Patients' perspectives of long-term follow-up for localised cutaneous melanoma

Eur J Surg Oncol. 2013 Mar;39(3):297-303. doi: 10.1016/j.ejso.2012.12.017. Epub 2013 Jan 1.

Abstract

Background: Little is known about the value of long-term follow-up for localised cutaneous melanoma from the patients' perspective. This study aimed to explore the benefits and potential downsides of follow-up; feelings about changes to frequency of follow-up, and patient-centred recommendations for improving follow-up care.

Methods: Qualitative analysis of 29 in-depth interviews conducted with Australian patients undergoing long-term follow-up after surgical treatment of stage I/II melanoma.

Results: Patient-perceived benefits of follow-up included reassurance, early detection of new melanomas and non-melanoma skin cancers, education about skin self-examination, the opportunity to ask questions, and reinforcement of 'sunsafe' behaviours. Downsides included anxiety leading up to and during follow-up visits; inconvenience of travel to attend visits; and lost work time. Patients varied in their engagement with skin self-examination, and their views on multiple skin excisions, but highly valued access to specialists for unscheduled visits. Most patients felt their follow-up intervals could be extended to 12 months if recommended by their clinician.

Conclusion: The benefits and potential downsides of follow-up should be discussed with patients when deciding on a melanoma follow-up plan to achieve a balance between inducing additional patient anxiety and providing reassurance. Follow-up intervals of 12 months appear to be acceptable to patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety / etiology
  • Australia
  • Early Detection of Cancer* / adverse effects
  • Early Detection of Cancer* / methods
  • Female
  • Health Promotion
  • Health Services Accessibility
  • Humans
  • Male
  • Melanoma / diagnosis*
  • Melanoma / prevention & control
  • Melanoma / psychology*
  • Melanoma / surgery
  • Middle Aged
  • Neoplasm Staging
  • Patient Education as Topic
  • Qualitative Research
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / prevention & control
  • Skin Neoplasms / psychology*
  • Skin Neoplasms / surgery