Skin cancer is the diagnosis of a quarter of all patients with cancer

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A Strategy for the Prevention and Diagnosis of
Treatment of Malignant Melanoma and Other Skin
CancersStrategy Review Workshop
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Secondary Care of Melanoma and Other Skin
Cancers Strategic DevelopmentsDr Maureen Y
Walsh
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Skin cancer is the diagnosis of a quarter of all
patients with cancer
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Most of the work in the treatment of skin cancer
is on an outpatient basis and the true extent of
the disease has largely gone unrecognised
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Prevention and Early Detection
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There is a need for continuing education of the
public on the risks of developing skin cancer and
on the signs and symptoms of skin cancer
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Education needs to be targeted at specific groups
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There is a need for continuing education of
primary healthcare professionals in recognition
of the early signs and symptoms of skin cancer
and referral of patients to the appropriate
specialist
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Dermatologists should take responsibility for
regular update sessions for members of the
Primary Cancer Teams
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Service Provision
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Patients with all types of skin cancer and
especially melanoma should be referred to an
appropriately trained specialist
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The treatment of skin cancer is primarily surgical
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It should be undertaken by specialists who have
appropriate training and experience in dealing
with these lesions and who are familiar with and
comply with current guidelines
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Roberts D. et alThe British Association of
Dermatologists The Melanoma Study Group. UK
Guidelines for the Management of Cutaneous
Melanoma.Br. J. Dermatol. Jan 2002. 146 (1)
7-17
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Telfer N R et alBritish Association of
Dermatologists Guidelines for the Management of
Basal Cell Carcinoma.Br. J. Dermatol. Sept
1999. 141 (3) 415-23
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Motley R. et alThe British Association of
Dermatologists The British Association of
Plastic Surgeons The Royal College of
Radiologists Faculty of Clinical Oncology
Guidelines for the Management of Cutaneous
Squamous Cell Carcinoma.Br. J. Dermatol. Jan
2002. 146 (1) 18-25
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The Royal College of Pathologists Minimum
datasets for the histopathological reporting of
common skin cancers.February 2002
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Lesions suspicious of melanoma need to be seen
within two weeks of referral
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Patients with lesions suspicious of basal cell
carcinoma referred to hospital should be seen
within three months
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Patients referred to hospital with a lesion
suspicious of squamous cell carcinoma should be
seen ideally within a month and not later than
three months
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There is a need for additional investment in
staff dealing with the increasing workload of
skin cancer
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There is a need for a regional disfigurement
clinic with appropriately trained staff
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Mohs micrographic surgery needs to be funded and
more widely available
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There is a need for specialist trained nurses in
dermatology to deal with patients with skin cancer
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Nurses have an increasing role in skin cancer
prevention
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In head and neck cancers and the rarer skin
cancers nursing support is essential
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Multidisciplinary Working
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The development of multi-disciplinary teams for
melanoma and other rare skin cancers
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There is a need to develop multidisciplinary
teams (MDT) in each of the cancer units and the
cancer centre for the management of patients with
melanoma, lymphoma, soft tissue tumours, advanced
metastatic tumours and tumours at specific body
sites
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Regional Multidisciplinary Melanoma Audit Team
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Resource Implications
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Additional investment is required to enable
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Increase in the number of staff to deal with skin
cancer
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The establishment of a regional disfigurement
service
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Increased availability of Mohs micrographic
surgeons
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There is a need to encourage the development of
new treatments for skin cancer including
photo-dynamic therapy and Mohs micrographic
surgery
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Achieving these standards should not be at the
expense of patients with chronic skin disease who
need dermatological treatment
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