The Trust

Macmillan Skin Clinical Nurse Specialist

If you have skin cancer or are having tests to confirm, it can be a worrying time for you, your relatives or carers. The skin clinical nurse specialist (CNS) can offer support and advice at any time throughout the cancer journey.

The CNS sees patients with a diagnosis of skin cancer in the Macmillan Cancer Resource Centre, The Hub at Waters Green, Macclesfield or  Readesmoor Practice, Congleton and in their own home.

The CNS is a member of the skin cancer multidisciplinary team (MDT) and is able to contact any member of the team who are involved in the patient’s care on their behalf. The nurse maintains close links with the community nursing teams, GP’s and other hospitals within the region that they may need to be referred to, such as The Christie Hospital, Salford Royal and Wythenshawe Hospital to ensure continuity of care.

The service operates within both the acute and Community business groups.

Our team 

The team consists of one Macmillan Skin Clinical Nurse Specialist, Kate Howlen.

Kate Howlen provides support, advice and care to patients diagnosed with skin cancer.

Tel: 01625 264035

Fax: 01625 264120


Our services 

The service provide information, advice, education and support for patients, their families and carers from diagnosis onwards on areas covering:

  • Different types of skin cancer
  • Investigation and treatment options
  • Written information on planned procedures
  • Coping after treatment
  • Hospital and community services
  • Radiotherapy
  • Referral to specialist services, such as, counselling, complimentary therapies, lymphoedema clinic, benefits advisors, palliative care team etc.

Advice will be given on an informal basis to those patients who have not yet been referred to the East Cheshire Trust.

We raise public awareness to the early detection of skin cancers and sun safety. Skin cancer is, in the main, a preventable disease.

The services provided include a melanoma follow up clinic, mole mapping service of individual moles or full body photography.

Our Objectives

  • To act as a key worker to ensure a smooth, seamless pathway for all patients with skin cancer and their families
  • Provide advice on holistic management of patients referred to the service
  • Ensure that all patients are discussed at the skin MDT
  • Provide an holistic follow up service for patients diagnosed with melanoma
  • Ensure that all patients diagnosed with skin cancer are sent an information pack and the Specialist Nurse contact details
  • Raise awareness as to the early detection of skin cancers and their prevention
  • Arrange relevant investigations as required
  • Provide support and education for patients / carers / staff

Liaise between the specialist hospitals within the network relating to the patients treatment.

Open times

The service operates 9am until 5pm Monday to Friday. Calls outside these times will be forwarded to the services voicemail.   

How do I refer/access the service

Any one with a skin cancer diagnosis can access the service by contacting Kate Howlen on her direct line: 01625 264035

Patients who require ‘mole mapping’ need to be referred to the Eastern Cheshire Dermatology Service by their GP.

How to find Macmillan skin specialist nurse

The Specialist Nurse is based within Eastern Cheshire Dermatology Service, Third Floor, Waters Green Medical Centre, Sunderland Street, Macclesfield, Cheshire, SK11 6JL.

She also visits the peripheral clinics at the Readesmoor Practice in Congleton. Kate Howlen also sees patients in the Macmillan Cancer Resource Centre at Macclesfield Hospital, in clinic at The Hub, Waters Green Medical Centre and sometimes in their own home. 


Q. What are the most common symptoms of skin cancer?


  • Any firm red lump that doesn’t go away
  • A patch of skin that has a waxy appearance
  • A new growth or sore that will not heal
  • A spot, mole or sore that itches, hurts, bleeds occasionally or has a change in sensation
  • A flat red spot which is scaly and crusty
  • Any sore with a pearly border or rim
  • Skin changes that develop a crust / scab

A mole that changes in any of the following ways:

  • Getting bigger
  • Changing shape, particularly getting an irregular edge
  • Changing colour - getting darker, becoming patchy or multi-shaded
  • Itching or painful
  • Bleeding or becoming crusty
  • Looking inflamed

Q. Can skin cancers be cured?

A. Yes, if detected and treated early. That it is why it is so important to raise awareness of what to look for and how to be sensible in the sun.

Q. What are the risk factors that can lead to skin cancer?

A. There is one main factor that increases the risk of developing skin cancer - ultraviolet light (UV). Ultraviolet light comes from the sun or sunbeds. But some people are more at risk of getting skin cancer than others. Risk factors related to sun exposure include:

Sun exposure - on holiday, as well as sitting in the garden. The more common skin cancer are caused by exposure to the sun over a long period of time.

Sunbeds – using sunbeds, particularly before the age of 35.

Moles - the more moles you have, the higher your risk of developing melanoma.

Being very fair skinned - especially with fair or red hair, or having lots of freckles.

Sunburn - getting badly sunburned increases your risk of melanoma

Previous radiotherapy

Some medications may lower your immune system and make you more prone to developing skin cancers.

Q. How do I balance getting enough Vitamin D and wearing a sun cream with a high protection factor (SPF)?

A. Vitamin D is essential for healthy bones. Low levels of vitamin D for long periods of time can lead to rickets in young people (which makes the bones bend), and osteoporosis if you are older (which causes bone thinning and increases the risk of fractures). Some studies say that if you are low in vitamin D, you have a higher risk of getting bowel cancer.

You can get vitamin D from sunlight and from your diet. It is added to some margarines and breakfast cereals, and can be found in fatty fish like salmon or sardines. Sunlight stimulates your skin to make vitamin D.

Some people worry that they may not get enough vitamin D if they don't sunbathe. It is important not to let your skin get burned in the sun, but it should be safe to spend 20 minutes in spring sunshine in a short sleeved shirt or blouse. The amount of sunlight you need to get enough vitamin D will always be less than the amount that makes your skin tan or burn. Some people are more at risk of low vitamin D levels, including those with darker skins and older people. If you are worried that you may be lacking vitamin D, talk to your GP.

In the UK, the winter sun is not strong enough to get your skin to produce much vitamin D. So by early spring, a lot of otherwise healthy people have low levels of vitamin D. The situation is worse the further north you live. So it is important to try to keep vitamin D levels within the normal range. We can try to do this by eating.

Useful resources

Information prescription service for information about cancer:


Macmillan Cancer Resource Centre, Macclesfield District General Hospital. Open 9 am – 5pm

Tel: 01625 663128


Macmillan Cancer Support.

Tel: 0808 808 0000


Living with a change in appearance:

The British Association of skin camouflage  Tel: 01254 703107


Financial or legal advice:

Citizens Advice

Also, the Macmillan Cancer Resource Centre can arrange appointments on a Friday afternoon to talk to a benefits advisor.