Follow-up of melanoma patients in 2020

The follow-up of the patient after having had a melanoma is fundamental. Depending on the risk staging of the cancer, it will be decided to do a specific follow-up or another. In the following talk I discussed how to follow up patients with melanoma in the context of the new adjuvant drugs and systemic treatments that exist in the year 2020. I also discussed which techniques may improve staging and follow-up in the future.

Below is the video of the presentation that is developed for melanoma care specialists. If you are a patient I recommend you to read: What are malignant tumors? and also How to detect skin cancer early?. I will also leave a couple of tips for patients after the video to learn more about follow-up care.

Follow-up after having been treated for melanoma

Follow-up after melanoma treatment is an important part of cancer care. The follow-up will be individualized in each patient depending on the stage of risk that each patient has. Follow-up is usually and should be performed by multidisciplinary teams, such as the dermatologist, the surgeon and oncologist, and the primary care physician.

Scheduling of follow-up visits

Follow-up visits for melanoma skin cancer are generally scheduled every 3 to 12 months depending on the stage and risk of the melanoma. If you were treated at an advanced stage of melanoma or have a high risk of recurrence, follow-up will generally occur more frequently during the first 2 to 3 years and may include imaging studies and tumor markers.

Patient self-examination

A fundamental part of the follow-up of the patient with melanoma is self-exploration. Many melanoma relapses occur near the scar or on the skin around where you had melanoma. Don't wait until your next scheduled appointment to report any signs or symptoms that are new or don't go away. Tell your health care team if you have noticed any of the following symptoms:

  • Any new bumps, moles or abnormal pigmented areas on your skin
  • Increased pain
  • New onset cough that does not go away

Visit with the Dermatologist

The likelihood of melanoma skin cancer returning is greatest during the first 5 years, so close follow-up is needed during this time. However, melanoma can recur at any time, so long-term follow-up is also important. Dermatologists usually suggest that people with a history of skin cancer have a skin exam at least once a year for the rest of their lives.

During follow-up visits

During a follow-up visit, we will ask you questions about the side effects of treatment and how you are coping. We will also ask you about any new signs or symptoms that concern you. At each visit we will always perform a complete physical exam, including an examination of all skin, to verify:

  • The site where the cancer was removed or treated
  • Complete skin examination with dermoscopy of the rest of the body, especially the areas that are exposed to the sun.
  • Palpation of the lymph nodes in the drainage area of the melanoma.

Will you need imaging studies during melanoma follow-up?

In patients at higher risk it is essential to perform imaging tests and tumor markers in the blood to try to make an early detection of a recurrence in case it occurs. Among the images we usually order are a CT scan or an MRI, to check if the cancer has spread to other parts of the body.

melanoma follow-up

If the cancer has returned (recurrence), we will always discuss in a multidisciplinary committee, and in conjunction with the patient, a plan for treatment and care.

Questions to ask about melanoma follow up

To make the right decisions always ask your health care team all the questions about follow-up care. You can also look for more information on melanoma at the Spanish association against cancer (AECC)

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Sebastian Podlipnik - Skin cancer

Sebastian Podlipnik

Dermatology Blog

I am a dermatologist and cum laude MD and author of multiple research studies. I specialize in skin cancer, laser technologies and cosmetic dermatology. The intention of this blog is to bring you closer to topics of interest in dermatology and research.

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