Patient-centred care means your treatment is planned around you, not only around your cancer. Your team should ask what matters to you, explain your options in plain language and make the decision with you. With skin cancer, that includes taking your worries about scarring and how you will look seriously from the first appointment.
- You should be asked about your worries, your home life and practical needs, as well as the skin cancer itself.
- Doctors are expected to give you enough information to make a real choice, and to ask what you want rather than assume it.
- Concerns about your appearance after surgery are a fair part of choosing a treatment.
- You can ask for a second opinion before you decide.
- You should be given written information and a contact for questions between appointments.
What does patient-centred care mean for skin cancer treatment?
It means your care is shaped by what you need and want, as well as by the type of skin cancer you have. NHS England describes personalised cancer care as a set of steps: an assessment of your needs, a care plan agreed with you, and a written summary of your treatment when it ends.
The same idea runs through the GMC’s guidance on consent, which every UK doctor must follow. It says doctors should give you the information you need to make a genuine choice and should find out your preferences rather than guess them.
This isn’t only about good manners. A US report on cancer care found that patients involved in their care are more likely to receive treatment that fits their own values.
What will I be asked at my appointments?
You will be asked about you as a person, not only about the lesion. Expect questions about your general health, other conditions you live with and the medicines you take, because these can affect which treatment suits you.
Many cancer services also offer a needs assessment. This is a structured conversation that covers physical, emotional, practical, financial and social concerns. It might pick up that you are worried about driving after surgery, caring for a partner, or time off work. UCLH’s patient guide explains what the assessment involves.
A needs assessment should be offered around diagnosis, at the end of treatment and whenever your needs change. If nobody has mentioned it, ask your nurse or your consultant’s team.
A good surgeon will also ask what matters most to you about the result. Some people care most about getting the cancer out in one go. Others are most worried about a scar on the nose or near the eye, or about how long the wound will take to heal. There is no wrong answer.
How are treatment decisions shared?
Your surgeon explains the options, including what each involves, the likely result and the risks, and you decide together. Shared decision-making doesn’t mean you are left to choose alone. It means your surgeon’s knowledge and your own priorities both count.
The Royal College of Surgeons of Edinburgh describes this as active involvement from the patient, including saying what you want from treatment and what quality of life means to you. If you are unsure what your priorities are, part of the surgeon’s job is to help you work that out.
For some cancers, your case is also discussed at a multidisciplinary team meeting, where surgeons, pathologists and nurses review it together. A UK study of NHS cancer team meetings found that clinicians valued knowing patients’ preferences, but time pressure meant those preferences were sometimes squeezed out. Telling your team what matters to you, and asking for it to be written down, helps it reach that discussion.
You don’t have to decide on the day. If you need time to think, talk to family or read the written information, say so.
Your appearance is part of the decision
Skin cancer surgery often happens on the face, ears, neck or hands, where any scar is visible to everyone you meet. Worrying about that is normal, and it is not vanity. It is a fair thing to weigh up when choosing between options.
For many patients, the cosmetic result and how well the area works afterwards, such as an eyelid closing properly, matter as much as removing the cancer. That is why it helps when reconstruction is planned at the first consultation rather than after the cancer has been cut out. Before you agree to surgery, you should understand both how the cancer will be removed and how the wound will be repaired.
Our cosmetic outcomes checklist sets out what to discuss. People feel very differently about scarring, so your surgeon should ask rather than assume.
What should I ask my surgeon?
Ask anything that will help you decide, and write your questions down before you go. These are a good starting point:
- What type of skin cancer do I have, and how serious is it?
- What are my treatment options, and why do you recommend this one?
- What will the scar look like, and how will the wound be repaired?
- What happens if I wait, or choose a different treatment?
- How long will healing take, and what will I need help with at home?
- Who do I contact if I have a problem or a question after I go home?
- What follow-up appointments will I need?
Bring someone with you to listen and take notes if you can. If you have high-risk skin cancer, you may face several decisions over a longer period, so keep your notes and written information together in one place.
Can I get a second opinion?
Yes, you can ask for a second opinion at any stage. In the NHS it isn’t a legal right, but you can ask your GP or your consultant to refer you to another specialist. If you are being seen privately, you can arrange to see another consultant yourself.
Asking is a normal part of deciding about surgery, and your surgeon should not take it as a criticism. It can help most when the cancer is on the face and there is more than one way to treat it or repair the wound.
Support during and after treatment
You should be given written information about your diagnosis and treatment, and contact details for questions between appointments, at every stage. Many cancer teams give you a named contact, often a cancer nurse specialist, who can answer questions and point you to other help.
A needs assessment and care plan can lead to referrals for practical, emotional or financial support, or to a dietitian or physiotherapist. When treatment ends, a written summary should go to you and your GP, so everyone looking after you knows what was done.
Talking to Miss Nayar
Miss Rakhee Nayar is a Consultant Plastic Surgeon, FRCS (Plast), MD, and one of fewer than 10 women in the UK dual-trained in both plastic surgery and Mohs micrographic surgery. That training means she can talk you through removing the cancer and repairing the wound in the same conversation, so reconstruction is part of the plan from the start. She sees patients privately at Circle Cheshire and offers e-consultations, and you can read more about Mohs surgery or book a consultation.
Frequently asked questions
What does patient-centred care mean when you have skin cancer?
It means your treatment is planned around your needs and priorities, not only the diagnosis. Your team should explain your options clearly, ask what matters to you, including how you will look afterwards, and decide with you.
Who looks after me during skin cancer treatment?
Your surgeon leads your treatment, and many cancer teams also give you a named contact, often a cancer nurse specialist. Your GP and other specialists may be involved too.
What is a needs assessment, and when should I be offered one?
It is a structured conversation about your physical, emotional, practical, financial and social concerns after a cancer diagnosis. It should be offered around diagnosis, at the end of treatment and whenever your needs change. You can ask for one if it hasn’t been offered.
Will my preferences be taken into account when my case is discussed?
They should be, but it helps to make them clear. Tell your surgeon or nurse what matters most to you and ask for it to be recorded, so it is in front of the team when your case is discussed.
This post is general information, not medical advice. Please talk to your own specialist about your situation.
Recommended
- Top skin health practices for cancer prevention and recovery
- How to support skin cancer patients: practical help guide
- Dermatologic oncology: what it is and why it matters
- Role of patient education in skin cancer outcomes
Filed under Choosing Your Care
