› Forums › General Melanoma Community › How many times to you visit the Dermatologist?
- This topic has 6 replies, 2 voices, and was last updated 11 years, 8 months ago by
becky15.
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- August 30, 2012 at 2:18 am
I was diagnosed with Melanoma in Situ about 7 years ago.
The diagnosis came as no surprise seeing as I come from a family history of melanoma. I have been seeing a dermatologist since high school. In addition, we all have several atypical moles. After my diagnoses, the doctor had me undergo a series of digital photographs so we could monitor changes at each visit.
For the first two years after my diagnosis I visited him every three months.
Since, every six.
This last visit, he said that we can make the visits yearly.
I was diagnosed with Melanoma in Situ about 7 years ago.
The diagnosis came as no surprise seeing as I come from a family history of melanoma. I have been seeing a dermatologist since high school. In addition, we all have several atypical moles. After my diagnoses, the doctor had me undergo a series of digital photographs so we could monitor changes at each visit.
For the first two years after my diagnosis I visited him every three months.
Since, every six.
This last visit, he said that we can make the visits yearly.
This scared me, seeing as like having an additional set of eyes on my moles. However, my dermatologist said he is confident with the vigilance I have shown him the last 7 years that I can monitor my moles myself and then come in for yearly visits. Furthermore, my moles have been 100% stable since my original diagnosis.
I am vigilant. Anything that is new or changes, I make and appt asap, but should I push for more visits? What is the norm?
Thanks. Jenni
- Replies
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- August 30, 2012 at 3:30 am
At 7 years out, yearly is fairly typical especially for lower staged individuals. I know a lot of stage 0/1 who move to yearly by 3 years out – almost all are there at 5 years out. So 7 years seems quite generous especially with no new primaries and stable moles. Personally, I've had 3 primaries and caught them all myself. I have photos I can use for reference. I think I am in a much better place to find a melanoma than my doc is. I know my body best. I go twice a year but only because that is the protocol for patients with multiple primaries at my institution. I'd be fine going yearly but I'm afraid I'd never get in to see my doctor if I deviated from their protocol.
My take is go ahead and go yearly. If you see something that bothers you, you can always schedule an interim visit. Just because your "normal" visits are yearly doesn't mean you can't be seen if anything catches your attention.
Best wishes,
Janner
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- August 30, 2012 at 2:19 pm
As quoted in the UK British Association of Dermotologists revised 2010 guidelines "Patients with a surgically treated single in situ melanoma do not require follow up as there is no risk of metastasis." I am stage 1a, diagnosed earlier this year, and for this group "a series of two to four visits over up to 12 months is suggested to teach self examination and then they may be discharged from regular follow up."
It therefore appears that a less stringent approach is adopted in the UK, maybe because of cost implications for our free NHS service although maybe not as I am paying privately for my melanoma care and even my consultant gives a discharge after 12 months although I can choose to continue under his care and pay for further visits with him. The problem for stage 1a patients being seen under the NHS is that they have no choice but to be discharged from follow up after 12 months. We do not have readilly available dermatology clinics here in the UK, apart from a few privately run "mole clinics", and the only way you can get to see a dermatologist is to be referred by your GP.
The medical profession also adopt a very strict attitude to the use of SLNB with stage 1 patients. My consultant was adamant that no one in the UK would perform a SLNB for a melanoma under 1mm, even though I was prepared to pay for one, as such a proceedure was outside the UK guidelines. From reading postings from the US, it's evident that these are performed on melanomas under 1mm there but my consultant's opinion is that there is a culture in the US to over test/ operate as there is a financial gain to be made from every procedure. In the UK, this is only the case with the small percentage of people who are seen privately, either through pay as you go or through a personal medical insurance scheme usually provided by their employer.
I would have willingly opted for a SLNB if this had been possible as I hate having the "what if" in my mind all the time and the thought that I'm not really a stage 1a, but the UK has one of the world's leading cancer centres in the Royal Marsden so I don't think the panel who devised the guidelines to coincide with the AJCC's revisions, have got it totally wrong.
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- August 30, 2012 at 2:19 pm
As quoted in the UK British Association of Dermotologists revised 2010 guidelines "Patients with a surgically treated single in situ melanoma do not require follow up as there is no risk of metastasis." I am stage 1a, diagnosed earlier this year, and for this group "a series of two to four visits over up to 12 months is suggested to teach self examination and then they may be discharged from regular follow up."
It therefore appears that a less stringent approach is adopted in the UK, maybe because of cost implications for our free NHS service although maybe not as I am paying privately for my melanoma care and even my consultant gives a discharge after 12 months although I can choose to continue under his care and pay for further visits with him. The problem for stage 1a patients being seen under the NHS is that they have no choice but to be discharged from follow up after 12 months. We do not have readilly available dermatology clinics here in the UK, apart from a few privately run "mole clinics", and the only way you can get to see a dermatologist is to be referred by your GP.
The medical profession also adopt a very strict attitude to the use of SLNB with stage 1 patients. My consultant was adamant that no one in the UK would perform a SLNB for a melanoma under 1mm, even though I was prepared to pay for one, as such a proceedure was outside the UK guidelines. From reading postings from the US, it's evident that these are performed on melanomas under 1mm there but my consultant's opinion is that there is a culture in the US to over test/ operate as there is a financial gain to be made from every procedure. In the UK, this is only the case with the small percentage of people who are seen privately, either through pay as you go or through a personal medical insurance scheme usually provided by their employer.
I would have willingly opted for a SLNB if this had been possible as I hate having the "what if" in my mind all the time and the thought that I'm not really a stage 1a, but the UK has one of the world's leading cancer centres in the Royal Marsden so I don't think the panel who devised the guidelines to coincide with the AJCC's revisions, have got it totally wrong.
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- August 30, 2012 at 2:19 pm
As quoted in the UK British Association of Dermotologists revised 2010 guidelines "Patients with a surgically treated single in situ melanoma do not require follow up as there is no risk of metastasis." I am stage 1a, diagnosed earlier this year, and for this group "a series of two to four visits over up to 12 months is suggested to teach self examination and then they may be discharged from regular follow up."
It therefore appears that a less stringent approach is adopted in the UK, maybe because of cost implications for our free NHS service although maybe not as I am paying privately for my melanoma care and even my consultant gives a discharge after 12 months although I can choose to continue under his care and pay for further visits with him. The problem for stage 1a patients being seen under the NHS is that they have no choice but to be discharged from follow up after 12 months. We do not have readilly available dermatology clinics here in the UK, apart from a few privately run "mole clinics", and the only way you can get to see a dermatologist is to be referred by your GP.
The medical profession also adopt a very strict attitude to the use of SLNB with stage 1 patients. My consultant was adamant that no one in the UK would perform a SLNB for a melanoma under 1mm, even though I was prepared to pay for one, as such a proceedure was outside the UK guidelines. From reading postings from the US, it's evident that these are performed on melanomas under 1mm there but my consultant's opinion is that there is a culture in the US to over test/ operate as there is a financial gain to be made from every procedure. In the UK, this is only the case with the small percentage of people who are seen privately, either through pay as you go or through a personal medical insurance scheme usually provided by their employer.
I would have willingly opted for a SLNB if this had been possible as I hate having the "what if" in my mind all the time and the thought that I'm not really a stage 1a, but the UK has one of the world's leading cancer centres in the Royal Marsden so I don't think the panel who devised the guidelines to coincide with the AJCC's revisions, have got it totally wrong.
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- August 30, 2012 at 3:30 am
At 7 years out, yearly is fairly typical especially for lower staged individuals. I know a lot of stage 0/1 who move to yearly by 3 years out – almost all are there at 5 years out. So 7 years seems quite generous especially with no new primaries and stable moles. Personally, I've had 3 primaries and caught them all myself. I have photos I can use for reference. I think I am in a much better place to find a melanoma than my doc is. I know my body best. I go twice a year but only because that is the protocol for patients with multiple primaries at my institution. I'd be fine going yearly but I'm afraid I'd never get in to see my doctor if I deviated from their protocol.
My take is go ahead and go yearly. If you see something that bothers you, you can always schedule an interim visit. Just because your "normal" visits are yearly doesn't mean you can't be seen if anything catches your attention.
Best wishes,
Janner
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- August 30, 2012 at 3:30 am
At 7 years out, yearly is fairly typical especially for lower staged individuals. I know a lot of stage 0/1 who move to yearly by 3 years out – almost all are there at 5 years out. So 7 years seems quite generous especially with no new primaries and stable moles. Personally, I've had 3 primaries and caught them all myself. I have photos I can use for reference. I think I am in a much better place to find a melanoma than my doc is. I know my body best. I go twice a year but only because that is the protocol for patients with multiple primaries at my institution. I'd be fine going yearly but I'm afraid I'd never get in to see my doctor if I deviated from their protocol.
My take is go ahead and go yearly. If you see something that bothers you, you can always schedule an interim visit. Just because your "normal" visits are yearly doesn't mean you can't be seen if anything catches your attention.
Best wishes,
Janner
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Tagged: cutaneous melanoma
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