What to look out for after surgery

Patient guide

Surgery for melanoma is usually performed with the aim of cure and most people diagnosed with melanoma are cured after their original surgery. However melanoma is a type of cancer and there is a risk of the cancer coming back, known as recurrence. You can find out more about your risk of recurrence in this section.

After surgery, melanoma can come back in three ways. Melanoma can come back at, or close to, the place it originally started, this is called a local recurrence. In this case it is usually felt as a nodule on or near your original scar. The nodule may feel as if it is sitting on top of the skin or under the skin. It is likely to look very different to your original melanoma and may not be obviously pigmented (brown).

Melanoma can spread to nearby lymph nodes. In this case it is usually felt as a smooth lump underneath the skin, about the size of half a grape. Lymph nodes exist throughout your body but are easiest to feel in your neck, above your collar bones, under your arms or in your groins. Lymph nodes can get temporarily bigger or become tender if you have an infection, such as a sore throat or other viral infection. However if you feel a lump under your skin that has not gone away within three weeks, you should contact your Melanoma Team (most coughs, colds and viruses settle within three weeks).

Your melanoma team may have shown you how to examine your lymph node. An informational video on ‘How to examine your lymph nodes,’ can be viewed here

Less often melanoma will spread in the bloodstream to organs within the body, such as your lungs, liver or brain. For many patients with melanoma this is a very unusual occurrence as most people diagnosed with melanoma are cured after surgery and are at extremely low risk of recurrence.

For a small proportion of patients there is a higher risk of distant spread of the melanoma and your medical team may offer you surveillance scans and may suggest that you monitor yourself for any new symptoms. It is not possible to provide a comprehensive list of symptoms to look out for, although examples would include a persistent new cough, persistent pain without any obvious explanation, or unexplained weight loss.

Instead, we would encourage you to discuss any unexplained new symptom lasting more than three weeks with your Melanoma Team. They can then decide with you whether it might be sensible to bring forward your next surveillance visit, or whether any other investigation might be helpful.

Finally, any patient diagnosed with melanoma is at higher risk of developing new melanomas or other skin cancers. It is for this reason that it will always be important that you report new, worrying skin lesions in the future. If your melanoma was several years ago, it can be helpful to remind your GP that you have already had a melanoma, so that they can bear this in mind when they assess you.