Melanoma: Follow-Up Care

Approved by the Cancer.Net Editorial Board, 01/2019

ON THIS PAGE: You will read about your medical care after cancer treatment is completed and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with melanoma does not end when active treatment has finished. Your health care team will continue to check that the cancer has not come back, manage any side effects, and monitor your overall health. This is called follow-up care or surveillance and monitoring.

Your follow-up care plan may include regular physical and dermatologic (skin) examinations and/or medical tests to monitor your recovery for the coming months and years. The purpose of monitoring is to look for a recurrence or spread of the disease, as well as a new primary melanoma. The follow-up and surveillance program for a person with a history of melanoma is based on a person’s risk of recurrence, is highly individualized, and can vary from person to person. The most important parts of this surveillance are your medical history and physical exams.

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence, which means that the cancer has come back. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will ask specific questions about your health. Some people may have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors, including the type and stage of cancer originally diagnosed and the types of treatment given.

In general, physical and skin examinations are performed every 3 to 6 months for the first 2 to 3 years and then once a year after that. However, your doctor may recommend a different follow-up schedule. A chest x-ray, CT scan, MRI, and/or PET-CT scan may be recommended if the melanoma has a higher chance of coming back. For people treated for early-stage melanoma, scans are not generally recommended during follow-up care.

The anticipation before having a follow-up test or waiting for test results can add stress to you or a family member. This is sometimes called “scan-xiety.” Learn more about how to cope with this type of stress.

Preventing and detecting second skin cancers

Routine screening with a skin examination for a new melanoma and non-melanoma skin cancer is a necessary part of follow-up care, as is sun protection and sun avoidance. Screening for melanoma and other skin cancers may include mole mapping (photography of the moles) by a doctor or other health care professional. If possible, you should ask your doctor for copies of your photographs and learn how to perform a skin self-examination. There is growing evidence that individuals who are followed using photographs are diagnosed at an earlier stage of melanoma.

Protecting your skin from UV radiation is important to help prevent second skin cancers, either melanoma or non-melanoma skin cancer. Many people who are treated for melanoma lead an active, outdoor lifestyle. It is important to take steps to protect yourself from further skin damage. You can protect against further sun damage by:

  • Participating in outdoor activities before 10:00 AM or after 4:00 PM

  • Wearing long sleeves and pants

  • Using a broad-spectrum sunscreen with an SPF of at least 30. Please remember to reapply sunscreen every 2 hours or, if you are sweating or in the water, every hour.

  • Wearing UV-protective sunglasses

  • Wearing a hat

A major consideration following diagnosis and treatment of melanoma is adjusting a person’s lifestyle to use sun-protective or sun-avoidance measures at all times, as well as avoiding indoor tanning devices. In addition, if a person works in an area where there is high UV exposure, there may be job-related issues to consider. Learn more about protecting your skin from the sun.

Managing long-term and late side effects

Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. Other side effects called late effects may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on the type of cancer, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may have certain physical examinations, scans, or blood tests to help find and manage them.

For an early-stage, thin melanoma, the surgery is most often outpatient surgery with little need for rehabilitation. With a thicker melanoma and possible skin grafts, depending on the location, there may be some need for rehabilitation following treatment. As explained in Coping With Treatment, some patients experience lymphedema or chronic pain. Talk with your health care team about how these can be managed.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help keep track of the cancer treatment you received and develop a survivorship care plan after treatment is completed.

This is also a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their family doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with him or her and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.