CRH Skin Cancer 2023.jpegThe Dermatology Department at Chesterfield Royal Hospital offers different services to treat many different skin conditions including skin cancers. You are normally referred to the Dermatology department by your GP. If they suspect you may have skin cancer this will most likely have been done referred in by your GP as a 2-week wait.

You will then be seen in the clinic. Depending on your diagnosis depends on your next step. We can offer surgery within our dermatology department. Although sometimes we feel it would be better to offer surgery in an alternative setting and may refer you to other specialist departments, either here or at other hospitals, normally in Sheffield.

We offer surgical treatments as well as topical treatments depending on the patient’s diagnosis. We also offer follow-up consultations, which can be done face-to-face, via video or by telephone. Follow-ups can vary from patient to patient. Sometimes no follow-ups are required and you may be discharged without need for any.

We aim to provide the best standard of care and work closely with colleagues in other areas to do this. We can give written information about your diagnosis and contact information for further information if you are given a skin cancer diagnosis. If you are given a diagnosis of basal cell carcinoma you do not normally need any further treatment or follow-up. This will be explained with your results.

Essential Information for New Patients

You will be seen in Dermatology Suite 3. The appointment time and length can vary depending on who you see and what you have been referred to. You may either see a specialist Doctor or a Specialist Nurse. If you would like to have a chaperone with you during your consultation, let the clinician know and this can be arranged. When you attend for your first appointment, you will be asked about the lesion you have been referred with, its history and any symptoms it is causing. You will also be asked about any medications you take; it is helpful to bring a list of these with you when you attend (there is no need to bring your medication(s)). The lesion will most likely be looked at with an instrument called a dermatoscope (this magnifies the image of the lesion) it is a hand-held device that is placed on the skin surface.

We may also ask if we can take pictures of the lesion. It can also be beneficial to look at other areas of your body if you have other lesions. On your first appointment, you will be told if the lesion is benign, if there is a suspicion of cancer or a level of uncertainty. A biopsy or excision will be arranged according to the clinical appearance if required. Sometimes we will take a photograph of the lesion and measurements and ask to see you again roughly 3 months afterwards to reassess and compare, following national guidelines.

If you are referred for surgery in Dermatology, your appointment would normally last between 30-60 minutes. However, the surgery is not normally carried out on the same day as your initial appointment. 

Based on the clinician’s expert opinion and following national guidelines they will allocate the most suitable level of urgency to your treatment need and decide which type of surgical list you would be most suited to (minor operation or day case- this would not take all day). Sometimes you will be given an appointment request form to take to reception to obtain a date or it will be sent out in the post. The surgery can be carried out by one of our Doctors or a nurse who has undertaken additional training and competence to carry this out.

If you need to be referred to a different speciality either here at the Royal or at a different hospital, you will be referred by the clinician you have seen and they will discuss and explain this to you. If you are seen by a different department they will most likely want to contact you before you have any treatment to plan your treatment.

Clinics can sometimes run late so extra time needs to be considered for this. Follow-up intervals will vary depending on the type of skin cancer you are diagnosed with. They can include full body skin, scar and lymph gland checks, advice on the prevention of further skin cancers and what to do if you suspect another. 

The aftercare will be tailored to the individual needs and diagnosis.

Yes, please do.

We appreciate the need for patients to be fully supported and our aim is to enable this whenever possible. Please be aware that our consultation rooms and our waiting rooms are small and we cannot accommodate large numbers of family members or friends under normal circumstances.

It is helpful if you can ensure that you are accompanied by the same family member or friend on each attendance.

Please note, that relatives or friends are not able to be present whilst in theatre, or CT or MRI scans are being performed.

You can contact the outpatient appointments line on 01246 512673

Alternatively, you can telephone the number on your appointment letter.

Every patient with a skin cancer diagnosis will have different treatment plans and follow-up pathways. The treatment and follow-up options will be discussed at diagnosis. You will be given time to make your decision regarding your next treatment, contact details will be given at this time so you will know who to get in touch with. Some treatments can only be carried out at Sheffield. If this is the treatment you want to go ahead with we will refer you to them.

Examples of treatments

These vary greatly depending on diagnosis and initial treatment. 

  • Wide local excision an extra piece of skin taken from around the area that you had initially excised.
  • Sentinel lymph node biopsy is a test that is normally carried out at the Hallamshire Hospital at Sheffield. It is dependent on your initial diagnosis as to whether it is appropriate it is not available to everyone. This is carried out under general anaesthetic. The plastic surgeons will discuss this procedure in more detail if you decide to go ahead.
  • At Clinic follow-ups, you will be seen in clinic where skin and lymph gland checks may be carried out and concerns addressed relating to your diagnosis. Sometimes we will ask if you would prefer a telephone review or a video call, though we would always like to see you face-to-face for alternate visits. It is your choice if you would or would not like a virtual follow-up.

What is Patient Initiated Follow Up (PIFU) 

After your recent visit to the hospital, you may have chosen to self-manage your Squamous Cell Carcinoma (SCC) condition with support from the hospital when you need it. This is called a ‘Patient Initiated Follow-up (PIFU) pathway. 

Mid-PIFU is suitable for patients who cannot be discharged from hospital services, typically for long-term conditions. It gives the patient the choice of obtaining advice from the clinical team if they experience a flare up or wish to book an appointment. 

Benefits for patients 

  • It helps avoid unnecessary trips to the hospital - saving patients money and time!  
  • Helps patients take control of their own healthcare.  
  • Gives patients an option to have appointments when they need them.  
  • Improves patient engagement. 

When do I need to speak to you? 

You or your carer can get in touch if you’re worried about your condition and feel you need to speak to us. 

Key symptoms that trigger a face-to-face appointment or telephone review:  

  1. A lump on or close to your existing SCC scar site- either on top of, or under your skin's surface.  
  2. A lump, swelling or fullness in your lymph glands. 

A demonstration of how to do this will have been carried out at your previous appointment/s Further information on how to check yourself can be found in a short film that the Chesterfield Royal Hospital's specialty nurses have made  https://youtu.be/YSJNxvkm_UQ 

How do I get in touch? 

A clinic letter with more information, including contact information and phone numbers, will be sent to you through the post.  

What can you do? 

It’s advised that you examine yourself head to toe once a month: Keep an eye out for new or changing lesions that grow, bleed, or do not heal.  

Practice sun safety: Making daily sun protection a part of your lifestyle is the single most effective way to reduce your risk of developing skin cancer. 

How to check your Lymph nodes: 

You can learn more about self-checking your lymph nodes (also known as "glands") by clicking on the link below. It explains what lymph nodes are, why it's important to check them, and how frequently to do so.  

Top sun safety tips: 

  • Protect your skin with clothing, and don’t forget to wear a hat that protects your face, neck and ears, and a pair of UV protective sunglasses. 
  • Spend time in the shade between 11am and 3pm when it’s sunny. Step out of the sun before your skin has a chance to redden or burn. Keep babies and young children out of direct sunlight. 
  • When choosing a sunscreen look for a high protection SPF (SPF 30 or more) to protect against UVB, and the UVA circle logo and/or 4 or 5 UVA stars to protect against UVA. Apply plenty of sunscreen 15 to 30 minutes before going out in the sun and reapply every two hours and straight after swimming and towel-drying. 
  • Sunscreens should not be used as an alternative to clothing and shade, rather they offer additional protection. No sunscreen will provide 100% protection. 

Web links to detailed leaflets: 

You should not use your PIFU pathway if: 

  • You want to speak to someone about a different condition or you develop a new skin complaint. 
  • The agreed time for your PIFU pathway has ended. 
Squamous Cell Carcinoma (SCC) PIFU Patient Information Leaflet

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