Melanoma

Skin cancer can take a number of forms but the most common types are malignant melanoma, basal cell carcinoma and squamous cell carcinoma.

The Royal Marsden provides treatments for all types of skin cancer at its hospitals. The management of skin cancer can be very different depending upon the type of skin cancer and also whether the disease is localised only to the skin or exists in other parts of the body. However, The Royal Marsden has experts who can manage patients with all types of skin cancer at any stage of the disease. The services on offer include:

  • Diagnosis, tests and investigations: primary assessment and diagnosis
  • Cancer genetics
  • Surgery, including reconstructive surgery
  • Chemotherapy
  • Radiotherapy
  • Isolated limb perfusion
  • Critical care
  • Rehabilitation
  • Palliative and supportive care
  • Clinical trials

Diagnosis and assessment

The Royal Marsden's Skin Unit includes experts in the field of dermatology, plastic surgery, general surgery, medical oncology and radiation oncology.

There are regular clinics from all specialities at both hospitals and facilities for one-stop assessment in the Rapid Diagnostic and Assessment Centre. Our skin diagnostic clinic provides a one-stop service, meaning that patients will generally be seen, photographed and have their lesion removed (if appropriate) on the same day. Referrals for suspected melanomas, squamous cell carcinomas and basal cell carcinomas are all seen, as are patients with multiple naevi who may need long-term monitoring.

The Royal Marsden is equipped to see patients who are referred directly from GPs in primary care, but also has a national referral pattern for second opinions, particularly for patients with rarer forms of skin cancer and for melanoma.

Treatment

Patients with any form of skin cancer at any stage can be treated comprehensively at The Royal Marsden. There is a full range of surgical and oncological treatments available.

The Royal Marsden is the only centre in the UK which offers isolated limb perfusion for advanced melanoma affecting the limbs. It is also one of the few centres in the UK to offer laser vaporisation of in-transit metastases, a useful procedure for less advanced melanoma.

The Royal Marsden’s Skin Unit also focuses on non-invasive ultrasound surveillance of lymph nodes for patients with melanoma. This avoids the need for the extra procedure of central node biopsy in patients with malignant melanoma.

Clinical trials

The Royal Marsden is at the forefront of research into the treatment of all forms of skin cancer, but particularly malignant melanoma. Great emphasis is placed on research collaborations between the Skin Unit and the Institute of Cancer Research, and these collaborations have led to major advances in the understanding and future treatment prospects of patients with malignant melanoma.

The Royal Marsden receives regional and national referrals of patients who wish to be involved in national and international clinical trials of new treatments for malignant melanoma and other skin cancers.

Dr Larkin talks about breakthroughs in melanoma:

Shared care

The Royal Marsden has strong links with other skin cancer units in London. There is a joint dermatological appointment between Chelsea and Westminster NHS Foundation Trust and The Royal Marsden. Similarly, The Royal Marsden works closely with Epsom and St Helier University Hospitals NHS Trust skin unit and St George’s Healthcare NHS Trust. This allows patients to be referred between centres depending on their treatment needs.