Improving outcomes for people with skin tumours including melanoma

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Improving Outcomes for People with Skin Tumours including Melanoma Appendix 7 Appendix 7 Abbreviations A7 AHP AIDS AJCC AK AMS BAD BCC CME CMO CNS CPD CT CTCL DH ENT EORTC EQA GDG GP GPwSI HAART HDA HES HIV ICD ILI ILP IT ITU allied health professional acquired immune deficiency syndrome American Joint Committee on Cancer actinic keratosis atypical mole syndrome British Association of Dermatologists basal cell carcinoma continuing medical education Chief Medical Officer clinical nurse specialist continuing professional development computed tomography cutaneous T-cell lymphoma Department of Health ear, nose and throat European Organisation for Research and Treatment of Cancer external quality assessment Guidance Development Group general practitioner general practitioner with a special interest highly active antiretroviral therapy Health Development Agency Hospital Episodes Statistics human immunodeficiency virus International Classification of Diseases isolated limb infusion isolated limb perfusion information technology intensive care unit 172 National Institute for Health and Clinical Excellence
KS LHB LSMDT MCC MDT MM MRI NCC-C NCRI NCRN NICE NMSC NSF ONS PCT PDT PEDW PET RCGP SCC SHA SIGN SNB SSMDT UKACR UV WHO XP Kaposi’s sarcoma local health board local hospital skin cancer multidisciplinary team Merkel cell carcinoma multidisciplinary team malignant melanoma magnetic resonance imaging National Collaborating Centre for Cancer National Cancer Research Institute National Cancer Research Network National Institute for Health and Clinical Excellence non-melanoma skin cancer National Service Framework Office for National Statistics primary care trust photodynamic therapy Patient Episode Database in Wales positron emission tomography Royal College of General Practitioners squamous cell carcinoma strategic health authority Scottish Intercollegiate Guidelines Network sentinel node biopsy specialist skin cancer multidisciplinary team United Kingdom Association of Cancer Registries ultraviolet World Health Organization xeroderma pigmentosum Improving Outcomes for People with Skin Tumours including Melanoma Appendix 7 A7 Guidance on cancer services: skin tumours including melanoma 173
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NHS National Institute for Health a
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Contents Improving Outcomes for Peo
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Patient information ...............
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Resource implications .............
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Foreword Improving Outcomes for Peo
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- referral - review of patient care
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early detection have been published
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The epidemiology of skin cancers an
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The incidence of MM increases with
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Figure 5. Mortality from MM, Englan
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Figure 8. Incidence of NMSC, Englan
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Risk factors for skin cancer As ski
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Figure 12. Rates of episodes of inp
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Two-week wait data Urgent skin canc
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• Improving the experience of car
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12. National Institute for Clinical
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Patient-centred care Improving Outc
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This document and the NICE Referral
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A checklist may be used by healthca
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Quality assurance Surveys of patien
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One cross-sectional study found tha
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One RCT conducted with patients wit
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• Every skin cancer MDT having ac
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to estimate a separate cost for ser
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department or they may be referred
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The 2-week waiting time standard an
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The local hospital skin cancer mult
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A function of the LSMDT is to audit
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• lymphoedema therapists • phar
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SSMDT meetings should be at least f
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As set out in the section on ‘Arr
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• Palliative care specialists. Si
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Videoconferencing and teleconferenc
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A basic knowledge of skin cancer hi
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B. Anticipated benefits At present,
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One systematic review (of the abili
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One retrospective study compared pa
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• Critical incidents where treatm
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Network-wide protocols It is not po
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Initial investigation, diagnosis, s
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Figure 14. Skin lesion - patient pa
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curettage (as recommended in BAD gu
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Diclofenac 3% gel (Solaraze) is lic
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Histopathology services for skin ca
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Patients with anogenital Bowen’s
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B. Anticipated benefits Better-qual
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One RCT compared teledermatology wi
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One systematic review based upon 12
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Expert review evidence suggests tha
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Immunotherapy An RCT comparing allo
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• Adherence to treatment protocol
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F. Research priorities • Given th
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For patients with low-risk BCC or S
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Follow-up for patients after treatm
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C. Evidence Evidence exists that ea
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One observational study found that
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The written and photographic inform
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Genetic predisposition to MM may al
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patients with cutaneous lymphoma sh
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A. Recommendations Generic recommen
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Cutaneous lymphoma All patients sho
Page 123 and 124: Children and young people with skin
Page 125 and 126: Gorlin’s syndrome Two expert revi
Page 127 and 128: Process • Audit of adherence to p
Page 129 and 130: • Cutaneous lymphoma is so rare t
Page 131 and 132: Dermal and subcutaneous tumours Aty
Page 133 and 134: c) The guidance will also refer to
Page 135 and 136: 4.2.2 Healthcare settings and servi
Page 137 and 138: Referral from the Department of Hea
Page 139 and 140: Table A1. Summary of service option
Page 141 and 142: For those cancer networks with part
Page 143 and 144: Appendix 4 How this guidance manual
Page 145 and 146: Appendix 5 People and organisations
Page 147 and 148: Professor Julia Newton-Bishop Mr Ba
Page 149 and 150: • Bristol South and West PCT •
Page 151 and 152: • Healthcare Commission • Help
Page 153 and 154: • Royal College of Surgeons of En
Page 155 and 156: Appendix 5.3 Researchers carrying o
Page 157 and 158: Appendix 5.4 Expert advisers to the
Page 159 and 160: Appendix 5.5 Report* commissioned t
Page 161 and 162: Appendix 6 Glossary of terms Improv
Page 163 and 164: Chemoprophylaxis The use of a drug
Page 165 and 166: Electrodesiccation A surgical metho
Page 167 and 168: Immunotherapy Treatment by stimulat
Page 169 and 170: Morbidity A diseased condition or s
Page 171 and 172: Prognosis A prediction of the likel
Page 173: Systemic therapy Treatment that rea
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