You may have been referred to our dermatology department with a lesion, or with symptoms that could be caused by a skin cancer. It is important that, if you do have a cancer, we diagnose it as quickly as possible.

Patients with suspected skin cancer should be referred by their GP or specialist via a ‘two-week wait (2ww)’ pathway, which means you should receive an appointment for assessment in the hospital within two weeks.

When we see you, we may have to do some investigative tests, either on the same day or shortly afterwards.

Tests may include a surgical biopsy of the lesion — a minor procedure carried out with local anaesthetic. More rarely, an ultrasound examination is carried out.

If a skin cancer is diagnosed during the initial tests, we may offer further tests to ‘stage’ the cancer — this means establishing the size and type, and if there is any spread of the cancer. 

These tests may include a CT scan, PET scan or an MRI scan. Ultrasound scans are sometimes also used.

All patients who have a major skin cancer lesion will be discussed in a weekly group meeting of clinicians (including dermatologists, oncologists and histopathologists) to agree on the best treatment options for you.

This is called the skin cancer multidisciplinary team meeting.

Most minor skin cancer lesions are treated with simple surgical excision, carried out under local anaesthetic. We also use topical (cream) treatments or superficial radiotherapy.

For other lesions treatment will depend on the type of skin lesion, the presenting stage and your general fitness.

Sometimes, patients need a combination of surgery and systemic treatment (ie treatment that is given periodically as an intravenous infusion).

Sometimes, a suitable treatment may involve taking part in a clinical trial and, if indicated, this option will be presented to you.

A treatment given as part of a clinical trial may take place at the Royal Free London, or you may be referred to another NHS centre.