Surviving melanoma

Author: Vanessa Ngan, Staff Writer; Copy Editor: Clare Morrison; Chief Editor: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, October 2013. About Melanoma is sponsored by the New Zealand Dermatological Society Incorporated.


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The next steps

You’ve been diagnosed with melanoma, you’ve had it surgically cut out, and you might have received some other treatment along the way. Your doctor has given you the “all clear” – so what more do you need to know?

Chances are, especially if your melanoma was caught in the early stages, you may never get another melanoma.

Recurrent melanoma

A melanoma coming back after it has been treated is called a recurrence. The chance or risk that melanoma will recur after treatment of the first melanoma is grouped into the following categories:

  • Low risk – less than 20% risk of recurrence
  • Intermediate risk – 20–50% risk of recurrence
  • High risk – greater than 50% risk of recurrence.

The risk of recurrence depends on what your first (primary) melanoma was like. The risk increases if your first melanoma was:

  • A thick tumour
  • Ulcerated (open sore that bleeds easily and crusts over)
  • Surrounded by other small melanomas (satellite metastases).

Another primary melanoma

Your chances of getting a second primary melanoma on your skin are now several times higher than someone who’s never had one. This is because of your genetic make-up, the amount of sun damage you've received, and the way your immune system has responded.

As well as melanoma, you are also at a higher risk of other types of skin cancer when compared to people that have never had melanoma.

What will happen at my follow-up appointments?

The main purpose of follow-up visits is to detect recurrences early and also to detect any new primary melanoma at the first possible opportunity.

After receiving treatment for your first melanoma, you will get a follow-up plan written specifically for your needs. Follow-up visits are generally based on what stage your first melanoma was:

  • Stage I melanoma – follow-up visit every year for the next 10 years
  • Stage II melanoma – depending on the severity of melanoma in this stage, follow-up every 4–6 months for 2–3 years and then once every year up to 10 years
  • Stage III melanoma – every 3 months in the first year, every 4 months in second year, every 6 months until year 5, and then once a year until year 10
  • Stage IV melanoma – as for Stage III but with additional visits as required

Self skin-checks are a vital part of follow-ups and you should make sure you do them at least once a month.

Your follow-up visits may be with your family doctor or specialist, or may be shared between them. At these visits your doctor may:

  • Ask you some questions about your skin and general health
  • Check the scar where your first melanoma was removed
  • Feel your lymph nodes
  • Do a full general and skin examination

If you develop any symptoms to suggest your melanoma may have come back, follow-up may also include blood tests and radiographic imaging, including x-ray, CT, MRI and/or PET scan.

 

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Related information

 

On DermNet NZ

Melanoma follow-up video (Debra Yeh).

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Skin cancer

App to facilitate skin self-examination and early detectionRead more.

Text: Miiskin