NCCN Guidelines for Patients® | Melanoma - page 66

NCCN Guidelines for Patients
Melanoma, Version 1.2014
Treatment guide
Regional melanoma
Chart 5.3.3
shows the follow-up tests that are
recommended after completing primary or adjuvant
treatment for stage III regional melanoma. Follow-
up tests are used to monitor you after treatment
and 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. Your doctor may suggest more or less frequent
follow-up testing based on your risk for recurrence.
A complete skin exam by your doctor is
recommended every year for life. In addition, you
should examine your own skin and lymph nodes on a
regular basis. You should also have regular medical
history check-ups and physical exams. During the
physical exam, your doctor will carefully examine
your lymph nodes and skin. The chart above lists the
recommended exam schedule.
An ultrasound of nearby (regional) lymph nodes
may be used for follow-up in certain situations. One
situation is when the physical lymph node exam
findings are unclear. The second situation is if you
did not undergo the sentinel lymph node biopsy that
was offered. The third situation is if you did not have
a complete lymph node dissection after the sentinel
lymph node biopsy found cancer.
Imaging tests are recommended to check out specific
signs or symptoms of cancer. You may also have
imaging tests to screen for cancer recurrence or
metastases. Screening means testing to detect
a disease when there are no signs or symptoms
present. You may have imaging tests for screening
every 4 to 12 months and a brain MRI every
year. These tests may be done for up to 5 years
after treatment has ended. Imaging tests are not
recommended after 5 years if there has been no
recurrence and you don’t have any symptoms.
Routine blood tests to check for recurrence are not
recommended. (See Part 2 on page 16 for more test
If follow-up tests show that the cancer has come back
(recurred), treatment options will depend on the type
Follow-up tests
Stage III
• Complete skin exam every year for life,
• Regular self-exam of skin and lymph nodes,
• 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 regional lymph node ultrasound,
• Imaging tests for specific symptoms,
• 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
Chart 5.3.3 Regional melanoma follow-up testing
1...,56,57,58,59,60,61,62,63,64,65 67,68,69,70,71,72,73,74,75,76,...108
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