Melanoma & Other Skin Cancers

Skin Cancer Prognosis and Follow-Up Care

For patients treated for melanoma, follow-up for a second melanoma is critical. The National Comprehensive Cancer Network offers guidelines for follow-up based on the stage of disease (Table 1). In addition to a physical examination that focuses on evaluation of the skin and lymph nodes, follow-up may include blood work and computerized tomography to determine if there are signs of growth or recurrence, especially if signs and symptoms are apparent.

Recurrent melanoma may be treated with surgical excision if it is localized, and treatment in a clinical trial may involve chemotherapy or immunotherapy.

Table 1. Recommendations for Follow-Up after Treatment for Melanoma*

Stage of Melanoma Recommended Follow-up
Stage 0 (in situ)
Skin examination at least annually for the lifetime of the individual
Stage IA
History and physical exam (especially for evaluation of the skin and lymph nodes) every 3-12 mos. for 5 yrs., then annually
Stage IB-III
History and physical exam (especially for evaluation of the skin and lymph nodes) every 3-6 mos. for 2 yrs., then every 3-12 mos. for 2 yrs., then annually Chest x-ray, serum LDH level, CBC, LFT every 3-12 mos. (optional) CT scans to follow-up on specific signs and symptoms

*Recommendations according to guidelines developed by the National Comprehensive Cancer Network.
LDH = lactate dehydrogenase; CBC = complete blood count; LFT = liver function studies; CT = computerized tomography.

 

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