Skin cancer

The first sign you notice may be a change in how an area of skin looks. This may be on any area of skin but usually affects an area of skin that gets a lot of exposure to the sun. 

There are different symptoms of skin cancer. If you have any of these or notice any changes in your skin, it is important to have them checked by your GP.

You usually begin by seeing your GP. If your GP thinks your symptoms could be linked to cancer they refer you to a specialist skin doctor (a dermatologist) at your local hospital. Sometimes, a specially trained GP may be able to remove the affected area of skin first.

Your GP decides how quickly you need to be seen based on your symptoms and national guidelines.

If they think you have an SCC, they refer you to see the dermatologist within 2 weeks. If the GP thinks you have a BCC, you will usually see the dermatologist within 18 weeks. This is because nearly all BCCs are slow-growing and unlikely to change during this time. Sometimes, you will be seen sooner. Your GP can explain the referral process to you.

The dermatologist will do the following:

• Examine the affected area of skin. They may use an instrument called a dermatoscope, which looks like a magnifying glass with a light.
• Ask how long you have had it and if you have noticed any other changes.
• Check the rest of your skin for any other unusual areas.

It is not always possible to tell the difference between skin cancers and benign (non-cancerous) conditions just by examining the skin. Your doctor may advise that you have a sample of tissue taken (biopsy). This is a simple procedure that you can have in an outpatient department.

 You have a local anaesthetic to numb the area first. Then they remove all or part of the affected area and send it to the laboratory. A doctor who specialises in analysing cells (pathologist) will look at it under a microscope.

Different types of biopsy are used. Your doctor or nurse will tell you what to expect. If you need stitches these will be removed after a few days.

If the biopsy shows you have a skin cancer, your doctor usually checks over the rest of your skin for other possible areas of skin cancer.

Occasionally, some people may need further tests.

If you had treatment for skin cancer before, your doctor may want to check whether it has come back.

For basal cell carcinoma (BCC)

You will not usually need any further tests, as long as the cancer has been completely removed. This is because BCCs almost never spread.

For squamous cell carcinoma (SCC)

Your doctor may feel the lymph nodes close to the cancer to check whether any are enlarged.

If they think the cancer may have spread, which is rare, they may recommend surgery to take samples of the nearby lymph nodes.

You may have some scans if your doctor thinks the cancer has started to spread. These can include:

These scans are not usually needed when you are first diagnosed. Your doctor will explain more about these tests to you.

Waiting for test results can be a difficult time. We have more information that may help.

After surgery for BCCs and very early-stage SCCs you may not need long-term follow-up care. But your doctor may want you to have regular check-ups for a time. This is to make sure your treatment has been successful and the cancer has not come back.

Once you have had a skin cancer you have a higher risk of:

• developing it again in the same area (a recurrence)
• getting another skin cancer somewhere else on your skin.

You should check your skin regularly for any new symptoms or changes that could be cancer. You could use a mirror if there are areas like your back you cannot see easily or ask a relative or friend to help.

If you have problems or notice any new symptoms in between check-ups, tell your doctor straightaway.

After treatment for skin cancer it is very important to protect your skin from the sun. This can help prevent further skin cancers. Being exposed to a small amount of sunshine without getting red or burning, helps our bodies make vitamin D. If you are not exposed to the sun often, you can ask your dermatologist or GP to check your vitamin D levels and for advice on getting enough vitamin D.

Doctors try to minimise the effects of skin cancer treatments on your appearance. Many people have only minor scarring after treatment but for others it may be more obvious.

If treatment has changed your appearance you may feel differently about your body image. Although this often improves with time, you may feel self-conscious about how you look. Camouflage make-up to cover a scar, may help you to feel better about how the area affected looks.

Even though your skin cancer is likely to be cured, you may feel anxious or upset for a while after you have been diagnosed.

Everyone has their own way of dealing with a diagnosis and the different emotions they may experience. Macmillan is here to support you. If you would like to talk, you can:

• Call the Macmillan Support Line on 0808 808 0000.
• Chat to our specialists online
• Visit our skin cancer forum Online Community to talk to people who have been affected by skin cancer, share your experience, and ask an expert your questions.