Cancer came back in the same spot 5 years after Mohs Surgery. Any options?

Your best option is to repeat the Mohs procedure. Recurrent skin cancer can be a bit sneaky and hard to see its full extent. I would strongly recommend you have it removed with a Mohs technique.

The best treatment modality for any recurrent tumor, is still Mohs micrographic surgery. Even though the recurrence rate of this surgery would be higher than that of your first surgery, it still has the lowest recurrence rate of any other treatment modality.