Skin Cancers
Survivorship
Whether your treatment is complete or you are managing your illness with maintenance therapy, life after a skin cancer diagnosis is different. Your focus will turn to learning how to keep yourself healthy, both physically and emotionally. To help you know where to begin, you are encouraged to have a survivorship plan.
Some cancer centers have survivorship programs that will guide you through this transition. If yours doesn’t, work with your medical team to develop a plan customized for you. Or, create one on your own. After all, who knows more about your experience than you?
Your Survivorship Plan
A survivorship plan maps out your entire cancer experience, from diagnosis onward. It should include the following sections.
Full medical history. This comprehensive section contains your cancer diagnosis, including the date of diagnosis and the type, stage and location of your cancer; treatments, including drug names, dosages, dates and side effects; diagnostic test results; symptoms; and supportive care, including counseling. Provide your family’s medical and cancer histories if you can.
Follow-up care plan. This part of the plan details your maintenance medications or therapies (if you have them), along with the type, dosage, frequency and duration. It includes a schedule for upcoming appointments and provides referral(s) for cancer rehabilitation, such as physical or occupational therapy, speech therapy, a lymphedema specialist or others.
Making and keeping your follow-up appointments is critical. Staying on schedule for lab work and in-person appointments provides your health care team with valuable information about your health. However, do not wait for a follow-up appointment if you are exhibiting a new symptom. Contact your health care team as soon as possible if you have a concern. To help you stay on schedule, download and print your own Survivorship Care Plan/Follow-up Care Plan at PatientResource.com/SurvivorshipPlan
Long-term lingering or late effects. Some side effects can linger post-treatment. Late effects are side effects that may show up weeks, months or even years after your treatment ends. Be sure to ask your health care team about the possible signs and symptoms so you can recognize and manage them early.
Immune-related adverse events (irAEs). Although they are not common, irAEs can occur with certain types of immunotherapy for up to two years after completing treatment. Ask your doctor if you are at risk, how to identify the symptoms and when to seek emergency care (see Supportive Care, page 14). Tell all new medical professionals you see that you’ve received immunotherapy.
Risk for recurrence. Because skin cancer often recurs and secondary cancers are a risk, ask your doctor about recommended screening guidelines and monitoring tests, such as the circulating tumor DNA (ctDNA) blood test that checks for MCC recurrence.
Basal cell carcinoma (BCC) comes with a risk of these cancers:
- Melanoma
- Lip
- Other skin cancers
Cutaneous squamous cell carcinoma is accompanied by a risk of these cancers:
- Lip
- Lungs
- Pharynx
- Larynx
- Salivary glands
- Non-Hodgkin's lymphoma
Merkel cell carcinoma has been linked to these cancers:
- Brain
- Salivary glands
- Biliary tract
- BCC
- Some blood cancers
Melanoma is also a risk. Learn more about melanoma prevention by downloading the Patient Resource Melanoma Guide at PatientResource.com/Melanoma
Emotional support resources. Get to know the skin cancer community. Surrounding yourself with people who have been affected by skin cancer, whether as survivors, caregivers, advocates or medical professionals, is comforting. They can relate to your emotions and are a safe place to share your feelings. Ask your medical team for recommendations for local and online advocacy and support groups.
Healthy lifestyle. Making smart choices offers multiple benefits. Ask a member of your health care team to help you create nutrition and fitness plans. Stop smoking, vaping or using tobacco products. Seek out help because those are hard habits to break on your own. Avoid tanning devices, and make it a habit to put on sunscreen every time you go outside.
Picking Up Where You Left Off
As you consider going back to work or the other commitments that filled your days, you might also consider changing up your old routine.
At work, ask your supervisor about the Americans with Disabilities Act to know your rights in the workplace. Changes may include a flexible schedule or reduced hours, a redesigned workstation, the ability to work remotely or different responsibilities. Or, you may decide it is time for a total career move.
Take a step back in your current volunteer activities or community roles. You may decide to become more involved with cancer advocacy and sharing what you’ve learned with others who are going through a similar situation.
Keep in mind that change may bring anxiety or stress. Be sure to reach out to someone in your social or support circle to help you with this transition.
