Regular check-ups after surgery for melanoma
Following your surgery, you will need to have regular check-ups.
As well as a physical examination of your skin, an important part of your regular check-ups will be an examination of the lymph nodes near where your melanoma was removed. This is because, even after surgery, there is a small chance that your melanoma will return. This is known as recurrence.
Your doctor will decide how often you will need check-ups based on the stage of your melanoma. The check-ups will gradually become less frequent if you have no further problems. Ongoing check-ups may be recommended for life.
It is important that you be shown how to check your own skin and that you do it regularly.
Do the check
Look over your entire body regularly. Skin cancers can be in places you cannot see yourself, so you may need to ask someone to help you check.
Remember to check places that are hard to see or might not normally get exposed to the sun, such as:
• behind your ears
• the bottom of your feet
• your fingernails and toenails.
If you do not have someone who can check these awkward places for you, try using a hand mirror.
It is a good idea to keep track of how spots and moles look, so you know if they have changed since you last checked your skin.
If you notice any changes in your skin or in your general health, contact your GP.
Once you have been diagnosed with melanoma, you are at a higher risk than the average person of developing a new melanoma.
Identifying family/whānau at risk of melanoma
It may be helpful for all immediate family/whānau members (parent, brother, sister, or child) to have full skin checks as immediate family members are at increased risk of melanoma. If you have close relatives who have had melanoma, talk to your GP about your family/whānau’s risk.
Protecting your skin is important
If you have had melanoma, it is especially important to protect your skin all year round.
Never allow your skin to burn. Don’t rely on sunscreen alone.
It is especially important to protect your skin:
•When the UV index is 3 or above (usually in the daylight saving months in New Zealand between 10am and 4pm). You can find out what the UV level is by going to the Sun Protection Alert on www.sunsmart.org.nz or through the uv2Day smartphone app.
• At the beach, as reflections from water and sand can increase radiation.
• At high altitudes, especially near snow which strongly reflects radiation.
You can protect your skin in the following ways.
• Slip on a shirt
Slip on a shirt with long sleeves. Fabrics with a tighter weave and darker colours will give you better protection from the sun.
• Slip into the shade
Slip into the shade of an umbrella or a leafy tree. Plan your outdoor activities for early or late in the day when the sun’s
UV levels are low.
• Slop on sunscreen
Slop on plenty of broad-spectrum, water-resistant sunscreen of at least SPF 30. Apply 20 minutes before going outside and reapply every two hours, and especially after being in water or sweating.
• Slap on a hat
Wear a hat with a wide brim or a cap with flaps. More people are sunburnt on the face and neck than any other part of the body.
• Wrap on sunglasses
Choose close-fitting, wrap-around-style sunglasses. Not all sunglasses protect against UV radiation, so always check the
label for the sun protection rating.
And do not use sunbeds.
You need to apply your sunscreen correctly for it to be fully effective.
Apply sunscreen 20 minutes before going outside. The average-sized adult should apply at least one teaspoon to each arm and to the face (including the ears and neck), and at least a teaspoon to each leg and the front and the back of their body.
Sunscreen should be reapplied every two hours when you are outdoors and more often if you are sweating or in water.
The importance of vitamin D
Vitamin D is important for strong bones and good health. The main way we get vitamin D is from sunlight on our skin. For the general population, some sun exposure when the UV Index is less than 3, is recommended.
People with a history of skin cancer should protect themselves from the sun all year round.
Speak to your GP about whether you need a vitamin D supplement.
Questions you may want to ask after surgery for melanoma
You might like to find out:
• when you can return to work
• when you will be able to drive again
• who your regular melanoma follow-up checks will be managed by
• who you should see to have a complete skin check
• how often these checks should happen
• what problems you should watch out for.