Patient Experience

Patient Experience


Skin cancer is the most common form of cancer in Ireland. There are many different types, but the most common are basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Each year, skin cancer affects approximately 7,000 people for the first time. A large proportion of these will go on to develop a second, third or more skin cancers. Once you have had one type of skin cancer, you are at a higher risk of developing other forms of the disease. There are many other forms of skin cancer, most of which are rare. Thankfully, most skin cancers are not life-threatening. Even the most dangerous form, malignant melanoma, is curable if caught in the early stages.  

The most important cause of skin cancer is the damage caused by the sun’s ultraviolet radiation (sunburn) and overall sun exposure.  Also important is your skin type and how it reacts to the sun: fair/red hair, blue/green eyes, freckles and the ability to tan. In addition, some skin cancers have a genetic basis.

The body’s organs and tissues are made up of building blocks called cells. In healthy tissue, cells replace or repair themselves when they get damaged or are worn out. Different skin cancers occur when skin cells do not behave as normal and continue to grow even when there is no need. If the cancerous cells continue to grow locally or are in the early stages and have not spread, the cancers do not result in serious disease or death but can cause disfigurement. If, however, the cancer cells spread elsewhere in the body, death can result. That is why identifying skin cancer early is so important.

There are certain risk factors that can increase your chance of developing skin cancer. These include:

  • Exposure to ultraviolet radiation (UVR) during childhood and adolescence
  • Repeated exposure to UVR throughout life, for example, working or recreation outside
  • Episodes of severe sunburn
  • A light complexion (red or fair hair, blue or green eyes and skin that burns easily, freckles and skin that does not tan)
  • Older age
  • A previous skin cancer (non-melanoma skin cancer)
  • A personal or family history of melanoma
  • A large number of moles
  • Unusual types of moles
  • Immunosuppressed (including organ transplant recipients).

St James’s Hospital is one of the national skin cancer diagnostic centres and one of the eight national treatment centres. It is the only centre in Ireland performing a specialised type of surgery for high-risk skin cancers called Mohs micrographic surgery.  

  • Actinic Keratosis–Sun Damage Spots

    • Rough, red or pink scaly patches on sun-exposed areas of the skin such as the face, hands and upper chest.
    • Warning signs of sufficient sun to cause a skin cancer.
    • Possible precursor to squamous cell carcinoma.

    Basal Cell Carcinoma

    • Raised, pink, waxy bumps that may bleed following minor injury.
    • Scaly red lesions that do not heal.
    • Small raw patches of skin that break down and do not heal.
    • May have superficial blood vessels.

    Squamous Cell Carcinoma

    • Dull red, rough, scaly raised skin lesions. May be tender or painful.
    • Appears on sun-exposed areas (head, neck, ears, lips, back of the hands and forearms).
    • Squamous cell carcinoma tumors can grow very rapidly or very slowly.
    • Squamous cell carcinoma tends to be more invasive and more aggressive in transplant patients.
    • Is slow-growing, invades locally and rarely spreads. (Can spread in about 2% of patients).


    • Cancer of tanning pigment (melanin) cells.
    • Brown/black/multiple colours.
    • Irregularly coloured, with irregular border and/or shape or irregular edges.
    • Can be slow or fast growing.
    • Can resemble a mole but looks different to your other moles, the so-called “ugly duckling sign”.
    • Prognosis depends on how deep into the skin the tumour has invaded.
  • The treatments options for skin cancer include surgery, radiotherapy, chemotherapy and other drug treatments. Your treatment plan will depend on the type of skin cancer you have, and each patient’s treatment will be tailored to their individual needs. The aim of treatment is to remove the cancer and stop any further growth or spread of cancer.

    In deciding the most suitable treatment, your doctor will consider:

    • The type of skin cancer
    • The individual features of your skin cancer
    • Where on your body the cancer is
    • Whether the cancer is at risk of spreading, for example, malignant melanoma, and whether it has spread to your lymph nodes.

    In St James’s Hospital, treatment for skin cancer is provided by a variety of specialists. The skin is the largest organ in the body, so many different specialties are involved in treating the many different forms of skin cancer. Most commonly, it is treated by dermatologists, plastic surgeons, radiation oncologists, head and neck surgeons, maxillofacial surgeons and medical oncologists. Diagnosing skin cancer can be difficult, but St James’s Hospital has two consultant pathologists with special skills in the laboratory diagnosis of skin cancer. Any complex or difficult skin cancer and all melanomas are discussed by these specialists at multidisciplinary skin cancer meetings.

  • The skin cancer team at St James’s Hospital involves many different specialties in different departments: Dermatology, plastic surgery, otolaryngology, maxillofacial surgery, radiation oncology, and medical oncology. 

    Dermatology Consultants


    Mohs Micrographic Surgery Nurses

    • Edel McGrath
    • Carol Day
    • Dorothy Hand
    • Grainne Harrington

    Mohs Surgery Laboratory Scientists

    • Mary Monks
    • Ciara Murphy
    • Lorraine Mc Carra

    Melanoma CNS

    • Leonie Mahon

    Plastic Surgery


    Medical Oncology

    • Dr Fergal Kelleher



    Data Manger

    • Anita Cafolla

    MDT Coordinator

    • Avril Nolan
  • Support services available for skin cancer patients:

    The Irish Skin Foundation

    Charles Institute UCD, University College Dublin, Dublin 4

    Phone (01) 7166299

    Irish Cancer Society

    43/45 Northumberland Road, Dublin 4

    Phone (01) 2310500  Fax: (01) 2310555

    National Cancer Helpline

    Phone 1800 200 700

    Marie Keating Foundation

    Unit 9, Millbank Business Park, Lucan, Co. Dublin

    Phone (01) 6283726 Fax: (01) 6283759