Skin Cancer

Services

Cancer Services

The Luton and Dunstable Hospital NHS Foundation Trust's Cancer Unit is part of the Mount Vernon Cancer Network.  The Network covers a geographical area from North London to mid-Bedfordshire, west to Buckinghamshire and east to Hertfordshire, providing services to a population of two million people.  The Mount Vernon Hospital Cancer Centre provides specialist care, including radiotherapy and complex chemotherapy, with the local Cancer Units and the Primary Care Trusts providing routine and on-going care, including chemotherapy.

Oncology services are provided by consultant staff from Mount Vernon, taking part in combined clinics with the Luton and Dunstable hospital staff.

To access the service please visit your GP

The lead clinician for cancer services is Mr. Mike Pittam, Consultant Surgeon.

Multi-Disciplinary Team (MDT) meetings for all tumour sites are held on a regular basis, mostly weekly, to discuss newly diagnosed or suspected cancer patients.  Some MDT meetings participate in video-conferencing with other Network Teams to encourage wider discussion and input to the patient pathway.  The MDT Office can be contacted on either: 01582 718 268 or 01582 718 099.

SKIN Clinics

  • Dermatology clinic: (5 days per week)
  • Parallel dermatology/oncology/plastic surgery clinics

Useful Numbers

Dr B de Silva 01582 497561
Sec to Mr Kang 01582 492738
Sue Semper 01582 560206

Who to Refer

Melanoma Information

  • Change is a key element in diagnosing malignant melanoma.  For low-suspicion lesions, undertake careful monitoring for change using the 7-point checklist (see below) for 8 weeks.  Make measurements with photographs and a marker scale and/or ruler
  • Be aware of and use the 7-point weighted checklist for assessment of pigmented skin lesions
    • Major features of lesions:
      • Change in size
      • Irregular shape
      • Irregular colour
    • Minor features of lesions:
      • Largest diameter 7mm or more
      • Inflammation
      • Oozing
      • Change in sensation
  • Lesions scoring 3 points or more (based on major features scoring 2 points each and minor features scoring 1 point each) in the 7-point checklist above are suspicious.  (If you strongly suspect cancer any one feature is adequate to prompt urgent referral)

Urgent Referral within 2 Weeks (under 2 week rule)

Melanoma

Refer urgently patients:

  • With a lesion suspected to be melanoma.  (Excision in primary care should be avoided)

Squamous cell carcinomas

  • Refer urgent patients:
  • With non-healing keratinizing or crusted tumours larger than 1cm with significant induration on palpation.  They are commonly found on the face, scalp or back of the hand with a documented expansion over 8 weeks
  • Who have had an organ transplant and develop new or growing cutaneous lesions as squamous cell carcinoma is common with immunosuppression but may be atypical and aggressive
  • With histological diagnosis of a squamous cell carcinoma

Non-urgent

  • Basel cell carcinomas are slow growing, usually with significant expansion over 2 months, and usually occur on the face.  If basal cell carcinoma is suspected, refer non-urgently

Investigations

  • All pigmented lesions that are not viewed as suspicious of melanoma but are excised should have a lateral excision margin of 2mm of clinically  normal skin and cut to include subcutaneous fat in depth
  • Send all excised skin specimens for pathological examination
  • When referring a patient in whom an excised lesion has been diagnosed as malignant, send a copy of the pathology report with the referral correspondence

Macmillan Cancer Support Rapid Referral Guidelines

Macmillan Cancer Support Rapid Referral Guidelines

Resources

Map of Medicine Patient Pathway

Suspected Melanoma Map of Medicine

Suspected Basal Cell Carcinoma Map of Medicine

NICE Guidelines:

CG27 Referral for suspected cancer: full guideline
http://guidance.nice.org.uk/CG27/Guidance

CG27 Referral for suspected cancer: quick reference guide
http://guidance.nice.org.uk/CG27/QuickRefGuide/pdf/English

CG27 Referral for suspected cancer: information for the public
http://guidance.nice.org.uk/CG27/PublicInfo/pdf/English

CG27 Referral for suspected cancer: NICE guideline
http://guidance.nice.org.uk/CG27/NICEGuidance/pdf/English

Website Resources

Skin Cancer (Melanoma) NHS Choices:
http://www.nhs.uk/conditions/Malignant-melanoma/Pages/Introduction.aspx

Macmillan Cancer Support - Melanoma:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Melanoma/Melanoma.aspx

The Royal Marsden NHS Foundation Trust
http://www.royalmarsden.nhs.uk/diagnosis-treatment/cancer/pages/skin.aspx

Cancer Research UK (Melanoma):
http://cancerhelp.cancerresearchuk.org/type/melanoma/

The Skin Care Campaign
http://www.skincarecampaign.org/

The British Association of Dermatologists:
http://www.bad.org.uk/site/1/default.aspx

Skin Cancer (Non-Melanoma) NHS Choices:
http://www.nhs.uk/conditions/Cancer-of-the-skin/Pages/Introduction.aspx

Macmillan Cancer Support - Non-Melanoma:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Skin/Skincancer.aspx

Cancer Research UK (Non-Melanoma):
http://cancerhelp.cancerresearchuk.org/type/skin-cancer/

Cancer Networks

Mount Vernon Cancer Network - for residents of Hertfordshire and South Bedfordshire
http://www.mountvernoncancernetwork.nhs.uk/

Patient Information Leaflets available from Luton & Dunstable Hospital

Patient Information on 2 Week Wait

Macmillan Cancer Support - Luton



Last updated: 20/06/2013

Update due: 20/06/2014