General measures
- Strive to maintain normal weight! Determination of BMI (body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program or program for the underweight – Especially in men, overweight seems to be one of the risk factors for malignant melanoma.
- BMI ≥ 25 → participation in a medically supervised weight loss program.
- Falling below the BMI lower limit (from the age of 19: 19; from the age of 25: 20; from the age of 35: 21; from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.
- Review of permanent medication due topossible effect on the existing disease.
- Avoidance of environmental stress:
- UV exposure (especially: UV-B radiation/solariums).
- Check skin regularly yourself (regardless of follow-up examinations).
Vaccinations
The following vaccinations are advised:
- Flu vaccination
- Pneumococcal vaccination
Regular checkups
Follow-up appointments are based on the stage of the disease:
- Stage IA (tumor thickness ≤ 1 mm without ulceration, no metastases/daughter tumors):
- Physical examination: 1st-3rd year every six months; 4th-10th year once a year.
- Stage IB-IIB (tumor thickness ≤ 1 mm with ulceration or increased mitotic rate or > 1 mm with and without tumor ulceration, and tumor thickness > 4 mm without ulceration, no metastases):
- Physical examination: 1st-3rd year every three months; 4th and 5th year twice a year; and 6th-10th year once or twice a year.
- Stage IIC (tumors > 4 mm with ulceration) and stage III (with lymph node metastases):
- Physical examination: 1st-5th year every three months; 6th-10th year every six months.
- Stage IV (with metastases in other organs).
- Follow-up care according to the course of the disease
Nutritional medicine
- Nutritional counseling based on nutritional analysis
- Nutritional recommendations according to a mixed diet, taking into account the general knowledge of nutrition in a tumor disease. This means:
- Consume only limited energy-rich foods.
- Moderate total fat intake
- Little red meat (pork, beef, lamb, veal) and sausages.
- Once or twice a week fresh sea fish, ie fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
- High-fiber diet (whole grains, vegetables).
- Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
- Reduce consumption of smoked and cured foods, because they contain nitrate or nitrite as a component of curing salt. Their preparation produces compounds (nitrosamines), which are risk factors for various tumor diseases.
- Refrain from polluted foods such as offal and wild mushrooms.
- Do not eat moldy food
- Observe the following special dietary recommendations:
- Diet rich in:
- Vitamins (A, C, D, E, folic acid).
- Minerals
- Trace elements (selenium, zinc)
- Omega-3 fatty acids – eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA).
- Secondary plant compounds (eg carotenoids, polyphenols).
- Probiotics (probiotic cultures)
- Diet rich in:
- Selection of appropriate food based on the nutritional analysis
- See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
- Detailed information on nutritional medicine you will receive from us.
Sports Medicine
- Endurance training (cardio training) and strength training (muscle training).
- In general, endurance training on a bicycle ergometer can be recommended, which is performed according to the principle of interval training. This means that load phases lasting 1 to 3 minutes alternate with rest phases also lasting 1 to 3 minutes. The training should be performed at about 80% of the maximum heart rate for a total of 30 minutes.
- Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
- Detailed information on sports medicine you will receive from us.
Psychotherapy
- Stress management, if necessary
- Detailed information on psychosomatics (including stress management) can be obtained from us.
Training
- Skin self-examination training program