Follow-up after treatment for melanoma
After the melanoma has been removed, your skin cancer specialist will want to see you again.
How many follow-up appointments you have and how often they are will vary depending on the stage of your melanoma. If your melanoma was 1mm thick or less and not ulcerated (stage 1A), it’s likely you’ll have follow-up appointments for 12 months after diagnosis. This is because the risk of a thin melanoma coming back is very small.
UK guidelines recommend that you should be seen two to four times over the 12 months. In these appointments you’ll be shown how to check the scar, the surrounding skin and lymph nodes closest to where the melanoma was. The team will also show you how to check your skin for further melanomas and will give you advice on protecting yourself from the sun. After the 12 months, it’s likely that you’ll be discharged. You’ll be told how to get in touch with the team again if you’re worried that your melanoma has come back or if you notice any new moles that you’re worried about.
People who have melanomas that are ulcerated and/or thicker than 1mm (stage 1B and above) are usually seen every three months for three years. After this, they tend to be seen every six months for two years. Further follow-up once a year after this period may be recommended for some people. If you had a melanoma in situ, the very earliest stage of melanoma, it’s likely that you’ll only be seen once after it’s been removed.
Your doctor or specialist nurse will examine your scar and the surrounding area. They’ll also check the lymph nodes close to the area where the melanoma was removed. If your melanoma was in the:
Leg - The lymph nodes behind your knees and in your groin will be checked.
Chest, back or abdomen - The lymph nodes in your groin, armpits, above the collar bones and in the neck will be checked.
Arm - The lymph nodes around the elbow, above your collar bones and in the lower neck will be checked.
Head or neck area - The lymph nodes in the side of your neck, under the chin, above the collar bones, behind your ears and at the back of your neck will be checked.
Some people may have photographs of their skin taken and some of their moles measured. This is just a way of comparing and keeping a check on any changes that may develop.
Your specialist nurse or doctor will advise you on what to look for and how to examine yourself for any signs of the original melanoma coming back or another melanoma developing. It’s important to do this at least once a month. This is because of the risk of getting another primary melanoma and the small risk of your melanoma coming back. The earlier anything like this is picked up, the more chance there is of curing it.
You’ll be asked to check (by looking and feeling):
your scar and the surrounding area
the lymph nodes nearby
your skin, from head to toe, for any new or changing moles - the ABCDE list will give you an idea of what to look for.
A good time to check your skin is after a bath or shower. Make sure you have plenty of light. Use a full length mirror and a small hand-held mirror for areas that are hard to reach. This will get easier with time, as you become more familiar with your skin and what your moles normally look like. You can ask your partner, a relative or friend to look at your back, neck and parts of your skin that are hard to see.