How treatment is planned

Once the diagnosis of advanced melanoma is confirmed, your treatment will be planned and given by a team of specialists. This is known as a multidisciplinary team (MDT).

Your MDT usually include a:

  • dermatologist
  • a plastic surgeon
  • a specialist surgeon
  • specialists in radiotherapy and chemotherapy
  • a pathologist
  • a skin cancer specialist nurse.

The team may include other healthcare professionals, such as a palliative care specialist.

The MDT takes several factors into account when advising you on the best treatment, including where the melanoma has spread to, your test results and general health.

Sometimes different treatments can be equally effective for controlling advanced melanoma. You may be asked to make a decision about your treatment. A treatment can’t be given without your consent. Make sure you have enough information about the options, what’s involved and the possible side effects. Once you understand your treatment, your doctor will ask you to sign a consent form.

If you want a second opinion, you should ask your specialist for a referral.

Planning your treatment

In most hospitals, a team of specialists will talk with you about the treatment they feel is best for your situation.

This multidisciplinary team (MDT) will include:

  • a dermatologist – a doctor specialising in the treatment of skin cancers and skin disorders
  • a plastic surgeon – a doctor specialising in reconstructive surgery
  • a specialist surgeon – depending on what area of your body the cancer has spread to
  • a medical oncologist – a chemotherapy specialist
  • a clinical oncologist – a radiotherapy and chemotherapy specialist
  • a pathologist – a doctor who examines samples from the tumour to see whether it’s a cancer and which type it is
  • a skin cancer specialist nurse – who gives information and support and co-ordinates your treatment.

It may also include other healthcare professionals, such as a palliative care specialist, research nurse, dietitian, physiotherapist, occupational therapist, psychologist or counsellor.

The MDT will take a number of factors into account when advising you on the best treatment. These include your general health, the area the melanoma has spread to and your test results.

Sometimes different treatments can be equally effective for controlling advanced melanoma. In this situation, your doctors may offer you a choice of treatments. If you’re asked to make a choice, make sure you have enough information about the different options, what’s involved and the possible side effects. This will help you decide on the right treatment for you.

Remember to ask questions about anything that you don’t understand or feel worried about. It may help to discuss the benefits and disadvantages of each option with your cancer specialist or nurse specialist, or with our cancer support specialists on 0808 808 00 00. We have more information on making treatment decisions.


Questions you could ask your specialist

It often helps to make a list of questions and to take a relative or close friend with you when you attend your hospital appointments. As well as giving support, they may be able to take notes for you, or remind you of any questions you want to ask. It may help you to make a list of questions before your next appointment. Here are some questions you might want to ask your doctor:

  • What are my treatment options?
  • Is this treatment aimed at helping me live longer or controlling my symptoms?
  • How long will it be before I feel the benefit of any treatment?
  • What are the side effects?
  • Can I carry on working?
  • Will I need to stay in hospital and, if so, for how long?

Some people find it useful to record the discussion with their doctor (with their doctor’s permission). Recordings can also be helpful for family and friends to listen to, so that you don’t have to keep repeating information.


Giving your consent

Before you have any treatment, your doctor will explain its aims. They will usually ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment.

No medical treatment can be given without your consent, and before you are asked to sign the form you should be given full information about:

  • the type and extent of the treatment
  • its advantages and disadvantages
  • any significant risks or side effects
  • any other treatments that may be available.

If you don't understand what you've been told, let the staff know straight away, so they can explain again. Some cancer treatments are complex, so it's not unusual to need repeated explanations.

It's a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion. You may also find it useful to write a list of questions before your appointment.

People sometimes feel that hospital staff are too busy to answer their questions, but it's important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions.

You can always ask for more time if you feel that you can't make a decision when your treatment is first explained to you.

You are also free to choose not to have the treatment. The staff can explain what may happen if you don't have it. It’s essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You don't have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.


Getting a second opinion

Your multidisciplinary team (MDT) uses national treatment guidelines to decide the most suitable treatment for you. Even so, you may want another medical opinion. If you feel it will be helpful, you can ask either your specialist or GP to refer you to another specialist for a second opinion. Getting a second opinion may delay the start of your treatment, so you and your doctor need to be confident that it will give you useful information. If you do go for a second opinion, it may be a good idea to take a relative or friend with you, and have a list of questions ready, so that you can make sure your concerns are covered during the discussion.


Second opinion


Back to Who will be involved in my treatment decision?

Making a complaint

Talking to your healthcare team can make it easier to cope. If you find talking difficult, there are things you can do.