Follow-up scans after surgery for melanoma

Follow-up scans after surgery for melanoma

25 January 2017

Early detection of melanoma is crucial for improving survival, and many patients with melanoma fear recurrence. Patients and clinicians are increasingly requesting regular scanning to try and catch melanoma early; however there can be disadvantages to this process that need to be considered.

A new research project will evaluate the benefits and economic implications of computed tomography (CT) and positron emission tomography (PET)/CT imaging in patients with Stage III melanoma who have not developed any symptoms of progression.

This project, recently funded by Cancer Australia, is a collaboration between Melanoma Institute Australia (MIA), the NHMRC Clinical Trials Centre at The University of Sydney, and the University of New South Wales.

Melanoma tends to spread to the lymph glands (Stage III), and internal organs including the lungs and brain (Stage IV), leading to a poor prognosis.

“If melanoma spread can be identified early, then targeted therapies and individualised treatment can be undertaken,” says Chief Investigator, Associate Professor Rachael Morton from The University of Sydney. “CT and PET scans can detect recurrences as small as 2mm in size. However there are also downsides to regular scanning which we need to evaluate.”

The disadvantages of regular scanning include exposure to radiation that can cause a new cancer in the future, getting the wrong result from a scan, incidental findings of other lesions that need to be investigated with further tests and scans, anxiety leading up to the scan, and out-of-pocket costs to patients.

This new project will evaluate the harms and benefits of annual CT or PET/CT scanning in asymptomatic Stage III melanoma patients. The study will provide quality, evidence-based information about annual scanning to clinicians to facilitate decision-making about appropriate surveillance strategies.