Metastatic Melanoma Follow-Up Care Is Important

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When you have completed treatment for metastatic melanoma, it is important for you to plan your follow-up care. Your doctor will work with you to determine what type of care you should continue to have and how often you will need to see your doctors. Follow-up care should be tailored to each person; however, there are some guidelines you can follow. Talk to your doctor about what your survivorship care plan should include.


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Risk of melanoma recurrence

People who have had melanoma before, even when it's been cured, have a high risk of getting it again. You may see a recurrence up to 10 years after your initial treatment. Follow-up care, therefore, is very important in identifying and treating any recurrences before they spread to other areas of your body.


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Regular skin checks

Everyone with metastatic melanoma should have regular skin and lymph node exams. People with melanoma spreading beyond the skin should get a physical exam every three to six months for the first two years after treatment, then every three to 12 months for the third, fourth, and fifth years. An annual exam is recommended for the sixth year after treatment and beyond.


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Routine imaging

In addition to skin exams, guidelines advise that you get routine imaging, including chest x-ray, computed tomography (CT), and/or positron emission tomography (PET) every three to 12 months. In addition, a brain MRI on an annual basis may be helpful.


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Self-examination

While regular visits to your dermatologist or oncologist should become part of your routine, self-examination is just as important. The Skin Cancer Foundation recommends you complete a head-to-toe examination once a month to note any new or changing spots or lesions.


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Screening for other cancers

Survivors of melanoma have a higher risk of developing other types of cancer. These include another skin cancer, breast cancer, non-Hodgkin's lymphoma, and cancers of the prostate, kidney, thyroid, small intestine, salivary gland, or soft tissue. Talk to your doctor about how often you should be screened for other types of cancer. Some doctors don't recommend it unless you have symptoms.


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Long-term side effects

Some treatments, including the immunotherapy medication ipilimumab (Yervoy), can cause side effects even after you have completed treatment. These can include problems with skin, hormonal glands, colitis, and hepatitis. If you have received immunotherapy for metastatic melanoma, be sure to discuss possible late or long-term side effects with your doctor, and how your follow-up care will address them.


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Prevention through diet

Although there is some debate on whether diet can reduce your risk of cancer, one study found that a some foods may have an anticancer effect toward melanoma. These include grape seed extract; green tea; herbs such as rosemary, oregano, basil, and marjoram; tomatoes and other red fruits; and figs.


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Adopt a healthy lifestyle

While the jury is still out on whether a healthy lifestyle can help prevent further cancers, it is known that eating right, exercising regularly, maintaining a healthy weight, and not smoking are important to health and improve your overall well-being.


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Continue with sun protection

Because people with melanoma are more likely to develop another skin cancer, including additional melanomas, it is important to maintain UV protection measures. Limit your exposure to UV rays, use sunscreen, and wear protective clothing including wide-brimmed hats and sunglasses.