Living as a Melanoma Skin Cancer Survivor

For many people with melanoma, treatment can remove or destroy the cancer. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but you might find it hard not to worry about cancer growing or coming back. (When cancer comes back after treatment, it is called recurrent cancer or a recurrence.) This is very common if you’ve had cancer.

For some people, the melanoma may never go away completely. These people may get regular treatments such as immunotherapy, targeted therapy, or chemotherapy to help keep the cancer under control for as long as possible and to help with any symptoms they’re having. Learning to live with cancer that does not go away can be difficult and very stressful. It has its own type of uncertainty.

Follow-up care

Even if you’ve completed treatment, your doctors will still want to watch you closely. Along with the risk of the melanoma coming back, people who have had melanoma have a high risk of developing another one, so it’s very important to keep all follow-up appointments. During these visits, your doctors will ask about any problems you’re having and may do exams and lab tests or imaging tests to look for signs of cancer or treatment side effects.

Some treatment side effects might last a long time or might not even show up until years after you’ve finished treatment. Your doctor visits are a good time to ask questions and talk about any changes or problems you notice or concerns you have.

Doctor visits and tests

How often you need follow-up doctor visits depends on the stage of your melanoma when you were diagnosed, your risk of the melanoma coming back (or getting a new melanoma), and other factors. During your visits, your doctor will pay close attention to any changes in your skin and lymph nodes. In addition to the exams, imaging tests such as ultrasounds or CT scans may be recommended for some people.

A typical follow-up schedule for people with early-stage melanomas that were removed completely might call for physical exams every 6 to 12 months for several years. If these exams are normal, the time between your doctor visits may be extended. Your doctor may recommend more frequent exams if you have many moles or atypical moles.

For thicker melanomas or those that had spread beyond the skin, a typical schedule might include physical exams every 3 to 6 months for several years. After that, exams might be done less often. Imaging tests such as ultrasounds or CT scans might be done as well, especially for people who had more advanced stage disease.

It’s also important for people who’ve had melanoma to do regular self-exams of their skin and lymph nodes. Most doctors recommend this at least monthly. You should see your doctor if you find any new lump or change in your skin.

You should also let your doctor know about any new symptoms (for example, pain, cough, shortness of breath, fatigue, loss of appetite, headaches, or swelling in the abdomen) that don’t go away. Melanoma can sometimes come back in other parts of the body and cause these types of symptoms, even many years after it was first treated.

People with melanoma that doesn’t go away completely with treatment will have a follow-up schedule that is based on their specific situation.

Ask your doctor for a survivorship care plan

Talk with your doctor about developing a survivorship care plan for you. This plan might include:

• A suggested schedule for follow-up exams and tests
• A list of signs or symptoms you might have if the melanoma comes back, including when you should contact your doctor
• A schedule for other tests you might need in the future, such as early detection (screening) tests for other types of cancer, or tests to look for long-term health effects from your cancer or its treatment
• A list of possible late- or long-term side effects from your treatment, including what to watch for and when you should contact your doctor
• Suggestions for things you can do that might improve your health, including possibly lowering your chances of the melanoma coming back or getting a new melanoma

Keeping health insurance and copies of your medical records

Even after treatment, it’s very important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.

At some point after your cancer treatment, you might find yourself seeing a new doctor who doesn’t know about your medical history. It’s important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment. Learn more in Keeping Copies of Important Medical Records.

Can I lower my risk of the melanoma progressing or coming back?

If you have (or have had) melanoma, you probably want to know if there are things you can do that might lower your risk of the cancer coming back, or of getting a new melanoma (or other skin cancer).

At this time, not enough is known about melanoma to say for sure if there are things you can do that will be helpful. We do know that people who have had melanoma are at higher risk for developing another melanoma or other type of skin cancer. Because of this, it’s very important to limit your exposure to UV rays (from the sun or tanning beds) and to continue to examine your skin every month for signs of melanoma coming back or possible new skin cancers. Skin cancers that are found early are typically much easier to treat than those found at a later stage.

Adopting healthy behaviors, such as not smoking, eating well, being active, and staying at a healthy weight, might help as well, but no one knows for sure. However, we do know that these types of changes can have positive effects on your health that can extend beyond your risk of melanoma or other cancers.

About dietary supplements

So far, no dietary supplements (including vitamins, minerals, and herbal products) have been shown to clearly help lower the risk of melanoma progressing or coming back. This doesn’t mean that no supplements will help, but it’s important to know that none have been proven to do so.

Dietary supplements are not regulated like medicines in the United States. They do not have to be proven effective (or even safe) before being sold, although there are limits on what they’re allowed to claim they can do. If you are thinking about taking any type of nutritional supplement, talk to your health care team. They can help you decide which ones you can use safely while avoiding those that might be harmful.

If the cancer comes back

If melanoma does come back at some point, your treatment options will depend on where the cancer is, what treatments you’ve had before, your overall health, and other factors. For more on how recurrent cancer is treated, see Treatment of Melanoma Skin Cancer by Stage. For more general information on dealing with a recurrence, see Understanding Recurrence.

Could I get a second cancer after melanoma treatment?

People who’ve had melanoma can still get other cancers. In fact, melanoma survivors are at higher risk for getting some other types of cancer:

• Another skin cancer, including melanoma (This is different from the first cancer coming back.)
• Salivary gland cancer
• Small intestine cancer
• Breast cancer (in women)
• Prostate cancer
• Kidney cancer
• Thyroid cancer
• Soft tissue cancer
• Non-Hodgkin lymphoma (NHL)

The most common second cancer in survivors of skin melanoma is another skin cancer.

There are steps you can take to lower your risk of getting another cancer and stay as healthy as possible. For example, it’s important to limit your exposure to UV rays, which can increase your risk for many types of skin cancer. It’s also important to stay away from tobacco products. Smoking increases the risk of many cancers.

To help maintain good health, melanoma survivors should also:

• Get to and stay at a healthy weight.
• Keep physically active and limit the time you spend sitting or lying down.
• Follow a healthy eating pattern that includes plenty of fruits, vegetables, and whole grains, and limits or avoids red and processed meats, sugary drinks, and highly processed foods.
• Avoid or limit alcohol. If you do drink, have no more than 1 drink per day for women or 2 per day for men.

These steps may also lower the risk of other health problems.

Melanoma survivors should also follow the American Cancer Society guidelines for the early detection of cancer, such as those for colorectal and lung cancer. Most experts don’t recommend any other specific tests to look for second cancers unless you have symptoms.

Getting emotional support

Some amount of feeling depressed, anxious, or worried is normal when melanoma is a part of your life. Some people are affected more than others. But everyone can benefit from help and support from other people, whether friends and family, religious groups, support groups, professional counselors, or others. Learn more in Life After Cancer.