Improving outcomes for people with skin tumours including melanoma

Improving Outcomes for
People with Skin Tumours
including Melanoma
Key recommendations
Key recommendations
• Cancer networks should establish two levels of multidisciplinary
teams – local hospital skin cancer multidisciplinary teams
(LSMDTs) and specialist skin cancer multidisciplinary teams
(SSMDTs). All health professionals who knowingly treat patients
with any type of skin cancer should be members of one of these
teams, whether they work in the community or in the hospital
setting.
• People with precancerous skin lesions should be either treated
entirely by their GP or referred for diagnosis, treatment and
follow-up to doctors working in the community who are
members of the LSMDT/SSMDT. If there is any doubt about the
diagnosis, people with precancerous lesions should be referred
directly to their local hospital skin cancer specialist, normally a
dermatologist, who is a member of the LSMDT/SSMDT. Where
appropriate, follow-up of these patients may be undertaken by
their own GP.
• Patients with low-risk basal cell carcinomas (BCCs) (see
‘Glossary of terms’, Appendix 6, for definitions) should be
diagnosed, treated and followed up by doctors working in the
community as part of the LSMDT/SSMDT (usually a GP with a
special interest in dermatology [GPwSI]), or a local hospital skin
cancer specialist, normally a dermatologist, who is a member of
the LSMDT/SSMDT and to whom they have been directly
referred. Where there is doubt about the lesion being low or
high grade, the patient should be referred directly to the
LSMDT/SSMDT.
• All patients with a suspicious pigmented skin lesion, with a skin
lesion that may be a high-risk BCC, a squamous cell carcinoma
(SCC) (see ‘Glossary of terms’, Appendix 6, for definitions) or a
malignant melanoma (MM), or where the diagnosis is uncertain,
should be referred to a doctor trained in the specialist diagnosis
of skin malignancy, normally a dermatologist, who is a member
of either an LSMDT or an SSMDT.
• Cancer networks should ensure, through the skin cancer
network site-specific group, that LSMDTs and SSMDTs work to
network-wide agreed protocols for:
8 National Institute for Health and Clinical Excellence