Melanoma secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Serge Korjian M.D.

Overview

The choice of work-up for secondary prevention of melanoma is based on the stage of melanoma at diagnosis. Secondary prevention includes monthly self-exams, routine dermatologic evaluations, and chest and brain imaging.

Secondary Prevention

Measures for secondary prevention for melanoma depends on the stage of melanoma at diagnosis. To view the stages of melanoma, click here.

  • The National Comprehensive Cancer Network (NCCN) recommends the following:[1]

Stage 0 at Diagnosis

  • Annual dermatologic evaluation for life
  • Patient education regarding monthly self-skin exams

Stage IA at Diagnosis

  • Dermatologic evaluation every 3-12 months for the first 5 years following diagnosis then annually thereafter
  • Patient education regarding monthly self-skin exams
  • Patient education regarding self-lymph node exam

Stage IB-IIA at Diagnosis

  • Dermatologic evaluation every 3-6 months for the first 2 years the every 3-12 months for 3 years, then annually thereafter
  • Patient education regarding monthly self-skin exams
  • Patient education regarding self-lymph node exam
  • Chest x-ray and measurement of CBC and LDH every 6-12 months may be considered (optional)

Stage IIB-IV at Diagnosis

  • Imaging screening by annual brain MRI AND either chest X-ray, positron emission tomography (PET), or CT scan (preferred) every 3-12 months for the first 5 years.
  • Dermatologic evaluation every 3-6 months for the first 2 years the every 3-12 months for 3 years, then annually thereafter
  • Measurement of CBC and LDH every 6-12 months may be considered (optional)
  • Patient education regarding monthly self-skin exams
  • Patient education regarding self-lymph node exam

References

  1. Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A; et al. (2013). "Melanoma, version 2.2013: featured updates to the NCCN guidelines". J Natl Compr Canc Netw. 11 (4): 395–407. PMID 23584343.

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