Follow-up after melanoma treatment
Follow-up aims to detect recurrence, a new primary melanoma and treatment-related problems at an appropriate time. The schedule is not identical for everyone and depends on stage, risk and previous treatment.
Surveillance is more than scans
Skin
The scar, the whole skin surface, and new or changing lesions.
Lymph nodes
Clinical assessment of regional nodal basins; ultrasound in selected situations.
Imaging
CT, PET-CT or MRI according to stage, risk and a defined clinical purpose.
Treatment effects
Persistent or delayed effects of surgery, immunotherapy, targeted therapy or radiotherapy.
Why there is no single universal calendar
ESMO notes that there is no single agreed optimal schedule for visits, blood tests or imaging after resected melanoma. Follow-up should be tailored to disease stage, individual risk, previous treatment, available resources and the patient’s needs.
Intensity follows risk
Higher-risk disease can justify more intensive surveillance, particularly during the earlier years. The exact interval should be written into your own follow-up plan rather than reconstructed from a generic online schedule.
Self-checks between visits
What to examine
- your skin and surgical scar;
- new or changing pigmented lesions;
- regional lymph-node areas within the agreed follow-up plan.
What to remember
- avoid sunburn;
- use appropriate sun protection;
- do not wait for a scheduled visit if a new persistent symptom appears.
European guidance recommends lifelong regular self-examination of the skin and peripheral lymph nodes.
When not to wait for the next scheduled visit
A new lump or swelling
A new lump, swelling or persistent change in a regional nodal area is a reason to contact the treatment team earlier.
A skin or scar change
A new lesion, pigment change, ulceration or another persistent change in or near the scar should be assessed.
A persistent unexplained symptom
A symptom that does not settle or is progressing is better discussed with the treatment team rather than held until the next planned date.
After immunotherapy
Possible immune-related adverse effects should be reported even after treatment has ended if new symptoms appear.
What should be written in a follow-up plan
- the melanoma stage and key risk factors;
- who is responsible for clinical and dermatological review;
- whether lymph-node ultrasound is needed;
- whether CT/PET-CT/MRI is planned and why;
- monitoring for systemic-treatment toxicity;
- who to contact between scheduled visits.
Follow-up is not only about recurrence
People who have had melanoma are at increased risk of another primary melanoma, so long-term dermatological surveillance remains important after the main oncology treatment has finished. Oncologists, dermatologists and other specialists may all contribute according to individual needs.
Reviewed sources
This is a general framework for follow-up. The frequency of visits and tests should be individualised according to stage, treatment and clinical risk.