Monitoring

Many patients who have had a melanoma removed from the skin have a very good prognosis, with only a small chance that the melanoma might return. But even those with the thinnest melanomas with the best prognoses still face some chance of recurrence. It is good policy to get close monitoring for recurrence, since early detection can often lead to more successful treatment. In addition, there is always some chance that you might develop a brand new melanoma in some other area of the skin (unrelated to the first one.

We usually recommend regularly systemic follow-up to help detect any spread of the melanoma over time to nearby lymph nodes or to other parts of the body. This systemic follow-up can be provided by your medical oncologist, or alternatively by your family physician. A common systemic follow-up schedule that we recommend includes a check-up about every 6 months for 5 years (which is the highest risk period for melanoma to come back). A check-up usually includes:

• taking a medical history (asking you about symptoms)
• a physical exam (focused on your lymph nodes, lungs, abdomen, and skin site near where the melanoma was located
• a blood test (checking for anemia, liver and bone enzymes, and a melanoma marker called LDH)
• sometimes a chest x-ray (to detect any spread to the lungs)
• sometimes a high resolution MRI scan (which can detect a small amount of cancer spread to lymph nodes). Dr. Peter Brett and Dr. David Feinberg in the North Bay Melanoma Program are currently running a clinical trial comparing the results obtained by MRI to those obtained at lymph node biopsy or by physical exam.

We always recommend regular skin follow-up to help detect any new melanoma you might develop in the skin in a different area from the original melanoma. Even if you are cured of your first melanoma, there will be some increased risk of developing one or more new melanomas in some other area of the skin over the years. A new melanoma in the skin would not be considered a recurrence, and would often have a good chance of cure if detected early. Skin follow-up can be provided by your dermatologist, or alternatively by your family physician. A common skin follow-up schedule that we recommend includes a total body skin exam every 6 months to a year for the rest of your life.