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From humble beginnings in the 1960s, the Sydney Melanoma Unit in Sydney, Australia, grew rapidly, and soon became the world's largest melanoma unit. Currently each year, about 1,200 new melanoma patients are referred to the Unit, and about 8,000 follow-ups occur. It has become the major referral centre for melanoma patients in NSW and overseas.
One of the Unit's unique features is undoubtedly its provision of integrated multidisciplinary care. This involves not only specialist surgeons treating patients with primary melanomas and recurrent disease, but also specialists in medical oncology, radiation oncology, nuclear medicine, histopathology, radiology, palliative care and oncology nursing. A weekly multidisciplinary clinical review meeting attended by all the Unit's professional staff allows evidence-based treatment policies to be developed.
The development of the SMU
In 1957, a landmark paper entitled "Sunlight as a cause of melanoma" was published by Drs Lancaster and Nelson in the Medical Journal of Australia. Since cancer registries had not yet been established, these authors were not able to assess melanoma incidence. However, from death certificates they reported that the death rate from melanoma in Australia was much higher than anywhere else in the world, with a distinct increase in death rate with decreasing latitude.
 Gerard Milton In 1966, he set up the first Australian Melanoma Clinic at Sydney Hospital and began the first prospective collection of information from patients with a written proforma designed by himself and Dr Cecil Lewis, who was Professor of Surgery in Perth, Western Australia. As patient referrals to the Clinic increased, it became necessary to offer chemotherapy and provide palliative care. The first domiciliary nursing service for patients with advanced disease receiving treatment with chemotherapy, immunotherapy or radiotherapy was established.
 William McCarthy
In 1972, the Clinic joined the WHO Melanoma Group and began to take part in international clinical trials. As patient numbers increased exponentially, it became clear that computerisation would be necessary to handle the vast amount of clinical, histopathological and epidemiological data that was accumulating. This was achieved in 1972 with the initial intention that the Clinic's database should be primarily a research tool, whilst at the same time providing indepth information on each patient’s treatment.
About this time, Dr Vincent McGovern of the Royal Prince Alfred Hospital in Sydney, who was an internationally recognised authority on the histopathology of melanoma, developed a close association with the Clinic by virtue of this interest. Following Dr McGovern's tragic death, Dr Stan McCarthy progressively developed the Unit's reputation for internationally pre-eminent melanocytic histopathology. He has awarded an officer of the Order of Australia (AO) in 1996 especially for his work on melanoma and cancer pathology.
In 1983, the Clinic was transferred from Sydney Hospital to the Royal Prince Alfred Hospital. The move to a larger hospital enabled services provided by the Clinic, now known as the Sydney Melanoma Unit, to be expanded. One notable development was the nation's first isolated limb perfusion service, set up by Dr John Thompson.
Dr Thompson was, at the time, an academic surgeon at the Royal Prince Alfred Hospital with training not only in surgical oncology but also vascular surgery and transplantation. Since 1993, Dr Thompson has led the Unit as the major contributor to the Multicenter Selective Lymphadenectomy Trial. During this time, Dr W.H.McCarthy set up the Melanoma Foundation within the University of Sydney, which soon began to generate funds that enabled the Unit to progress much more rapidly with its research and education programs. In 1990, following the retirement of Dr Milton, Dr McCarthy became the Executive Director of the Unit, until he was succeeded by Dr Thompson in 1998.
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Vincent McGovern |
Stan McCarthy |
John Thompson |
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Care at SMU 
