successfully removed and the skin has healed, a dot appears in the same place. Most likely, such a spot is a symptom of a relapse - the reappearance of a nevus. It may take 1-2 months from the moment of surgical removal to the visual appearance of a new mole, sometimes more.

When you carefully examine the brown spot that appears at the site of the removed mole, under a microscope you can see cells that are typical for all moles. They are capable of producing a brown pigment known as melanin. It is thanks to him that the nevus turns brown.

Forecast

Every year, melanoma is diagnosed in an average of 15 people out of every hundred thousand adults, approximately 3 patients die, and with a fairly stable mortality rate in the last quarter century, men began to die more often. Gender determines a lot in the prognosis of the disease, other things being equal, but young people experience the disease with less difficulty.

The probability of death with a late relapse is many times lower than with an early relapse. Early detection of progression promises better treatment results.

It is extremely difficult to predict the course of melanoma, because even a common process is not considered absolutely fatal; this malignant disease does not often live up to expectations. Don’t guess “to be or not to be”, contact specialists if you have problems, or better yet, before they appear - we will always help.

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Bibliography

1. Semiletova Yu.V., Anisimov V.V., Vagner R.I. /Treatment of patients with primary skin melanoma. Current state of the problem // Siberian Journal of Oncology. 2010. No. 4. 2. Semiletova Yu.V., Anisimov V.V., Lemekhov V.G. et al./Risk factors for relapse after radical treatment of skin melanoma//Sibir.onko.zhur.; 2012. No. 2 (50) 3. Stroyakovsky D. L., Abramov M. E., Demidov L. V. et al. /Practical recommendations for drug treatment of skin melanoma // Malignant tumors: Practical recommendations RUSSCO #3s2, 2018 (volume 4. de Vries E., Bray FI, Coebergh JW, Parkin DM /Changing epidemiology of malignant cutaneous melanoma in Europe 1953–1997: rising trends in incidence and mortality but recent stabilizations in western Europe and decreases in Scandinavia// Int J Cancer 2003; 107. 5. MacKie RM, Bray C., Vestey J., et al./Melanoma incidence and mortality in Scotland 1979– 2003 // Br J Cancer 2007;96.