NCCN Guidelines for Patients® | Melanoma - page 60

NCCN Guidelines for Patients
®
Melanoma, Version 1.2014
58
5.2
Treatment guide
In situ and local melanoma
Chart 5.2.3
shows the tests that are recommended
after completing treatment for stage 0, I, or II
melanoma. Follow-up tests are used to monitor you
after treatment to check for signs of recurrence or
metastasis. A recurrence is when cancer comes back
(recurs) after a period of time. Metastasis is when
cancer spreads from the first (primary) tumor to other
sites in the body. The tests and frequency of follow-up
described above are based on the risk of recurrence
for each stage.
Four main follow-up tests are used for all stages
of melanoma.
First, you should have a complete
skin exam by your doctor every year for life. You
should also examine your own skin on a regular
basis. Imaging tests such as a CT, PET/CT, or MRI
scan are only suggested if you have specific signs
or symptoms of cancer that your doctor needs to
check out. An ultrasound of nearby (regional) lymph
nodes may be used for follow-up in certain situations.
One is when the physical lymph node exam findings
are unclear. The second is if you did not undergo
the sentinel lymph node biopsy that was offered.
Stage
Follow-up tests
All stages
• Complete skin exam every year for life,
• Regular self-exam of skin,
• Imaging tests for specific symptoms, and
• Possible regional lymph node ultrasound
Chart 5.2.3 In situ and local melanoma follow-up testing
Stage IA
Stage IB
Stage IIA
• Tests recommended for all stages, and
• Check lymph nodes during skin self-exam,
• Medical history and physical exam with focus on
skin and lymph nodes
-- Every 6 to 12 months for 5 years, then
-- Every year as needed
Stage IIB
Stage IIC
• Tests recommended for all stages, and
• Check lymph nodes during skin self-exam,
• Medical history and physical exam with focus on
skin and lymph nodes
-- Every 3 to 6 months for 2 years, then
-- Every 3 to 12 months for 3 years, then
-- Every year as needed,
• Possible chest x-ray, CT, PET/CT scans every 4 to 12
months to screen for recurrence or metastases, and
• Possible brain MRI each year
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