Follow up for melanoma
This page tells you about follow up after treatment for melanoma skin cancer. There is information about
Follow up for melanoma
After your treatment you may need to have regular check ups. How much follow up you have will depend on the stage of your primary melanoma.
Stage 0 melanoma (melanoma in situ)
If you had a stage 0 melanoma that was just in the surface layer of skin (in situ melanoma) you will not need any further appointments. Your doctor or specialist nurse will show you how to check your skin.
Stage 1A melanoma
If you had a melanoma that was just in the upper layer of skin (stage 1A melanoma) you will have check ups 2 to 4 times over a year. Then your doctor will discharge you.
Stage 1B, 2 and 3 melanoma
If your melanoma was in the deeper layers of skin or had spread into the lymph nodes you will usually need to have check ups every 3 months for 3 years. After 3 years the check ups may only be every 6 months.
If you are worried about anything between follow up appointments, contact your hospital doctor or specialist nurse. At each appointment your doctor will examine you, and ask you about your health and whether anything is worrying you. If you have any symptoms or concerns you may be offered a scan or X-ray. This is to look for any signs that the melanoma has come back anywhere in the body.
If you have stage 2C melanoma and did not have a sentinel node biopsy, or you have stage 3 melanoma, your doctor may offer you regular CT or MRI scans. This is called surveillance imaging and is to look for signs that the melanoma has come back. Your doctor will talk to you about the advantages and disadvantages of having these scans.
You will have regular check ups with your specialist. How often you see your doctor will depend on how well you are and whether you are having treatment.
Coping with check ups
Many people find their check ups quite worrying. They may bring back all the worry about your melanoma. It may help to tell someone close to you how you feel. Many people find counselling helpful. Look in the coping with cancer section for information about counselling.
After your treatment your doctor will want you to have regular check ups. How much follow up you have will depend on the stage of your primary melanoma. Your doctor will also consider your risk of developing another primary melanoma.
There are 3 main aims of follow up. These are to pick up any signs of
- Melanoma coming back around your scar (local recurrence)
- Melanoma spread to your lymph nodes or other part of your body
- New primary melanomas that may develop
If you had a stage 0 melanoma that was only in the surface layer of skin (in situ melanoma), your doctor will discharge you when you have finished your treatment. So you will not need to go for any further follow up appointments. Your doctor or nurse will show you how to check your skin for melanoma.
If your melanoma was in the upper layers of skin (stage 1A) you will usually have 2 to 4 appointments in the first year. Then your doctor will discharge you.
If you have any symptoms that you are worried about, you can contact your hospital doctor or specialist nurse between follow up appointments. You should contact your specialist straight away if you notice
- Any other abnormal looking moles
- Any sign of the melanoma growing back in the same place
- Any growths or swelling near where the melanoma was removed
- Any swelling in the lymph nodes closest to the area of the primary melanoma
For example, if the melanoma was on your arm the nearest lymph nodes will be in the armpit. Have a look at the section about the lymphatic system for more information.
If you have stage 1B, stage 2 or stage 3 melanoma you usually need to have check ups every 3 months for 3 years. Then every 6 months for 2 more years. Your doctor may discharge you 5 years after you complete your treatment.
At each appointment you will be
- Examined by your doctor or nurse
- Asked about your general health and if anything is worrying you
You may have blood tests done to check your general health. If you have any symptoms or are worried about anything in particular, you may be offered a CT scan or ultrasound scan. These tests can check whether the melanoma has come back or spread to anywhere in the body. If you are worried, or notice any new symptoms that you think may be related to your cancer, you can contact your hospital doctor between appointments.
If you have stage 2C melanoma and did not have a sentinel node biopsy, or you have stage 3 melanoma, your doctor may offer you extra CT scans or MRI scans. You have these at regular intervals for a set period of time. It is called surveillance imaging. The doctors are looking to see if the melanoma has come back. Your doctor will talk to you about the advantages and disadvantages of surveillance imaging.
You can read more about the advantages and disadvantages of surveillance imaging on the National Institute for Health and Care Excellence (NICE) website. There is information in the melanoma assessment and management guidelines (NG14).
If your melanoma has spread, you will have regular check ups with your specialist. The appointments may be every three months, or even more often than that. How often you see your doctor will depend on how well you are and whether you are having treatment. Of course, you can contact your specialist at any time if you need an extra appointment because you are worried about something or if you feel ill.
Many people find their checks ups quite worrying. If you are feeling well and getting on with life, a hospital appointment can bring all the worry about your cancer back to you. You may find it helpful to tell someone close to you how you are feeling. If you are able to share your worries, they may not seem quite so bad. Many people find counselling helpful.
Find out about counselling in the coping with cancer section.
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