Follow up after treatment for melanoma skin cancer
After treatment for melanoma skin cancer, you have regular follow up appointments. You might also have tests including 
, and scans.
How often you have follow up appointments and for how long, depends on a number of factors including the of the melanoma.
Why you have follow up appointments
You have follow up appointments so your doctor can:
- check the melanoma hasn’t come back or spread
- treat any symptoms or side effects you may have
- explain how to reduce your risk of getting another melanoma
- answer any questions you have
How often are your follow up appointments?
How often you have follow up appointments and for how long, depends on:
- the stage of the melanoma
- if you had surgery to remove the melanoma or not
- if you have any other factors that increase the risk of the cancer coming back
Normally, if there are no signs that the cancer has come back, you will have fewer appointments each year. If the cancer does come back (recurrent cancer) your doctor will talk to you about further treatment.
Guidelines for the timing of follow up appointments in England, Wales and Northern Ireland are different to those in Scotland.
The National Institute for Health and Care Excellence (NICE) has guidelines recommending how often follow up appointments for melanoma skin cancer are. These are for England, but Wales and Northern Ireland also follow these guidelines.
Melanoma in situ (stage 0)
You usually see your doctor once after you have finished treatment. You do not normally need any scans or other tests. If there are no signs that the melanoma has come back, you won’t need any further follow up appointments.
Stage 1A
You generally have follow up appointments every 6 months for 1 year. You do not normally need any scans.
If there are no signs that the melanoma has come back at the end of the year, your doctor doesn’t normally need to see you again.
Stage 1B and 2A
You usually have follow up appointments:
- every 6 months for the first 1 to 2 years
- once a year after that
You may also have some ultrasound scans during the first 3 years.
If there are no signs that the melanoma has come back at the end of 5 years, your doctor doesn’t normally need to see you again.
Stage 2B and 2C
You usually have follow up appointments:
- every 3 months for the first 2 years
- 6 monthly in the third year
- once a year after that
You may also have some ultrasound, CT or MRI scans.
If there are no signs that the melanoma has come back at the end of 5 years, your doctor doesn’t normally need to see you again.
Stage 3 and stage 4
Follow up appointments for stage 3 and 4 melanoma depend on if you have had the melanoma removed or not. Cancer that can be removed is called resectable. If the cancer cannot be removed it is called an unresectable cancer.
Resectable stage 3 and 4
You usually have follow up appointments:
- every 3 months for the first 3 years
- 6 monthly for the next 2 years
You also have CT or MRI scans and you might have some ultrasound scans.
If there are no signs that the melanoma has come back at the end of 5 years, your doctor doesn’t normally need to see you again.
Unresectable stage 3 or 4
How often you have appointments depends on your situation and how well you are. You will see your doctor as often as you need. This is called personalised follow up.
The Scottish Intercollegiate Guidelines Network (SIGN) has guidelines for how often follow up appointments for melanoma skin cancer are.
Melanoma in situ (stage 0)
There are no SIGN guidelines for follow up of stage 0 melanoma skin cancer. Ask your doctor if they need to see you again after your surgery (wide local excision).
Stage 1A
You have follow up appointments every 3 to 6 months for a year. You do not usually need any scans or other tests.
If there are no signs that the melanoma has come back at the end of the year, your doctor doesn’t normally need to see you again.
Stage 1B and 2A
You generally have follow up appointments:
- every 3 to 4 months for the first 3 years
- 6 monthly for the next 2 years
You do not usually need any scans.
If there are no signs that the melanoma has come back at the end of 5 years, your doctor doesn’t normally need to see you again.
Stage 2B and 2C
You may have follow up appointments:
- every 3 to 4 months for the first 3 years
- 6 monthly for the next 2 years
- once a year after that
You usually have some CT or MRI scans during the first 5 years.
If there are no signs that the melanoma has come back at the end of 10 years, your doctor doesn’t normally need to see you again.
Stage 3 and stage 4
Follow up appointments for stage 3 and 4 melanoma depends on if you have had the melanoma removed or not. Cancer that can be removed is called resectable. If the cancer cannot be removed it is called an unresectable cancer.
Resectable stage 3 and 4
You may have follow up appointments:
- every 3 to 4 months for the first 2 or 3 years
- 6 monthly for the next 2 or 3 years
- once a year after that
You usually have CT or MRI scans during the first 5 years.
If you only had a small amount of melanoma in one , and there are no signs that the melanoma has come back at the end of 5 years, your doctor doesn’t normally need to see you again.
If you had a larger amount of melanoma in one lymph node or satellite or had in-transit metastases, your doctor usually continues to see you once a year. If there are no signs the melanoma has come back at the end of 10 years, your doctor doesn’t normally need to see you again.
Unresectable stage 3 or 4
How often you have appointments depends on your situation and how well you are. You will see your doctor as often as you need. This is called personalised follow up.
Contact your specialist nurse or doctor if you have any new symptoms or concerns. You don’t need to wait until your next appointment.
Other risk factors
Sometimes your doctor might want to see you more often than the guidelines suggest. This might be because:
- you have a higher risk of the melanoma coming back
- you have a higher than normal risk of getting another melanoma
- you’re pregnant
- your doctor recommended you have a
lymph node biopsy but you weren’t able to have it done
Your doctor can tell you how often your appointments are going to be. And if there are any other tests or scans they recommend you have.
What happens at your follow up appointment
Where you go for your follow up appointment depends on if you have:
- recently had surgery to remove the melanoma
- had chemotherapy, radiotherapy, targeted cancer drugs or immunotherapy
After surgery you might have follow up appointments at the surgical outpatients. And you normally go to the cancer (oncology) clinic if you've had other treatment.
Your surgeon and the might share your follow up. This means sometimes you might see the surgeon and other times you might see the oncologist.
At each appointment your doctor will examine you. And they will ask you about your general health and if anything is worrying you.
Your doctor or nurse will show you how to check your skin for new melanomas. And talk to you about:
- staying safe in the sun
- getting enough vitamin D
- getting help to stop smoking if you smoke
If you need any CT, MRI or ultrasound scans you normally have separate appointments for them.
How you might feel
Many people get anxious about their follow up appointments and scans. Talking about how you’re feeling might help. Some people can talk to their family or friends. But others find it more helpful to have counselling after cancer treatment. Talk to your doctor or nurse to help set this up.
