Melanoma
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Melanoma
Life after treatment
For most people, the cancer experience doesn’t end on the last day of treatment. Life after melanoma treatment can present its own challenges. You may have mixed feelings when treatment ends, and worry that every ache and pain means the melanoma is coming back.
Some people say that they feel pressure to return to “normal life”. It is important to allow yourself time to adjust to the physical and emotional changes, and establish a new daily routine at your own pace. Your family and friends may also need time to adjust.
Cancer Council 13 11 20 can help you connect with other people who have had melanoma, and provide you with information about the emotional and practical aspects of living well after cancer.
Most melanomas are caused by exposure to the sun’s UV radiation. After a diagnosis of melanoma, it is especially important to check your skin regularly and follow SunSmart behaviour. When UV levels are 3 or above, use all or as many of the following measures as possible to protect your skin.
Slip on clothing – Wear clothing that covers your shoulders, neck, arms, legs and body. Choose closely woven fabric or fabric with a high ultraviolet protection factor (UPF) rating, and darker fabrics where possible.
Slop on sunscreen – Use an SPF 30 or higher broad-spectrum, water-resistant sunscreen. Apply 20 minutes before going outdoors and reapply every 2 hours, or after swimming, sweating or any activity that causes you to rub it off. For an adult, the recommended amount is 1 teaspoon for each arm, each leg, front of body, back of body, and the face, neck and ears – a total of 7 teaspoons of sunscreen for one full body application.
Slap on a hat – Wear a hat that shades your face, neck and ears. This includes legionnaire, broad-brimmed and bucket hats. Check to make sure the hat meets the Australian Standard. Choose fabric with a close weave that doesn’t let the light through. Baseball caps and sun visors do not offer
enough protection.
Seek shade – Use shade from trees, umbrellas, buildings or any type of canopy. UV radiation is reflective and bounces off surfaces, such as concrete, water, sand and snow, so shade should never be the only form of sun protection used. If you can see the sky through the shade, even if the direct sun is blocked, the shade will not completely protect you from UV radiation.
Slide on sunglasses – Protect your eyes with sunglasses that meet the Australian Standard. Wraparound styles are best. Sunglasses should be worn all year round to protect both the eyes and the delicate skin around the eyes.
Avoid solariums – Do not use solariums. Also known as tanning beds or sun lamps, solariums give off artificial UV radiation and are banned for commercial use in Australia.
Check daily sun protection times – Each day, use the free SunSmart app to check the recommended sun protection times in your local area. For more information, visit the SunSmart website. You can also find sun protection times at the Bureau of Meteorology or in the weather section of daily newspapers.
After a melanoma diagnosis, you need to take special care to protect your skin from the sun’s UV radiation. This will reduce your risk of further melanomas.
The UV Index shows the intensity of the sun’s UV radiation. It can help you work out when to use sun protection. An index of 3 or above means that UV levels are high enough to damage unprotected skin, and you need to use more than one type of sun protection. The recommended daily sun protection times (see previous page) are the times of day the UV levels are expected to be 3 or higher. These will vary according to where you live and the time of year.
Sun exposure and vitamin D
UV radiation from the sun causes skin cancer, but it is also the best source of vitamin D. People need vitamin D to develop and maintain strong, healthy bones. The body can absorb only a set amount of vitamin D at a time. Most people get enough vitamin D through incidental exposure to the sun, while using sun protection. When the UV Index is 3 or above, this may mean spending just a few minutes outdoors on most days of the week, depending on where in Australia you live and the time of year.
After a diagnosis of melanoma, talk to your doctor about the best ways to get enough vitamin D while reducing your risk of getting more melanomas. Your doctor may advise you to limit your sun exposure as much as possible when the UV Index is 3 or above. In some cases, this may mean you don’t get enough sun exposure to maintain your vitamin D levels. Your doctor may advise you to take a supplement.
After you have had one melanoma, you have about 5 times the risk of developing a new melanoma compared with the average person of the same age. It is important to be familiar with your skin, examine it for changes and go to your follow-up appointments.
Your doctor can give you more details of how often you need follow-up appointments – more frequent visits are recommended for people with advanced melanoma. At these appointments, your doctor will examine the area that was treated and your lymph nodes to check that the melanoma hasn’t come back or spread. Your doctor will also check the rest of your skin for any new melanomas. Sometimes you will need to have regular CT scans or PET scans before follow-up appointments.
You may feel anxious before a follow-up appointment or test. Talk to your treatment team or call Cancer Council 13 11 20 if you are finding it hard to manage this anxiety. Between follow-up appointments, let your doctor know immediately of any symptoms or health problems.
For most people, early melanoma will not come back (recur) after treatment. The risk of the melanoma returning is higher for people with regional melanoma. Recurrence can occur at the site where the melanoma was removed (locally); in the lymph nodes; or further away in other body sites, such as the lung, liver or brain.
If the cancer returns, your doctor will discuss the treatment options with you. These will depend on where the cancer has recurred, as well as the number of sites, its extent and your general health. You may be offered immunotherapy, targeted therapy or the option to join a clinical trial.
If you have continued feelings of sadness, have trouble getting up in the morning or have lost motivation to do things that previously gave you
pleasure, you may be experiencing depression. This is quite common among people who have had cancer.
Talk to your GP, because counselling or medication—even for a short time—may help. Some people are able to get a Medicare rebate for sessions with a psychologist. Cancer Council SA operates a free cancer counselling program. Call Cancer Council 13 11 20 for more information
For information about coping with depression and anxiety, visit Beyond Blue or call them on 1300 22 4636. For 24-hour crisis support, visit Lifeline or call them on 13 11 14.
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This information is reviewed by
This information was last reviewed March 2023 by the following expert content reviewers: Prof H Peter Soyer, Chair in Dermatology and Director, Dermatology Research Centre, The University of Queensland, Diamantina Institute, and Consultant, Dermatology Department, Princess Alexandra Hospital, QLD; A/Prof Matteo Carlino, Medical Oncologist, Blacktown and Westmead Hospitals, Melanoma Institute Australia and The University of Sydney, NSW; Prof Anne Cust, Deputy Director, The Daffodil Centre, The University of Sydney and Cancer Council NSW, Chair, National Skin Cancer Committee, Cancer Council and faculty member, Melanoma Institute Australia; Prof Diona Damian, Dermatologist, Head of Department, Dermatology, The University of Sydney at Royal Prince Alfred Hospital, NSW, and Melanoma Institute Australia; A/Prof Paul Fishburn, General Practitioner – Skin Cancer, Norwest Skin Cancer Clinic, NSW and The University of Queensland; Claire Kelly, National Support Manager, and Emma Zurawel, Telehealth Nurse, Melanoma Patients Australia; Prof John Kelly, Consultant Dermatologist, Victorian Melanoma Service, The Alfred Melbourne and Monash University, VIC; Liz King, Manager, Skin Cancer Prevention Unit, Cancer Council NSW; Lee-Ann Lovegrove, Consumer; Lynda McKinley, 13 11 20 Consultant, Cancer Council Queensland; Angelica Miller, Melanoma Community Support Nurse, Melanoma Institute Australia incorporating melanomaWA, and Cancer Wellness Centre, WA; Dr Amelia Smit, Research Fellow, Melanoma and Skin Cancer, The Daffodil Centre, The University of Sydney and Cancer Council NSW; Prof Andrew Spillane, Professor of Surgical Oncology, The University of Sydney, The Mater and Royal North Shore Hospitals, NSW, and Melanoma Institute Australia; Kylie Tilley, Consumer; A/Prof Tim Wang, Radiation Oncologist, Crown Princess Mary Cancer Centre, Westmead Hospital, NSW.