Improving outcomes for people with skin tumours including melanoma

Improving Outcomes for
People with Skin Tumours
including Melanoma
Initial investigation,
diagnosis, staging and
management
Treatments using surgery and carbon dioxide laser techniques should
be available at regional centres via SSMDTs, but ILP and ILI would
only be required at supraregional centres.
Vaccine therapy for advanced MM remains uncertain and its use
should only be in the context of a clinical trial.
Before non-surgical treatment, a tissue sample for confirmation of the
diagnosis should usually be obtained.
Histopathology services should be adequately staffed and resourced to
cope with the potential increase in skin biopsies resulting from the
recommendations in this guidance. Commissioners should note,
however, that acknowledged current workforce shortages could delay
this implementation.
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NHS histopathologists in England and Wales must work in laboratories
that are seeking or have accreditation with Clinical Pathology
Accreditation Ltd.
All cancer networks should have easy access to appropriate
immunophenotypic, molecular biological and cytogenetic facilities.
Some of the latter are very specialised pathology services and may not
be provided by pathology laboratories within the LSMDT or SSMDT.
Cancer networks should identify one or more clinical oncologists and
medical oncologists with responsibility for the radiotherapy and
systemic treatment of patients with skin cancer.
Radiotherapy departments should have the appropriate equipment
including orthovoltage radiotherapy machines for the management of
patients with skin cancer.
All treatments identified in this chapter for the treatment of skin
cancer should be available for use by clinicians in all of the teams,
subject to locally agreed standards of competence.
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National Institute for Health and Clinical Excellence