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After any surgery, it is much more difficult to do a second surgery in the same area because of the fibrosis from the first surgery. It is also more difficult to do surgery after radiation because of fibrosis.

In general, radiation causes more problems because there is more fibrosis in the region than there is after surgery.

In this specific case there might also be other complications such as invasive spread, but Max only stated the recurrence was small. Getting a second opinion from a major CCC is advisable.

My CCC routinely handles these with salvage surgery followed by chemo. Currently chemo alone has no track record for stopping SCC.

We have five major CCC's in San Diego and several research CC's that they work with - most notably the Salk Institute and when ever possible, salvage surgery followed by chemo seem to be standard fair for those in my support group who have had to deal with recurrence.