St John’s Institute melanoma clinic
Skin cancer
We specialise in treating patients with melanoma or Merkel cell carcinoma (MCC).
Melanoma is a common type of skin cancer. Merkel cell carcinoma is a much rarer form of skin cancer.
You will be cared for by a team of health professionals who specialise in skin cancer, including:
- dermatologists (skin specialists)
- plastic surgeons
- oncologists (cancer specialists)
- dermatopathologists (specialists in diagnosing skin samples under a microscope)
- clinical nurse specialists (CNS)
- research nurses and a clinical trials coordinator
- outpatient clinic nurses to support you and help organise your clinic visit
Research is an important part of what we do. We may ask if you would like to take part in research studies to help improve the prevention and treatment of melanoma. Taking part is always your choice. If you decide not to take part, this will not affect your care in any way.
How to get an appointment
Your GP or local hospital can refer you to our clinic.
You cannot self-refer to this clinic.
Changing or cancelling your appointment
Phone: 07562 171025 or 07894 709189
Please tell us as soon as possible if you are unable to come to your appointment.
Before your appointment
After we receive your referral, we prepare carefully for your appointment.
We aim to schedule and review cases within 2 weeks, but this can sometimes take up to 4 weeks. If you have not received an appointment within 14 days of your local hospital visit, please contact us.
Phone: 07562 171025 or 07894 709189
Sometimes, results from earlier tests may not reach us in time, or may still be under review by our pathology or radiology teams. This can happen close to your appointment, so please be patient.
There can also be differences between the biopsy report from your local hospital and our report. We use our own report to confirm your final melanoma stage.
Before your appointment, we:
- review your skin biopsy to confirm your diagnosis and advise on next steps
- review your scans to understand your condition and we may recommend further scans if we need more information
- carry out a specialist case review, where a team of skin, cancer and surgical specialists look at your case together to agree the best plan of care for you
Please bring:
- comfortable clothing that is easy to remove for a skin examination
- a list of medicines you're taking, including any you buy from a pharmacy or shop and any herbal remedies
- a list of known allergies and medical conditions
- any food or drink you may need
- a notebook and pen
- a list of questions you would like to ask
You can bring a friend or relative to your appointment for support. They can help you remember all the information or take notes during your appointment.
If you have questions before your appointment, please contact the cancer nurse at your local hospital.
During your appointment
Your first visit will be to review your investigations and plan the next steps of your treatment.
During your visit, you may see different specialists in the service. Please allow up to 3 hours for your appointment.
You'll usually see a dermatologist first, followed by the plastic surgery team.
You’ll meet your skin cancer clinical nurse specialist (CNS). They will be your key worker throughout your treatment, and will give you contact details and more information.
During your appointment, you can ask questions and ask for more information about anything you do not understand. You may want to ask about:
- your diagnosis and stage
- your outlook
- treatment options and their benefits and risks
- whether you need further procedures
- follow‑up care and symptoms to watch for
- clinical trials that may be suitable
- whether a second opinion would be helpful
These questions help guide discussions and explain what happens next in your treatment.
You are usually referred to us after a skin lesion has been removed, and examined by a specialist doctor (histopathologist), who has made a diagnosis. They will send us a report, with information about your melanoma. This includes details such as the TNM stage and how deep the melanoma is (Breslow thickness). This information helps us understand how advanced it is and plan your treatment.
TNM staging
Staging is how we categorise your melanoma, and it helps to work out the best treatment for you.
TNM stands for ‘tumour, node, metastasis’, and a higher stage number (from 0 to 4) means your melanoma is more advanced.
Breslow thickness
This is the thickness of the melanoma, and is rated from T1 (1mm) to T4 (4mm). Knowing this can help us to work out which treatment is best for you.
The Melanoma Focus website has more information about how melanoma is staged.
Merkel cell carcinoma
For Merkel cell carcinoma cases, we might look at different markers. Your team will explain these during your appointment. Cancer Research UK has more information about Merkel cell carcinoma.
After your appointment
If you need surgery or any other treatment, this will normally be scheduled 4 to 6 weeks after your first appointment.
Treatment may include:
- a sentinel lymph node biopsy
- a wide local excision (surgery to remove any remaining melanoma)
- immunotherapy treatment
- further investigations such as an ultrasound, PET scan or MRI scan.
Your treatment plan is based on the stage of your cancer and guidance from the National Institute of Health and Care Excellence.
Early-stage (IA) and intermediate-stage (IIA) melanoma will be followed up at your local hospital. Higher-risk melanomas will be followed up more frequently at Guy's Hospital.
Follow-up appointments may be every 3 months to once a year.
If there are no concerns at your follow-up appointments, you will have a short consultation and a full skin examination. If you have a higher-stage melanoma (stage IIb and above), you will need regular PET scans and brain MRI scans.
