Treatment

Your doctors will tell you about the benefits, risks and side-effects of the treatments being offered.

Each person is different and your surgery and/or treatment will be tailored to your needs and discussed fully with you before proceeding. Throughout your care, procedures, surgery and treatment will not be carried out without your consent.

Skin cancer can be treated in a number of ways, or a combination of:

Some skin cancers can be treated in the clinic (treatments in the clinic include curettage and cautery, cryotherapy and excision) and some skin cancers can be treated with a cream. Other patients are booked for excision at one of the Northern Trust hospitals.

Patients requiring plastic surgery will be referred to the Ulster Hospital in Dundonald.

Radiotherapy for skin cancer is given in the Cancer Centre at Belfast City Hospital.

Chemotherapy is rarely needed for skin cancer, but can be given at Laurel House or the Cancer Centre at Belfast City Hospital.

Treatment for each skin cancer is different.

Non melanoma skin cancer

Most non melanoma skin cancers are treated by surgery. This involves removing (excising) the skin cancer including a margin of normal skin around it. This technique is usually done under local anaesthetic. The wound can normally be closed with stitches but sometimes in larger and more complex skin cancers a graft or skin flap is required.

In some cases Mohs’ micrographic surgery may be necessary. This is a specialised type of surgery, also known as margin control excision, performed under local anaesthetic. It is particularly useful for basal cell cancers which do not have a clear edge, are at difficult sites on the face or when the basal cell cancer has come back again. This technique aims to make sure that all the tumour is removed while preserving as much normal skin as is possible.

For more information on treatment of non-melanoma skin cancer including surgery, please visit the Macmillan Cancer Support website.

Melanoma

The main treatment for melanoma is surgery. After biopsy when the diagnosis has been confirmed a second surgery or wide local excision is usually required. This is to decrease the likelihood of the melanoma recurring. If a large area is removed a skin graft may be required. If the melanoma has spread to the lymph nodes then surgery to remove the affected lymph glands may be needed.

Occasionally other treatments are used after surgery if there is high risk that the melanoma may come back. These are known as adjutant treatments and are usually given as part of a clinical trial.

If a melanoma comes back after treatment and spreads to other organs then other treatments (chemotherapy and radiotherapy) may be used either alone or in combination to try to shrink the tumour and control symptoms.

For more information on treatment of melanoma skin cancer including surgery, please visit the Macmillan Cancer Support website.

After treatment

Many patients on completing their skin cancer treatment can be discharged with advice on checking their skin, others will continue on an outpatient review programme.  The main reason for this is to make sure that the skin cancer has not come back or spread elsewhere and to provide the patient with support and information.  Review appointments or appointments with a GP are also a good opportunity to discuss any worries or problems.

In general patients who have already had a skin a cancer are at a greater risk of developing another skin cancer. They are also more at risk of developing a recurrence at the site where the tumour was before. Therefore it is important to check the skin for changes once a month.

For more information on the signs and symptoms a patient should look out for and for quick guide to self-examination of your skin, please visit the Northern Ireland Cancer Network website.

If any new symptoms are noticed, or if there are any worries between outpatient visits the patient should discuss these with their GP who will arrange for an earlier appointment if necessary.