How skin cancers are diagnosed

At the hospital

Most people with suspected skin cancer are referred to a specialist at their local hospital for advice and treatment. A specialist in treating skin diseases is called a dermatologist. Your treatment may be carried out by the dermatologist. However, depending on the area of the body affected by the cancer and the type of treatment needed you may also be referred to:

• a general surgeon
• a plastic surgeon
• a clinical oncologist (radiotherapy and chemotherapy specialist).

Often these different doctors all work together and are known as a multidisciplinary team, or MDT. Other staff will be available to help if necessary such as:

• specialist nurses who give information and support
• pathologists who advise on the type and extent of the skin cancer
• social workers
• counsellors and psychologists.

Biopsy

The specialist will be able to tell a great deal from a simple examination of the affected area of skin. However, it is not always possible to tell the difference between skin cancers and benign conditions by examination alone. You may be advised to have a biopsy.

This is a quick and simple procedure which can usually be done in the outpatients department using a local anaesthetic. The doctor will remove all or part of the lump and send it to the laboratory. In the laboratory it will be analysed under a microscope by a pathologist.

Further tests

Most people with non-melanoma skin cancer will not need any further tests.

As basal cell carcinomas almost never spread, there will probably be no need for further tests as long as the cancer has been completely removed.

As squamous cell carcinomas may occasionally spread, your doctor may want to do one or two other tests as well as the physical examination and biopsy. This is to make sure that there is no need for further treatment.

The tests are particularly important if you have had treatment for skin cancer before and it has come back (recurred). During the physical examination, the doctor will probably feel the lymph glands close to the cancer to see if any of them are enlarged. Your specialist may recommend that you have an operation to remove some of the nearby nodes if they think there is a risk that the cancer has spread to them.

Occasionally, CT scans and MRI scans are done if your doctor thinks there is a possibility that the cancer has begun to spread.

You will probably be asked to have a chest x-ray and possibly blood tests to assess your general health. If any other tests are necessary, your doctor will discuss these with you.

It may take 2-4 weeks for the results of the biopsy to be ready. A follow-up appointment to give you the results may be arranged before you go home. This waiting period will be an anxious time for you. It may help to talk things over with a close friend or relative, or a support organisation.