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Non-melanoma skin cancer

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Follow-up after treatment for non-melanoma skin cancer

Non-melanoma skin cancer behaves differently in each person, and a standard follow-up schedule would not work for everyone. People with non-melanoma skin cancer should talk to their doctor about a follow-up plan that suits their individual situation. Follow-up care is often shared among the cancer specialists (oncologists), dermatologist and family doctor.

After treatment has ended, new symptoms 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 lump or abnormal spot near the treatment area
  • any new or unusual spot on the skin
  • swelling of lymph nodes

The chance of non-melanoma skin cancer recurring is greatest in the first 5 years after treatment, so close follow-up is needed during this time.

In addition to recurrence, people who have had one non-melanoma skin cancer are at high risk of developing a second primary non-melanoma skin cancer elsewhere. For both BCC and SCC, the risk of developing a second primary cancer is greatest in the first year.

It is important for people who have had non-melanoma skin cancer to check their skin regularly for any new spots. They should also reduce their exposure to sun and ultraviolet (UV) radiation to help prevent or delay the development of another non-melanoma skin cancer. Early detection is important because it increases the chances of finding and treating a second primary tumour in its early stages.

Schedule

Follow-up after non-melanoma skin cancer treatment varies by tumour type (BCC or SCC).

Basal cell carcinoma

BCC rarely spreads to other parts of the body. However, it can come back near the treatment site and new tumours can develop elsewhere on the body.

Follow-up visits are usually scheduled:

  • every 6 months for the first 5 years after initial treatment
  • once a year

People with only one tumour and no risk factors, such as basal cell nevus syndrome, may not be offered follow up.

Squamous cell carcinoma

SCC has the potential to spread to other parts of the body, so follow-up is usually done more often and may be scheduled based on tumour characteristics.

For SCC, follow-up is usually scheduled:

  • every 3 months for the first 2–3 years after initial treatment
  • every 6 months

Follow up can vary by centre, depending on the availability of dermatologists.

Procedures

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:

  • examination of the treatment site
  • skin examination of entire body, focusing on areas that are frequently exposed to the sun
  • assessment of the nearby lymph nodes

Imaging tests, such as x-rays, magnetic resonance imaging (MRI) and computed tomography (CT) scans, may be ordered if the doctor suspects the cancer has come back (has recurred).

If a recurrence is found during follow-up, the oncology team will assess the person with cancer to determine the best treatment options.

See a list of questions to ask your doctor about follow-up after treatment.

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