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Referral to a specialist

Your GP should arrange for you to see a specialist within 2 weeks if you have skin changes that could be due to melanoma skin cancer. 

Seeing your GP

Abnormal looking moles are quite common but melanoma is quite rare in comparison. So it can be difficult for GPs to decide who may have a melanoma and who may have a non cancerous change in a mole or area of skin.

There are guidelines for GPs to help them decide who needs an urgent referral.

Urgent referral

Urgent referral means that you should see a specialist within 2 weeks.

GPs use a 7 point scale for assessing changes in moles. The scale has 3 major features and 4 minor ones. The major features are:

  • change in size
  • change in colour, such as getting darker, becoming patchy or multi shaded
  • change in shape

Each of these scores 2 points.

The 4 minor features are:

  • 7mm or more across in any direction
  • inflammation
  • oozing or bleeding
  • change in sensation, such as itching or pain

Each of these features scores 1 point. 

You need an urgent referral if you score 3 points or more.

You'll also have an urgent referral if a test to closely examine the skin (dermatoscopy) suggests you could have melanoma.

Your GP will consider an urgent referral to a specialist if you have a new growth on your skin, with or without pigment (colour). This could be a type of melanoma called nodular melanoma.

Specialist skin cancer teams

Everyone with suspected melanoma is seen by a member of a skin cancer multidisciplinary team. A multidisciplinary team (MDT) is a team of health professionals who work together to decide on the best way to manage your care. The MDT can include many different health professionals including:

  • skin specialists (dermatologists)
  • plastic surgeons
  • cancer specialists
  • specialist nurses
  • doctors who specialise in diagnosing illness from tissue specimens (histopathologists)
  • GPs with a special interest in skin cancer

There are 2 levels of MDT for melanoma and other skin cancers:

  • the local hospital skin cancer multidisciplinary team (LSMDT)
  • specialist skin cancer multidisciplinary team (SSMDT).

LSMDTs are usually in cancer units in district general hospitals. SSMDTs are more likely to be in larger hospitals that have cancer centres, or plastic surgery centres.

Your GP, or doctor from the local team will refer you to the specialist team if:

  • you live close to the SSMDT, in which case it will act as both your local and specialist centre
  • you are under the age of 19
  • you have more than one melanoma
  • you were born with a large mole (more than 20cm across) that looks as though it may be becoming a melanoma
  • your melanoma is at higher risk of coming back or has come back
  • the melanoma has spread to another part of your body
  • you need treatment that the LSMDT does not provide
  • you are taking part in a clinical trial

Information and help

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About Cancer generously supported by Dangoor Education since 2010.