NCCN Guidelines for Patients® | Melanoma - page 71

NCCN Guidelines for Patients
: Melanoma
Version 1.2013
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Part 6: A step-by-step treatment guide
Clinical trial:
on a test or treatment to
assess its safety or how
well it works
Lymph nodes:
Groups of
special disease-fighting
cells throughout the body
formed by cancer cells that
spread from the first tumor
to other parts of the body
Supportive care:
Treatment for symptoms of
a disease
Systemic therapy:
used to treat cancer cells
throughout the body
Visceral organs:
tissue internal organs such
as the intestines that digest
See page 16 for test
details and page 34
for treatment details.
Part 6.5.3 describes the follow-up tests that are recommended after completing
treatment for metastatic melanoma. Follow-up tests are used to check for cancer
return (recurrence) or spread. These tests are important for treated stage IV
melanoma with no current signs of cancer.
A complete skin exam by your doctor is recommended every year for life. You
should also examine your own skin and lymph nodes once a month. 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.
Imaging tests are recommended if specific signs of cancer appear. You may also
receive imaging tests to check (screen) for cancer recurrence that isn’t causing
symptoms. Possible imaging tests for screening include a chest x-ray, CT scan,
and PET/CT scan every 3 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.
6.5.3 Follow-up testing
Follow-up tests
Stage IV
• Complete skin exam every year for life,
• Monthly self-exam of skin and lymph nodes,
• Imaging tests for specific symptoms, and
• Medical history and physical exam
- Every 3 to 6 months for 2 years, then
- Every 3 to 12 months for 3 years, then
- Every year as needed,
• Possible imaging tests every 3 to 12 months to screen for
recurrence, and
• Possible brain MRI each year
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