Skin Unit

The Skin Unit provides high-quality, accessible care for patients with skin cancer from south and west London. It also receives national referrals, particularly for patients with advanced melanoma.

The unit has a full complement of experts in the field of skin cancer, including dermatological surgeons, reconstructive surgeons, general surgeons, medical oncologists and clinical oncologists. There is also a major research unit based at the Institute of Cancer Research that collaborates closely with the clinicians at the Skin Unit.

The Royal Marsden's Skin Unit has a national and international reputation in the treatment of advanced melanoma because of its involvement in clinical trials for patients with stage IV melanoma and its treatment of patients with advanced stage III melanoma. In particular, The Royal Marsden is the only national provider of isolated limb perfusion with tumour necrosis factor alpha which is a valuable treatment for bulky melanoma confined to the limbs.

Treatment

Primary disease

The Royal Marsden's Skin Unit has dermatologists and reconstructive surgeons at both its hospitals in Chelsea and Sutton. This allows patients to be fully assessed and undergo treatment for primary skin cancer at the same institution.

There is a fortnightly multidisciplinary meeting where all of the members of the skin multidisciplinary team consider every patient’s case individually.

Advanced disease

The Royal Marsden also has a complete complement of experts for the treatment of patients of all types of skin cancer where the disease is no longer limited to the skin.

The full range of surgical treatments, including lymph node dissections and resections of other sites of distant disease, can be provided at The Royal Marsden. Similarly, a full range of radiotherapy techniques is available, and standard and investigational chemotherapy techniques are also fully provided.

One particular area of specialisation at The Royal Marsden is the management of in-transit metastases for malignant melanoma. This can be achieved using the technique of isolated limb perfusion with melphalan and tumour necrosis factor; this is a complex procedure but can be extremely successful for the management of advanced malignancy on the arm or leg. At present, The Royal Marsden is the only hospital offering this service in the UK, although a number of European centres also offer this technique.

The Royal Marsden also offers laser vaporisation, which is a simpler technique for less advanced disease but is also available in only a few centres in the UK.

Research and clinical trials

The Royal Marsden’s Skin Unit has a national referral basis for patients who are being considered for entry into clinical trials for new chemotherapy. There are strong academic links with The Institute of Cancer Research which has pioneered recent advances in the understanding of the genetics of melanoma. These have recently led to the development of new drugs for the treatment of skin cancer.

Because of this strong emphasis on clinical research many of the Unit's patients are offered chances to take part in national and international trials of new treatments, particularly for malignant melanoma. The Unit has published extensively on all aspects of skin cancer.

Staff

Head of Unit

Consultants

Institute of Cancer Research (ICR) colleagues

  • Professor Richard Marais, Professor of Molecular Oncology

Service Manager

  • Caitriona Liebenberg, Service Manager