Follow-up care after treatment

Follow-up care for everyone

After your treatment for melanoma you should be offered the follow‑up care described below, as a minimum. If you have a higher than average risk of developing another melanoma (for example because there is a history of melanoma in your family or because you have many moles), you may be offered extra check‑ups.

If you've had stage 0 melanoma you should be discharged after your treatment is finished.

If you've had stage 1A melanoma you may be offered between 2 and 4 check‑ups during the first year after you finish treatment. You may be discharged at the end of that year.

If you've had stage 1B, stage 2 or stage 3 melanoma you may be offered follow‑up care for 5 years after you finish treatment. You would have check‑ups every 3 months for the first 3 years, then every 6 months for the next 2 years.

If you've had stage 2C or stage 3 melanoma you may also be offered CT or MRI scans at regular intervals for a set period of time (known as surveillance imaging). See regular follow-up scans after stage 2C or stage 3 melanoma for more information.

If you've had stage 4 melanoma you should be offered a personalised plan for your follow‑up care.

At every check-up

You should have a full examination of your skin and the lymph nodes nearest to the melanoma. You and your family or carers should also be offered support with problems related to your melanoma, such as physical side effects from treatment, anxiety and worry about the melanoma or practical problems with work, school or finances.

You should be reminded about:

  • how to check your skin for melanoma

  • how to avoid risk factors for poor health, such as skin damage from the sun and smoking (see other NICE guidance for details of our guidance on smoking cessation)

  • how to make sure you get enough vitamin D.

Regular follow-up scans after stage 2C or stage 3 melanoma

If you've had stage 2C or stage 3 melanoma you may be offered CT or MRI scans at regular intervals for a period of time. This is called surveillance imaging. You may be offered this as part of a clinical trial. Your care team should discuss the possible advantages and disadvantages of regular follow‑up scans with you. These are shown in the table below.

Possible advantages of having regular follow‑up scans (surveillance imaging)

Possible disadvantages of having regular follow-up scans

If the melanoma comes back (known as recurrent melanoma), it's more likely to be detected sooner. It is possible that this could lead to a better outcome by allowing treatment with drugs (such as immunotherapy drugs) to start earlier.

Although early drug treatment of recurrent melanoma might improve the outcome, there is currently no evidence to show this.

You might find it reassuring to have regular scans.

You might find that having regular scans makes you anxious.

Sometimes a scan will show an abnormality that turns out to be harmless. This can mean that you will have unnecessary tests, and will become more anxious.

Regular scans can put you at risk of other problems, for example:

  • They expose the body to radiation, which can increase the risk of cancer in the future.

  • Scans of the brain and neck increase the risk of developing cataracts.

  • Scans of the chest cause a very small increase in the risk of thyroid cancer.

NICE has also produced a decision aid (called an 'option grid') to help you discuss with your healthcare professional whether to have follow-up with regular CT scans.

Questions you might like to ask your care team

  • Where will I have my check‑ups?

  • Will my GP be involved?

  • How long will I have check‑ups for?

  • How often should I check my skin for melanoma? What signs should I look for?

  • What should I do if I get signs of melanoma between check‑ups?

  • How likely is it that I'll get melanoma again?

  • What can I do to avoid getting melanoma again?

  • Do I need to keep taking vitamin D supplements?

  • Do I need to avoid the sun completely from now on?

  • If I decide to stop smoking, is there any support I can have?

  • My melanoma was stage 2C/stage 3. Will I be offered regular follow‑up scans?

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