Skin cancer and melanoma

Our service
Type of treatment available
Research and clinical trials
For patients
For clinicians
Sources for further information
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Our service

Advice to patients diagnosed with skin cancer

Dermatopathologist, Professor Rino Cerio talks about the different types of skin cancers, the various treatment options, including the latest therapies available at Barts Cancer Centre, as well as how to be referred here.

Skin cancer is the most common cancer in the UK and rates of skin cancer are increasing rapidly. The management of skin cancer is an increasing part of the work of Barts and The London’s Skin Centre, one of the largest dermatology departments in the UK and the second largest in London. Together, with Barts Cancer Centre, we provide the most specialist care and treatment for skin cancer patients.

Each year we treat at least 150 new patients with melanoma, and more than 600 patients with other forms of skin cancer. Our service also includes the family cancer clinic for surveillance of individuals and families with atypical mole syndrome and other genetic conditions, who are at increased risk of developing skin cancer. We also have a transplant skin cancer clinic for organ transplant recipients and other immuno-suppressed individuals who are also at increased risk for developing skin cancer.

There are two main types of skin cancer - melanoma and non-melanoma.

Non-melanoma skin cancer is the most common kind of skin cancer diagnosed in the UK with approximately 100,000 new cases each year. The good news is that it is completely treatable in the vast majority of cases. There are two main types of non melanoma skin cancer, basal cell and squamous cell.

Melanoma is less common than non-melanoma with approximately 10,000 people diagnosed a year. It often starts in an existing or new mole.

To find out more about how we treat these skin cancer conditions please read on below:

Type of treatment available

The treatments and equipment used at our centre are at the forefront of modern healthcare. As with all of our services at Barts Cancer Centre, treatments offered will depend on individual cases and the stage of cancer. This will be discussed in detail with every patient by one of our medical team once a diagnosis has been made. Our treatments include:

Surgery

This is the first line treatment for most types of skin cancer. This is normally done under local anaesthetic and in many cases is the only treatment needed for non melanoma skin cancers. Some patients may also need a skin graft to help close up the area from which the cancer has been surgically removed. This is usually a minor procedure.

Radiotherapy

This is a targeted x-ray treatment used to treat some types of skin cancer. It is used if surgery is not possible and is given over several days or weeks as an outpatient. For more details about radiotherapy for the treatment of cancer, please click here. (link to radiotherapy in cancer treatments)

Photodynamic therapy

This is a newer, non-surgical treatment used for certain types of non-melanoma cancer (usually basal cell carcinoma) and pre-cancerous areas. This works by exposing the cancerous areas with a special cream, followed by light, which causes the cancer cells to die. It uses laser or other light sources combined with a light-sensitive drug (sometimes a photosensitising agent) to destroy cancer cells, and in some cases is an alternative to surgery for such conditions. Barts Cancer Centre has the only photodynamic therapy service in the North East Thames area.

Cryotherapy

This is another treatment option for precancerous areas and some basal cell carcinomas. It works by freezing an area to destroy the cancer cells.

Specialist anti-cancer ointments

This treatment is proven to be very effective in some cases, especially for pre-cancerous lesions and some basal cell carcinomas.

Sentinel lymph node biopsy

This is a specialist test that finds out if the skin cancer (usually melanoma) has spread to the lymph nodes. At Barts Cancer Centre we offer this to new patients with certain stages of melanoma. After this test, an operation may be needed to remove nearby lymph glands if these have been affected.

Caring and treating patients after an organ transplant

Some forms of skin cancer are more common after a patient has had an organ transplant, and this is due to a weakened immune system. The risk of squamous cell cancer (SCC) is increased as much as 100 times. Chances of basal cell carcinoma (BCC) and melanoma are also increased after an organ transplant.

For those patients who do unfortunately develop skin cancers after a transplant, we run a dedicated skin clinic. In this clinic, we see all newly transplanted patients and give them advice on skin cancer prevention and detection, and keep them under life-long surveillance.

This was the first such clinic in the UK and is now recognised nationally and internationally as the gold standard of care for high-risk patients. Our dedicated group of doctors working in this clinic are examining why such patients are more prone to this kind of skin cancer.

Research and clinical trials

Barts has been at the forefront of medical discovery since it was founded nearly 900 years ago and today, our research continues to be recognised for its originality, significance and rigour. The results of the work we do here means we are constantly improving the treatments and care we can offer patients.

At Barts Cancer Centre, we have an active research programme into skin cancer and other skin conditions. Current skin cancer research is focused on investigating various aspects of the epidemiology, causes, treatment and prevention of the three major forms of skin cancer: melanoma, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Much of this research is undertaken in the Centre for Cutaneous Research and The Cancer Research UK Skin Tumour Laboratory based in the Blizard Institute of Cell and Molecular Science, Queen Mary University of London.

Among the main skin cancer research projects are:

Epidemiological and clinicopathological studies of skin cancer in organ transplant recipients.
Prevention and treatment of transplant related skin cancer.
Genome wide genetic and epigenetic changes in SCC and precursors.
Role of human papillomavirus in SCC.
Genetics and signalling pathways in BCC.
Apoptosis and p53 pathogenesis of melanoma.
The role of azathioprine and other immunosuppressive drugs in transplant skin tumours.
The role of L-Arg/ASS in melanoma development.

Our patients are also eligible to enter National Cancer Research Institute (NCRI) and European Organisation for Research and Treatment of Cancer (EORTC) skin cancer trials researching new treatments and the numbers of our patients entered in recent years has increased.

We have opened trials for melanoma patients including AVAST-M, a Cancer Research UK funded trial for patients with high risk melanoma being treated with Adjuvant aVASTIN. We also have a trial called BRIM, which is a global study on previously untreated patients with stage four melanoma.

For more information about clinical trials for skin cancer, please speak to your consultant or nurse specialist.

For patients

Every individual’s cancer is different, and our doctor or specialist nurse will be happy to answer any questions you may have about your treatment and any trials or experimental treatments that may be appropriate for you.

For clinicians

Our clinics include:

Multidisciplinary clinic weekly on Tuesday mornings.
Transplant associated skin tumour clinic weekly on Wednesday mornings.
Family Skin Cancer Clinic on the last Thursday of each month.

We treat patients with complex conditions who are referred to us by surrounding district general hospitals in north east London and as far as Essex.

We consistently achieve national access targets for patients with suspected cancer and for treatment following diagnosis. Referral criteria and forms are all available on our website, please click here for referral forms.