NCCN Guidelines for Patients® | Melanoma - page 80

NCCN Guidelines for Patients
®
Melanoma, Version 1.2014
78
5.5
Treatment guide
Metastatic melanoma
Chart 5.5.3
shows the follow-up tests that are
recommended after completing treatment for
metastatic melanoma. Follow-up tests are used to
monitor you after treatment to check for cancer return
(recurrence) or spread (metastasis). These tests are
important if you were treated for stage IV melanoma
and have no current signs of cancer.
A complete skin exam by your doctor is
recommended every year for life. In addition, you
should also 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 if specific signs
or symptoms of cancer appear. 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. (Read Part 2 on page 16 for more test
details.)
Stage
Follow-up tests
Stage IV
• 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 5.5.3 Metastatic melanoma follow-up testing
1...,70,71,72,73,74,75,76,77,78,79 81,82,83,84,85,86,87,88,89,90,...108
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