Screening Visit Procedures

Skin Cancer Navigation

The video from our US colleagues reminds us that skin cancer is an international problem and should be dealt with using international standards.

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You may have been referred by your doctor, an outside specialist, or one of our consultants, or simply decided that screening is a good idea.

Skin cancer screening can be quite individual to meet your needs, although pattern recognition is a key principle. An area where artificial intelligence can be used, along with the experience of a consultant.

Both can help to analyse full body, or microscopic digital images. Issues can be found, or alternative methods suggested to diagnose subtle changes in your skin.

A Typical Visit

A specialist nurse will record a detailed history of skin cancer risk factors, especially related to melanoma. If this is not your first visit, existing notes can be checked and updated.

They will then take a series of body images in preset positions. If you have attended before, these will automatically be compared to previous images to identify any change, if not, they act as a base.

Where lesions, or moles raise concerns, detailed dermoscopy images can be taken, analysed and compared to previous images if they exist. Whilst the latest AI systems help, nothing is left to chance, your consultant also reviews the images.

They may decide on further examination, such as digital dermoscopy, or checking lymph nodes in your groin, neck, or armpits. The latter is a good idea for any patient who has previously had a melanoma.

Should other options make sense, perhaps confocal microscopy, or electrical impedance spectroscopy, they will be organised. If not, any areas of interest can be highlighted and checked again on a follow up visit.

Short Term Monitoring

Visits for many patients are at longer term intervals, although as mentioned above, there can be situations where more concentrated monitoring is valuable.

This is known as sequential digital dermoscopy, useful if your consultant is concerned about a lesion but not sufficiently for immediate action. A better solution than surgical removal of a perhaps innocent area.

Think of a scale from 1 (absolutely benign) to 5 (a clear melanoma). Actions for both are evident but what about lesions which are 2, 3, or 4, the grey areas at the heart of long and short term screening.

Dismissing them as benign would be false reassurance, immediately attacking them with a scalpel no better. Short term monitoring has been shown to detect more melanomas and reduce the number of normal moles removed, a double advantage.

Underlying Principles

If you have atypical moles, a lot of moles, or a personal, or family history of skin cancer, screening is essential. We would also encourage anyone who has had above average sun exposure to take part.

The high quality images produced can identify very subtle changes. Essential when skin cancers, not least melanoma, can grow very slowly at first, or as with lentigo maligna occurence, or recurrence, be invisible to the naked eye.

Skin cancer screening has three advantages. The pleasure of an all clear, avoidance of unnecessary tissue removal, or scarring and early detection, which reduces treatment, along with increasing cure rates.

All of these fit with our ethos of minimum intervention and maximum cure, through safe procedures taking half an hour of your time. The return you get from spending this with the latest equipment and good specialists is invaluable.

We want to see more people have less skin cancer treatment and a safe future. The foundation of this is effective skin cancer screening.