Follow up after treatment for melanoma skin cancer
After treatment for melanoma skin cancer, you have regular check ups at the hospital. You might also have tests including scans. Over time, these appointments become less frequent.
You have follow up appointments so your doctor can:
- check the melanoma hasn’t come back or spread
- treat any symptoms or side effects you may have
- explain how to to reduce your risk of getting another melanoma
- answer any questions you have
What happens
You might go for check ups at the surgical outpatients after surgery. You go to the cancer clinic if you have had targeted cancer drugs, immunotherapy, chemotherapy or radiotherapy. The surgeon and the 
might share your follow up. This means you see the surgeon sometimes and the medical oncologist other times. You should also be followed up by a dermatologist to check if you develop a further melanoma.
At each appointment your doctor will examine you. And they will ask you about your general health and if anything is worrying you.
Depending on your stage of melanoma your doctor might send you for scans (CT, MRI or ultrasound scan) as part of your follow up.
Contact your doctor or specialist nurse (key worker) if you have any concerns. You should also contact them if you notice any new symptoms between appointments. You don’t have to wait until your next visit.
Many people find their check ups quite worrying. A hospital appointment can bring back any anxiety you had about your cancer. But some people find these appointments reassuring.
It can help to tell someone close to you how you’re feeling. Sharing your worries can mean they don’t seem so overwhelming. Many people find it helpful to have counselling after cancer treatment. Talk to your doctor or nurse to help set this up.
How much follow up you have depends on the stage of your melanoma. Your doctor will also consider your risk of developing a new melanoma.
The National Institute for Health and Care Excellence (NICE) has guidelines recommending how often follow up appointments for melanoma skin cancer are. These are for England, but Wales and Northern Ireland also follow these guidelines.
Melanoma in situ (stage 0)
You normally see your doctor once after you have finished treatment. You do not normally need any scans or other tests. If there are no signs that the melanoma has come back, you won’t need any further follow up appointments.
Stage 1A
You usually have follow up appointments every 6 months for 1 year. You do not normally need any scans.
If there are no signs that the melanoma has come back at the end of the year, your doctor doesn’t normally need to see you again.
Stage 1B and 2A
You normally have follow up appointments:
- every 6 months to start with
- every 1 year afterwards
You may also have some ultrasound scans during the first 3 years.
If there are no signs that the melanoma has come back at the end of 5 years, your doctor doesn’t normally need to see you again.
Stage 2B and 2C
You normally have follow up appointments:
- every 3 months for the first 2 years
- every 6 months in year 3
- every 1 year afterwards
You may also have some ultrasound, CT or MRI scans.
If there are no signs that the melanoma has come back at the end of 5 years, your doctor doesn’t normally need to see you again.
Stage 3 and stage 4
Follow up appointments for stage 3 and 4 melanoma depend on if you can have the melanoma removed. Cancer that can be removed is called resectable. If the cancer cannot be removed it is called an unresectable cancer.
Resectable stage 3 and 4
You usually have follow up appointments:
- every 3 months for the first 3 years
- every 6 months for the next 2 years
You also have CT or MRI scans and you might have some ultrasound scans.
If there are no signs that the melanoma has come back at the end of 5 years, your doctor doesn’t normally need to see you again.
Unresectable stage 3 or 4
How often you have appointments depends on your situation and how well you are. You will see your doctor as often as you need. This is called personalised follow up.
The Scottish Intercollegiate Guidelines Network (SIGN) has guidelines for how often follow up appointments for melanoma skin cancer are.
Melanoma in situ (stage 0)
There are no SIGN guidelines for follow up of stage 0 melanoma skin cancer in Scotland. Ask your doctor if they need to see you again once your treatment has finished.
Stage 1A
You usually have follow up appointments every 3 to 6 months for a year. You do not normally need any scans or other tests.
If there are no signs that the melanoma has come back at the end of the year, your doctor doesn’t normally need to see you again.
Stage 1B and 2A
You usually have follow up appointments:
- every 3 to 4 months for the first 3 years
- every 6 months for the next 2 years
You do not normally need any scans.
If there are no signs that the melanoma has come back at the end of 5 years, your doctor doesn’t normally need to see you again.
Stage 2B and 2C
You normally have follow up appointments:
- every 3 to 4 months for the first 3 years
- every 6 months for the next 2 years
- every 1 year afterwards
You normally have some CT or MRI scans during the first 5 years.
If there are no signs that the melanoma has come back at the end of 10 years, your doctor doesn’t normally need to see you again.
Stage 3 and stage 4
Follow up appointments for stage 3 and 4 melanoma depends on if you can have the melanoma removed. Cancer that can be removed is called resectable. If the cancer cannot be removed it is called an unresectable cancer.
Resectable stage 3 and 4
You usually have follow up appointments:
- every 3 to 4 months to start with
- every 6 months afterwards
You also normally have CT or MRI scans during the first 5 years.
If you only had a small amount of melanoma in one , and there are no signs that the melanoma has come back at the end of 5 years, your doctor doesn’t normally need to see you again.
If you had a larger amount of melanoma in one lymph node or satellite or in-transit metastases, your doctor usually continues to see you once a year. If there are no signs the melanoma has come back at the end of 10 years, your doctor doesn’t normally need to see you again.
Unresectable stage 3 or 4
How often you have appointments depends on your situation and how well you are. You will see your doctor as often as you need. This is called personalised follow up.
You usually need check ups:
- every 3 months for 3 years
- every 6 months for 2 more years
Your doctor might discharge you 5 years after you complete your treatment. Or you might continue with yearly follow up appointments.
You might have blood tests to check your general health. If you have any symptoms or are worried about anything in particular, you might have a scan.
If you have stage 2C melanoma and did not have a sentinel node biopsy, or you have stage 3 melanoma, your doctor might offer you extra CT scans or MRI scans. You have these at regular intervals for a set period of time. It is called surveillance imaging. The doctors are looking to see if the melanoma has come back. Your doctor will talk to you about the advantages and disadvantages of surveillance imaging.
You have regular check ups with your specialist. The appointments may be every three months, or even more often than that. How often you see your doctor will depend on how well you are and whether you are having treatment. Of course, you can contact your specialist at any time if you need an extra appointment because you are worried about something or if you feel ill.
This page is due for review. We will update this as soon as possible.
