Cancer Research UK main site

Newly diagnosed with melanoma- what should I expect from my GP

Londons_calling
Offline

I had a mole removed privately (the NHS said it was fine & did not require removal) and it can back as stage 1a superficial spreading melanoma. 
My private dermatologist send a letter to my gp practice asking for them to refer me to my local hospital to undertake the wle and further treatment as required. My gp then failed to act on this referral letter and only did so after 2 chasers from me. I have submitted a complaint to the practice about failing to act on the letter.

My question is actually about what I should expect from my gp going forward. Does their involvement end with the referral. I have a complicated medical history involving a previous melanoma and another cancer so I was surprised that my gp did not get in touch to discuss implications of this diagnosis for my overall health. Am I expecting too much from my gp?

Thanks in advance for any insights.

  • Offline

    I also have had a melonoma removed.  I think that once the GP has referred you they consider they’ve done their bit. I would go to the oncology dept. at the hospital, see if they have received the referral, and, if so, deal with them.

  • Offline in reply to Tony82

    Tony,

    It won't be referred to oncology but to dermatology who then refer it on if the melanoma was Stage 2b or above and oncology were involved in giving drug treatment.

    Angie (Stage 3 melanoma patient since 2009)

  • Offline

    Hi Londons_calling

    Your GP won't be involved in your care for melanoma if you are early stage (1a) - they would only be involved if you were a higher stage & on adjuvant drug treatment. Their involvement would only be to deal with any side effects of the drugs in some circumstances if a higher stage.

    They are, however, kept informed as to your hospital care & they should deal with any referrals requested by doctors. I'm shocked that your GP didn't follow the private consultant's instructions & that you had to chase them up, especially when you've had a previous melanoma (which smacks of not reading your medical history). I'm glad to hear you have made a complaint - don't be fobbed off because melanoma is a cancer that can be successfully treated when caught early. 

    The good thing is that your melanoma is 1a which means it's been caught early. After the Wide Local Excision that you will have (once the referral has been sorted out) you should have a 6 month check by dermatology & then be discharged after 12 months. Out of interest, what stage was your previous melanoma and was it in the same general area as this latest one?

    Angie (Stage 3 melanoma patient since 2009)

  • Offline in reply to AngieT

    Thank you Angie. This is very helpful. My previous melanoma was stage 1a also. I had it around 30 years ago & had 5 years of follow up - protocols must have changed since then if it is now 6 months. 

    This new melanoma is in a different place & different side of the body and given that it is so long after my first one I feel its unlikely to be directly related.

    My concern is really which doctor is responsible for the 'big picture'. I, like you, think that my gp did not look at my medical history before making the referral (which also explains why my relevant medical history was not included in the referral form).

    Do gp's really get notified that their patients have a cancer diagnosis (in my case my 3rd cancer diagnosis) and it is just noted on their files - no call, no discussion, no check in with the patient, no review of their medical history? Maybe that is to be expected and I am hopelessly out of touch with what level of care is offered by gp's currently.

    I am not overly concerned about this skin cancer. I knew that another one would be coming down the line - I have so many risk factors so its inevitable that there will be more.  My concern is the future melanoma that will kill me because it isn't caught early enough - I am being sent back to the hospital that missed this current one, I have a gp that seems to have no role in my health and actually is putting me more at risk and a system that leaves the responsibility of catching melanomas to me which is feeling a bit overwhelming at the moment.

    Apologies for going on - I am feeling a bit sorry for myself.

  • Offline in reply to Londons_calling

    Don't apologise, you have been let down by your GP and are within your rights to be mad. NICE say that the GP is primary care & the hospital is secondary care. Once a cancer diagnosis is made, you are then under secondary care for treatment. The hospital will inform the GP, probably online - my GP surgery communicate with my local hospital online so information comes through much quicker. However, a private consultant will do it by letter. Either the letter hasn't been copied onto your GP practice record or it's been recorded but not brought to the attention of the GP or, the GP hasn't acted on it. Whichever reason, you have been badly let down & the fact your GP hasn't checked back in your records isn't good. My GP practice flag a patient's record if they've ever had a cancer diagnosis so that any new GP can see that when dealing with the patient. It doesn't matter that my original diagnosis (Stage 1b) was 29 years ago and my second, Stage 3, was 16 years ago, any new GP at my surgery always mentions it when looking at my record.

    I can also understand the concern about the dermatologist that missed your current melanoma. I would consider mentioning your concerns &, should you be referred for any future moles, ask for a second opinion from another dermatologist there. I had complete faith in my dermatologist but in her younger days she would still get a colleague in to check that they thought the same as her. Even my plastic surgeon (the head of that department) would get a colleague to confirm his findings! As a patient we are within our rights to ask for a second opinion. Sadly we quite often have to advocate for ourselves so don't be afraid to raise issues. My dermatologist gave presentations at our annual patient conference & she always told patients not to be afraid to advocate for themselves - that is our right!

    I know you've been waiting a while to get to this stage but, at Stage 1a and the fact it's been removed, there is only a very small chance that the delay in the Wide Local Excision will cause it to spread. Most results from a WLE come back negative so there is a good chance yours will too.  

Speak to a nurse

Quick links

Follow us

Registered with Fundraising Regulator (logo)
Cancer Research UK is a registered charity in England and Wales (1089464), Scotland (SC041666), the Isle of Man (1103) and Jersey (247). A company limited by guarantee. Registered company in England and Wales (4325234) and the Isle of Man (5713F). Registered address: 2 Redman Place, London, E20 1JQ.