Communication Between Patients, Doctors Crucial After Melanoma Surgery

Patients with melanoma play a vital role in their own post-surgical care, as one expert explained to CURE®.

“Patients that are coming to see us, once they have (received) a diagnosis of melanoma, they are often very concerned, especially when they learn about the disease and how aggressive it can be,” Dr. Justine V. Cohen, a medical oncologist with Dana-Farber Cancer Institute in Boston, said. “And so, they want to follow up and they want to be seen.”

The provider’s goal, Cohen explained, is to detect any post-surgical recurrence of melanoma as early as possible. The stage of a patient’s disease can provide valuable insight into potential recurrence risk, because, as Cohen explained, “then we can devise a good plan for that patient, how often they need to come back, do they need scans, do they just need a history and physical, how often they should be checking their blood work, etc.”

“Patients should feel empowered to ask about their stage of melanoma,” Cohen said. “And the reason why is because they need to know the risk of recurrence. Because when we know the risk of recurrence, we can say, ‘Well, this is what this is what's likely to happen’ or ‘This is what's not likely to happen.’ So, when patients understand their stage, they understand what their risk is, and they know how often to follow up with their doctor.”

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The provider’s four standard means of detecting melanoma recurrence, as Cohen explained, are asking the patient if they are experiencing symptoms (such as detecting lumps or bumps, fatigue or generalized symptoms such as a lack of appetite), examining the patient, conducting scans and bloodwork analysis.

Cohen cited a study, published in 2008 in the journal Annals of Surgical Oncology that, as she said, “showed that patients actually detect recurrences better than the other three methods that we have.”

Researchers, writing in Annals of Surgical Oncology, found that “more than half of melanoma recurrences are self-detected; these patients have the most favorable post-recurrence survival rates because of the type of recurrence detected. The mode of detection is a significant predictor of post-recurrence survival.”

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“It's really important for patients to have very open lines of communication with their doctors,” Cohen said. “Because if we don't see patients (often), let's say we see a patient once every six months, that's a long time to go between visits and so we rely on patients calling us if new things pop up between those (visits every) six months. So, I always tell patients to call me (and) that I want to know if they're developing any strange symptoms, like they're losing weight unintentionally or they're more fatigued than usual or they have unusual lumps anywhere, any sort of issues. I want to know about that.”

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