Basal cell carcinoma is the most common skin cancer of all. It grows slowly and it very rarely spreads elsewhere in the body, which is genuinely reassuring news if it’s what you’ve been diagnosed with.

What it does do, if it’s left alone, is grow steadily outwards and downwards into the surrounding tissue. On the face in particular, around the nose, eyelids or ears, that can become a problem, which is why treating it sooner rather than later is usually the sensible course.

Squamous cell carcinoma is the second most common type. It tends to grow more quickly than a BCC, and while most are straightforward to treat, a small proportion can spread to nearby lymph nodes if left.

That means SCCs are usually treated more promptly, and depending on where it is and what the biopsy shows, we sometimes need to check the surrounding area as well as the lesion itself.

Skin cancers can look like a lot of very ordinary things, which is exactly why they’re often ignored. The changes worth having checked include:

• a sore, spot or ulcer that hasn’t healed after four weeks
• an area that bleeds, scabs over, then breaks down again
• a small pearly or waxy lump, sometimes with tiny visible blood vessels
• a flat, scaly, red or pink patch
• a firm, crusted or tender lump that’s growing
• any patch of skin that’s changing and you can’t explain why

Most of these turn out to be harmless. Any unusual symptoms are worth getting checked, in particular a lesion that doesn’t heal, as skin cancers found early are almost always simpler to treat.

Diagnosis usually starts with an examination of the skin, often with a dermatoscope, followed by a biopsy where a small sample, or sometimes removal of the whole lesion is taken to confirm exactly what it is. For larger or deeper cancers a scan is occasionally needed.

Surgery to remove the cancer is the most common treatment for non-melanoma skin cancer, and for many people it’s the right one. That’s carried out by a surgeon rather than by me, where surgery is needed, patients are referred on to trusted colleagues in the region, and can come back to the clinic afterwards if further treatment is required. Dermatology colleagues also use treatments such as cryotherapy, curettage, creams and photodynamic therapy for some early lesions.

Radiotherapy is the part I provide and specialise in, and it’s a well-established alternative treatment for non-melanoma skin cancer. It’s often considered where the cancer sits somewhere surgery would be difficult or leave a poor cosmetic result, such as the nose, ear, eyelid or lip, where an operation isn’t advisable for other health reasons, or where someone would simply rather not have surgery. It’s also used after surgery in certain cases, where the pathology suggests a higher risk of the cancer returning.

If you’ve been told surgery is the only option, or you’ve been offered an operation on your face and you’re uneasy about it, that’s worth a conversation. Seeing me privately means we can look properly at whether radiotherapy would suit your particular cancer, and I can arrange that quickly rather than adding another wait to the process. If surgery really is the better route, I’ll tell you, but you’ll have had the alternative explained before you commit to anything.

Melanoma develops from melanocytes, the cells that give skin its pigment. Most melanomas start as a new, abnormal-looking mole or mark on the skin, usually a dark area, although they can be more than one colour. Others develop from a mole you already have that changes over time.

Most melanomas are related to ultraviolet exposure, particularly episodes of sunburn, but they can also appear on skin that has had very little sun: the soles of the feet, under a nail, or on areas usually covered up.

The ABCDE guide is a useful way of checking a mole or mark:

• A — Asymmetry: one half doesn’t match the other
• B — Border: the edges are uneven, blurred or ragged
• C — Colour: more than one shade, or an uneven mix of brown, black, red or pink
• D — Diameter: larger than about 6mm, or getting bigger
• E — Evolving: it’s changing in size, shape, colour or feel

It’s also worth acting on a mole that starts to itch, bleed or become crusty, a new pigmented mark appearing in adulthood, a dark streak under a fingernail or toenail, or a mole that simply looks different from all your others.

If something has changed, you should definitely get it checked out. It’s a quick thing to check, and it’s much better to be told it’s nothing than to wait and wonder. The earlier it is caught, the higher the chance of successful treatment.

Melanoma is diagnosed by removing the whole lesion and examining it under the microscope. The report tells us how deep it has grown and other features that indicate how it’s likely to behave. Depending on those findings, further surgery may be recommended to take a wider margin of skin, along with a sentinel lymph node biopsy to check whether any cells have travelled to the nearest lymph nodes. Scans are sometimes arranged to complete the picture.

Surgery is the main treatment for melanoma, and for early disease it’s usually all that’s needed. Where melanoma is more advanced, immunotherapy and targeted drug treatments have transformed what’s possible over the last decade, and these form part of specialist melanoma care.

Radiotherapy has a more selective role in melanoma, and that’s the part I can help with. It may be used after surgery to the lymph nodes where there’s a higher risk of the cancer returning locally, for certain melanomas of the face, where surgery would mean removing a large area of skin, and to control symptoms if melanoma has spread. If radiotherapy is worth considering in your case, I’ll explain exactly where it fits alongside everything else.