The first 60 days: Skin cancer (all types)
Skin cancer covers the very common and rarely dangerous basal cell and squamous cell carcinomas, the less common but more serious melanoma, and rarer tumours such as Merkel cell carcinoma and Kaposi sarcoma. Almost all of it is caused by ultraviolet light and most of it is found and cured by simple surgery. Below, week by week, is what OnCo's record of Skin cancer (all types) says about the first two months: the order is typical, the timing is yours to ask about. Sections appear only where the record has something to say. Orientation, not medical advice.
What happens now
Staging tests establish exactly what and where the cancer is. Everything else follows from the answers.
Ask which of these were tested and what the results were; see the report reader for what each value means.
These specialties appear in the standard of care for this cancer. In most centres they meet weekly as a tumour board to agree each plan; you can ask when yours was discussed and what was decided.
- PathologistNamed in the standard of care for: Melanoma.
- SurgeonNamed in the standard of care for: Basal cell and squamous cell carcinoma, Melanoma.
- Medical oncologistNamed in the standard of care for: Basal cell and squamous cell carcinoma, Melanoma.
- Clinical oncologist (radiotherapy)Named in the standard of care for: Basal cell and squamous cell carcinoma.
A second opinion from a centre that treats many similar cases is normal, not rude; the standard of care tells you what to compare it against.
Each row is a setting from the standard of care, in the order it usually arises. Not all will apply to you; your stage and biomarkers decide which do. The guideline grade, where recorded, says how strong the evidence is.
Sun protection, avoiding sunbeds and treating actinic keratoses; regular skin checks for people at high risk, with dermoscopy and AI tools improving lesion triage.
Surgical excision or Mohs surgery; topical or photodynamic therapy for superficial lesions; radiotherapy when surgery is unsuitable; hedgehog inhibitors for advanced basal cell carcinoma and cemiplimab or pembrolizumab for advanced squamous cell carcinoma. See the subtype pages.
- 3.Melanoma
Excision with margins by thickness, sentinel node biopsy, adjuvant PD-1 blockade or BRAF/MEK inhibitors for high-risk disease, and checkpoint immunotherapy or targeted therapy for advanced disease. See the melanoma page.
Generated from this cancer's standard of care, biomarkers and open problems. Take the group that matches where you are. To tick, add your own and print, open the one-page appointment sheet.
Newly diagnosed
- What is my exact diagnosis, stage, and grade, and which tests established them?Everything else follows from an accurate stage and subtype.
- Which biomarkers have been tested on my tumour (for example Dermoscopy and biopsy for diagnosis, Breslow thickness, ulceration and sentinel node status in melanoma, BRAF V600 mutation in melanoma, PD-L1 and tumour mutational burden as imperfect immunotherapy markers, Merkel cell polyomavirus status), and what were the results?These results decide eligibility for targeted therapy, immunotherapy, and trials.
- Which subtype is my cancer, and does that change the recommended treatment?Recognised subtypes for this cancer include Basal cell carcinoma, Cutaneous squamous cell carcinoma, Melanoma.
- Is germline (inherited) genetic testing recommended for me or my family?Inherited variants can change treatment and matter for relatives.
Basal cell and squamous cell carcinoma
- For my situation (basal cell and squamous cell carcinoma), which of the standard options do you recommend and why?Guideline options include: Surgical excision or Mohs surgery; topical or photodynamic therapy for superficial lesions; radiotherapy when surgery is unsuitable; hedgehog inhibitors for advanced basal cell carcinoma and cemiplimab or pembrolizumab for advanced squamous cell carcinoma. See the subtype pages.
- Am I a candidate for Cemiplimab, Vismodegib, and what side effects should I expect?Knowing the expected toxicities helps you plan work, family, and supportive care.
Melanoma
- For my situation (melanoma), which of the standard options do you recommend and why?Guideline options include: Excision with margins by thickness, sentinel node biopsy, adjuvant PD-1 blockade or BRAF/MEK inhibitors for high-risk disease, and checkpoint immunotherapy or targeted therapy for advanced disease. See the melanoma page.
- Am I a candidate for Pembrolizumab, Nivolumab, Dabrafenib, and what side effects should I expect?Knowing the expected toxicities helps you plan work, family, and supportive care.
Prevention
- For my situation (prevention), which of the standard options do you recommend and why?Guideline options include: Sun protection, avoiding sunbeds and treating actinic keratoses; regular skin checks for people at high risk, with dermoscopy and AI tools improving lesion triage.
Any stage
- Are there clinical trials I could join, for example of Fianlimab, Lifileucel?Trials are how the next standard of care is set; asking early keeps options open.
- Would a second opinion at a high-volume centre change anything, and can you help arrange it?Rare or high-stakes decisions benefit from a centre that treats many similar patients.
- What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?Supportive care improves quality of life and helps patients complete treatment.
- I read that “Non-melanoma skin cancer is missing from most cancer registries, so its true burden is unknown”. How does that affect my plan?Open problems are where trials and second opinions matter most.
- I read that “Melanoma incidence continues to rise in fair-skinned populations”. How does that affect my plan?Open problems are where trials and second opinions matter most.
Trials open now for this cancer in OnCo, largest phase first. Joining a trial is a decision like any other: ask what the comparison arm is, whether a placebo is used, and what happens if you leave. The cancer page searches ClinicalTrials.gov live for more.
- A Study of Lifileucel (Tumor-infiltrating Lymphocytes) in Adults With Advanced MelanomaPhase 2 · active · NCT07288203A Phase 2, Multicenter, Open-label Study of Lifileucel (Tumor-infiltrating Lymphocytes [TIL]) in Participants With Previously Treated Advanced Melanoma
- Study of RP1 Monotherapy and RP1 in Combination With Nivolumab (IGNYTE)Phase 2 · active · NCT03767348An Open-Label, Multicenter, Phase 1/2 Study of RP1 as a Single Agent and in Combination With PD1 Blockade in Patients With Solid Tumors [IGNYTE]
- Early Phase Study of KESONOTIDE™in Participants With Solid TumoursPhase 1/2 · recruiting · NCT06926075An Adaptive Phase I/II Study of KESONOTIDE™, a Novel hGIIA-vimentin Inhibitor, in Participants With Solid Tumours
- Study of AMXT 1501 and DFMO in Combination With Standard Therapies in Advanced Solid TumorsPhase 1/2 · recruiting · NCT07287917A Phase 1b/2 Trial Investigating the Safety and Efficacy of Oral AMXT 1501 and Oral DFMO in Combination With Standard of Care in Patients With Advanced Solid Tumors Who Progressed After Prior Therapies
Much of what helps in the first weeks is free if you know to ask: testing, helplines, rides and lodging, second opinions, trial travel.
- Skin cancer (all types): the full pageSkin cancer covers the very common and rarely dangerous basal cell and squamous cell carcinomas, the less common but more serious melanoma, and rarer tumours such as Merkel cell carcinoma and Kaposi sarcoma. Almost all of it is caused by ultraviolet light and most of it is found and cured by simple surgery.
- One-page appointment sheetYour questions, the words you may hear, what to bring, and space for the answers. Print it.
- Treatment sequencingWhich treatment tends to follow which, line by line.
- NavigatorStandard of care for your stage, what you have tried, and trials near you.