Immunology and dermatologists - how often to see them?

Hi Luizka

I am post-immunotherapy and I only ever see the oncology team and the endocrinology team who got involved because of one of my side effects of the immunotherapy.

This may be because I never saw a dermatologist to start with - I skipped the 'iffy mole' part.

Why don't you ask his Specialist Cancer Nurse (SCN)? He or she may know the answer or to have a word with the Dermatology department to check.

I think some patients who saw a dermatologist as the first step may continue to be checked at regular intervals to see if all their other moles are OK or if some should be removed. 

It will not replace his regular appointments with the oncologists.

All the best

Moira

Hi , I am another person who has never had a primary and therefore only seen a dermatologist once, this was in order to see if a primary melanoma could be found. I have had no further contact with a dermatologist, however I did ask about appointments once as I went to a melanoma patient conference where a heard that most patients including stage 4 patients see a dermatologist every 3 months separately to the oncologist. However most patients on immunotherapy said nothing was every found at these appointments, and remembering that immunotherapy works on the whole body I had a discussion with a skin cancer nurse and we agreed that an appointment was only necessary if I was worried about a particular patch of skin or lymph node, and I could be fast tracked into an appointment, the NICE guidance throws it open to individual follow up. 

I read in the profile that your Dad’s had a few occurrences which is why they may have booked a routine follow up appointment. I can’t tell if you are concerned that he has an appointment that he might not need as he is seeing oncologists probably every month, or wether you are concerned that he has one so far away. The oncologists don’t check my lymph nodes or skin which is what the dermatologist or skin cancer nurses might do, but I have scans every 3 months that would pick up any further spread in my body. 

It must be difficult for you being a long distance away from your Dad and trying to look out for him. You could try a question in the ask an expert section giving a bit more detail in the question about your Dads condition and current treatment drugs, and they may be able to either answer in general and or give a link to some info for you to ease your mind, if you haven’t already done so.

https://community.macmillan.org.uk/cancer_experiences/ask_the_expert/ask_a_nurse/discussions

Best wishes

Hi all,

This is really interesting. I did have a primary and am currently having immunotherapy. I’m under plastics and oncology, who sometimes check my lymph nodes and sometimes don’t bother - I think it depends which particular doc I end up with for the clinic appointment.

I was told I’d get follow-ups with dermatology, but no appointments have ever arrived, despite the hospital confirming they’d referred me back.

I’ve contacted the dermatologist myself a few tines for things I’ve been worried about, and they made me appointments within a few days, so I’ve not stressed too much about the routine ones never arriving. My dermatology is being provided through the NHS, but it’s outsourced to Virgin Healthcare, so I’m not sure if the system is working as it should or not, but I imagine that’s why I get fast appointments - they do weekend too which is rather useful!

I wish the hospital would make it clearer who is responsible for what though when you’re being seen by different teams... I’m never sure who I  can ask what, or if I should be waiting for the other team. 

Fun and games. X

Hi all, 

Long since the update, much happened in the in between and some family fall outs (putting it very lightly, mental health is all health and all critical, but as so, this was also unrelated to cancer) if you can imagine we had time for it (!) meant we all somehow paused on this particular trauma

Fortunately, the immuno seemed to be doing a trick, new melanoma looking spots popped up all over up the leg but then also zipped away after in Jan (so about 4-5months in) it was agreed to be working. They took him off it after 4 months

Still remaining on the foot tho and my dad is in agony of it. Now they think that isolated LI is not the best move and they want to try 'electrochemotherapy' instead - surprised they offered this but I think that as my dad is safe enough now and already twice consulted with that Dept in Leeds (was booked in for ILT twice now but missed) they probably think it's a good shot. They say the limb infusion could be too painful and now he doesn't have the other suspect melanomas on his shins (after immuno last 2months or so) its a good time

He doesn't have any more dermo appointments, and the last were canceled - maybe a mistake? Not sure but - phew, access to such things as immuno therapy and now electeotherapy (another new one to Google) I can see has been good. It is only the communication is serious lacking - even 'you are having this appointment because (lists very specific reasons) !' would be nice. My dad still doesn't even understand what the dermotologist does, but he stresses to make his plans to be there

Fingers crossed. A journey - but feeling like slowly getting to the good side of it at last.. Maybe

 Fingers crossed to for your Dad.