Moving on after treatment for melanoma skin cancer

For many people with melanoma, treatment may remove or destroy the cancer. Finishing treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer growing or coming back. (When cancer comes back after treatment, it is called a recurrence.) This is a very common concern in people who have had cancer.

It may take a while before your fears lessen. But it may help to know that many cancer survivors have learned to live with this uncertainty and are leading full lives. Our document called Living With Uncertainty: The Fear of Cancer Recurrence gives more detailed information on this.

For others, the melanoma may never go away completely. These people may get regular treatment with immunotherapy, targeted therapy, chemotherapy, or other treatments to try to help keep the cancer in check. Learning to live with cancer that does not go away can be difficult and very stressful. It has its own type of uncertainty.

Follow-up care

If you have completed treatment, your doctors will still want to watch you closely. Follow-up is needed to watch for treatment side effects and to check for cancer that has come back or spread. This is a good time for you to ask your health care team any questions you need answered and to discuss any concerns you might have.

Your follow-up should include regular skin and lymph node exams by yourself and by your doctor. How often you need follow-up visits depends on the stage of your melanoma when you were diagnosed and other factors.

The typical follow-up schedule for early stage melanomas includes physical exams every 3 to 12 months for many years. If these exams are normal, you can then get check-ups once a year. Your doctor may want to see you more often if you have many moles or moles that are not quite normal.

For thicker melanomas, or those that had spread beyond the skin, the schedule might include physical exams every 3 to 6 months for 2 years, then every 3 to 12 months for the next few years. After that, exams are done at least once a year. Some doctors also do chest x-rays or other tests every 6 to 12 months, especially for people who had more advanced stage disease.

It is important for melanoma skin cancer survivors to do regular self-exams of their skin. You should see your doctor if you find any new lump or change in your skin. You should also tell your doctor about any new symptoms that do not go away (for instance, pain, cough, tiredness, loss of appetite). Melanoma can come back many years after it was first treated.

A person who has had one melanoma may still be at risk for having another melanoma or a non-melanoma type of skin cancer. People cured of one melanoma should closely look at their skin every month and avoid too much sun.

If melanoma does come back, treatment will depend on where the cancer is, what treatments you’ve had before, and your overall health. For more information on how recurrent cancer is treated, see our document Melanoma Skin Cancer. For more details on dealing with a recurrence in general you may also want to see our document called When Your Cancer Comes Back: Cancer Recurrence.

Seeing a new doctor

At some point after your cancer is found and treated, you may find yourself in the office of a new doctor. It is important that you be able to give your new doctor the exact details of your diagnosis and treatment. Make sure you have this information handy and always keep copies for yourself:

• A copy of your pathology report from any biopsy or surgery
• Copies of imaging tests (CT or MRI scans, etc.), which can usually be stored on a CD, DVD, etc.
• If you had surgery, a copy of your operative report
• If you stayed in the hospital, a copy of the discharge summary that the doctor wrote when you were sent home
• If you had radiation treatment, a summary of the type and dose of radiation and when and where it was given
• If you had chemotherapy, targeted therapy, or immunotherapy, a list of your drugs, drug doses, and when you took them
• Contact information for doctors who have treated you and are familiar with your case

It is also important to keep health insurance. While you hope your cancer won’t come back, it could happen. If it does, you don’t want to have to worry about paying for treatment.