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Skin Cancer

What to Expect After Treatment is Completed 

Once you have made it through treatment, you need to have close follow-up with your doctorFollow-up plans are specific to the type of skin cancer you had: 

Follow-up for BCC of the skin 

  • Visit your doctor on a regular schedule (or earlier if you have any concerning symptoms) for a complete skin examination every six to twelve months for life. 
  • Make sure you use good sun protection and examine your own skin. 

Follow-up for SCC of skin 

  • If the cancer had not spread to any lymph nodes or anywhere else: 
  • Visit your H&N doctor on a regular schedule (or earlier if you have any concerning symptoms): 
  • Every three to twelve months for two years 
  • Then every six to twelve months for three years 
  • Then once per year for life 
  • Make sure you use good sun protection and examine your own skin. 
  • If the cancer had spread to any lymph nodes or anywhere else: 
  • Visit your H&N doctor on a regular schedule (or earlier if you have any concerning symptoms): 
  • Every one to three months for one year 
  • Then every two to four months for one year 
  • Then every four to six months for three years 
  • Then every six to twelve months for life 
  • Make sure you use good sun protection and examine your own skin. 

Follow-up for malignant melanoma of the skin 

  • Have a doctor’s evaluation every six to twelve months for five years, then annual visits. 
  • Visit a dermatologist for an annual skin exam. 
  • Learn how to do your own monthly skin exam and lymph node exam. 

In addition, for Stage IIB to IV malignant melanoma, you should: 

  • Have a doctor’s evaluation every three to six months for two years, then every three to twelve months for three years, then annual visits. 
  • Consider a chest X-ray, CT, PET/CT or brain MRI every four to twelve months to check for recurrent disease and spread to another site for up to five years. 

Follow-up for Merkel Cell Carcinoma 

  • Visit your cancer specialist on a regular schedule (or earlier if you have any concerning symptoms): 
  • Every three to six months for two years 
  • Then every six to twelve months for life 
  • Get imaging studies based on any suspicious findings by your doctor. This may include chest X-rays, CT scans, MRIs or PET scans. 
References

1 Miller DL, Weinstock MA. Nonmelanoma skin cancer in the United State: Incidence. J Am Academy of Dermatology. 1994;30:774.

2 American Cancer Society. Cancer Facts & Figures 2012. Atlanta: American Cancer Society; 2012.

3 Albores-Saavedra J, Batich K, Chable-Montero F, Sagy N, Schwartz AM, Henson DE. Merkel cell carcinoma demographics, morphology, and survival based on 3870 cases: a population based study. J Cutan Pathol. 2010:37:20-27.

4 LeBoit PE, Burg G, Weedon D, Sarasain A. (Eds.): World Health Organization. Classification of Tumours. Pathology and Genetics of Skin Tumours. IARC Press: Lyon 2006.

5 Rubin AI, Chen EH, Ratner D. Basal Cell Carcinoma. N Engl J Med. 2005;353:2262-2269.

6 Walling HW, Fosko SW, Geraminejad PA, Whitaker DC, Arpey CJ. Aggressive basal cell carcinoma: Presentation, pathogenesis, and management. Cancer and Metastasis Reviews. 2004;23(3-4):389-402.

7 Hollestein LM, de Vries E, Nijsten T. Trends of cutaneous squamous cell carcinoma in the Netherlands: Increased incidence rates, but stable relative survival and mortality 1989-2008. European Journal of Cancer. 2012;48(13):2046-2053.

8 Lardar T, Shea SM, Sharfman W, Liegeois N, Sober AJ. Improvements in the Staging of Cutaneous Squamous-Cell Carcinoma in the 7th Edition of the AJCC Cancer Staging Manual. Annals of Surgical Oncology. 2010;17(8):1979-1980.

9 Cockburn M, Peng D, Key C. Chapter 12: Melanoma. Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.

10 Edge SB, et al. The AJCC Cancer Staging Manual – Seventh Edition. American Joint Committee on Cancer 2010. Chapter 31: Melanoma of the Skin. P329.

11 Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Altekruse SF, Kosary CL, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations), National Cancer Institute. Bethesda, MD.

12 Agelli M, Clegg LX. Epidemiology of primary Merkel cell carcinoma in the United States. J Am Acad Dermatol. 2003;49:832-41.

13 Engels EA, Frisch M, Goedert JJ, Biggar RJ, Miller RW. Merkel cell carcinoma and HIV infection. The Lancet. 2002;359(9305):497-498.

14 Buell JF, Trofe J, Hanaway MJ, et al. Immunosuppresion and Merkel cell cancer. Transplant Proc. 2002;34(5):1780-1.

15 Penn I, First MR. Merkel cell carcinoma in organ recipients: report of 41 cases. Transplantation. 1999;68(11):1717-21.

16 Young JL, Ward, KC, Ries LAG. Chapter 30: Cancers of Rare Sites. Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.

17 Albores-Saavedra J, Batich K, Chable-Montero F, Sagy N, Schwartz AM, Henson DE. Merkel cell carcinoma demographics, morphology, and survival based on 3870 cases: a population based study. J Cutan Pathol. 2010:37:20.

18 Wang TS, Byrne PJ, Jacobs LK, Taube JM. Merkel Cell Carcinoma: Update and Review. 2011 Seminars in Cutaneous Medicine and Surgery: 30(1):48-56.

19 Robinson JK. Follow-up and prevention (basal cell carcinoma). In: Miller SJ, Maloney ME, eds. Cutaneous Oncology Pathophysiology, diagnosis, and management. Malden, MA: Blackwell Science; 1998:695-698.

20 Shin DM, Maloney ME, Lippman SM. Follow-up and prevention (squamous cell carcinoma). In: Miller SJ, Maloney ME, eds. Cutaneous Oncology Pathophysiology, diagnosis, and management. Malden, MA: Blackwell Science; 1998.

21 Romano E, Scordo M, Dusza SW, et al. Site and timing of first relapse in stage III melanoma patients: implications for follow-up guidelines. J Clin Oncol 2010;28:3042-3047.

22 Dicker TJ. Kavanagh GM, Herd RM, et al. A rational approach to melanoma follow-up in patients with primary cutaneous melanoma. Scottish Melanoma Group. Br J Dermatol 1999;140:249-254.

23 Johnson TM,Bradford CR,Gruber SB,Sondak VK,Schwartz JL. Staging workup, sentinel node biopsy, and follow‐up tests for melanoma: update of current concepts. Arch Dermatol. 2004; 140: 107–113.

24 Veronesi U, Cascinelli N. Narrow excision (1-cm margin). A safe procedure for thin cutaneous melanoma. Arch Surg 1991;126:438-441.

25 Balch CM, Urist MM, Karakousis CP, et al. Efficacy of 2-cm surgical margins for intermediate-thickness melanomas (1 to 4 mm). Results of a multi-institutional randomized surgical trial. Ann Surg 1993;218:262-267; discussion 267-269.

26 Haigh PI, DiFronzo LA, McCready DR. Optimal excision margins for primary cutaneous melanoma: a systematic review and meta-analysis. Can J Surg 2003;43:419-426.

27 Kuijpers DI, Thissen MR, Berretty PJ, et al. Surgical excision versus curettage plus cryosurgery in the treatment of basal cell carcinoma. Dermatol Surg 2007;33:579-587.

28 O’Connor WJ, Roenigk RK, Brodland DG. Merkel cell carcinoma. Comparison of Mohs micrographic surgery and wide excision in eighty-six patients. Dermatol Surg 1997;23:929-933.

29 Asgari MM, Moffet HH, Ray GT, Quesenberry CP. Trends in basal cell carcinoma incidence and identification of high-risk subgroups, 1998-2012. JAMA Dermatol 2015; 151:976-981.

30 Walther U, Kron M, Sander S, et al. Risk and protective factors for sporadic basal cell carcinoma: results of a two-centre case-control study in southern Germany. Clinic actinic elastosis may be a protective factor. Br J Dermatol 2004;151:170-178.

31 Marrazzo G, Thorpe R, Condie D, et al. Clinical and Pathologic Factors Predictive of Positive Radiologic Findings in High-Risk Cutaneous Squamous Cell Carcinoma.

32 Gupta SG, Wang LC, Penas PF, et al. Sentinel lymph node biopsy for evaluation and treatment of patients with Merkel cell carcinoma: The Dana-Farber experience and meta-analysis of the literature. Arch Dermatol 2006;142:685-690.

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