Follow-up after treatment for melanoma
Melanoma behaves differently in each person, and a standard follow-up schedule would not work for everyone. People with melanoma should talk to their doctor about a follow-up plan that suits their individual situation. Follow-up care is often shared among the dermatologist, surgeon, cancer specialists (oncologists) and family doctor. Follow-up care with a dermatologist is very important as there is an 8% lifetime risk of having another primary melanoma.
After treatment has ended, new signs and symptoms that don’t go away should be reported to the doctor without waiting for the next scheduled appointment. These may include:
- any new or unusual pigmented lesions
- any mole or spot that is changing in size, shape, colour or elevation
- any mole or spot that is itchy, ulcerated or bleeding
- swelling of lymph nodes
Melanoma can recur even after 10 years, so life-long follow up is usually recommended.
Follow-up after melanoma treatment varies. It can be different depending on the stage of melanoma and a person’s family history.
- Follow-up visits for people with stage 0 or IA melanoma are usually scheduled every year.
- People with stage IV melanoma may require follow-up visits:
- every 2–3 months for the first 2 years
- every 3–6 months for the next 3 years
- every year after that
- People with all other stages melanoma may require follow-up visits:
- every 3–6 months for the first 2–3 years
- every 4–12 months for the next 2 years
- every year after that
During a follow-up visit, the doctor usually asks questions about the side effects of treatment and how the person is coping. The doctor may do a complete physical examination, including:
- checking the scar and surrounding area
- feeling the nearby lymph nodes
- checking the lymph nodes behind the knee and in the groin for a melanoma on the leg
- checking the lymph nodes in the groin, armpits, collar bones and neck for a melanoma on the chest, back or abdomen
- checking the lymph nodes by the neck, chin, collar bone and ears
- checking the skin from head to toe for any other abnormal looking moles or spots
Tests may be ordered as part of follow-up or if the doctor suspects the cancer has come back (has recurred).
- chest x-ray
- complete blood count (CBC)
- blood chemistry tests, such as lactate dehydrogenase (LDH)lactate dehydrogenase (LDH)An enzyme that is involved in energy production in cells.
- computerized tomography (CT) scan
- magnetic resonance imaging (MRI)
If a recurrence is found during follow-up, the oncology team will assess the person with cancer to determine the best treatment options.
Establishing a national caregivers strategy
The Canadian Cancer Society is actively lobbying the federal government to establish a national caregivers strategy to ensure there is more financial support for this important group of people.