NICE has published guidance on the assessment and management of the skin cancer melanoma in children, young people and adults. The guideline recommends that all pigmented skin lesions should be assessed, this can be done by dermoscopy and other visualisation techniques. Therefore, confocal microscopy and computer-assisted diagnostic tools should not be routinely used when assessing pigmented skin lesions. During the diagnosis period, the vitamin D levels of the patient should be measure. If their levels are low they should be provided with advice on vitamin D supplements.
When managing melanoma NICE explains that excision should be offered when the clinical margin is at least 1cm for patients with stage one melanoma. Additionally, excision should be offered in stage two melanoma patients with a clinical margin of at least 2cm. Lymphadenectomy should be considered for patients with stage three melanoma and when their sentinel lymph node biopsy shows micro-metastases. Detailed verbal and written information on the possible advantages and disadvantages should be highlighted to these patients, a detailed table providing this information can be found within the guidance.
NICE also emphasises how communication is key and that all patients should have oral and written information given to them explaining the different types of cancer.