Melanoma and Other Skin Cancers

Surgical options for melanoma and other skin cancers include:

• Wide local excision: Surgeons remove melanoma and a rim (margin) of nearby healthy tissue. This technique typically removes more tissue than Mohs surgery and may eliminate trace levels of cancer. It’s an outpatient procedure we perform either in the office or an operating room, and you will likely go home the same day.
• Sentinel lymph node biopsy: When cancer spreads, it typically goes to nearby lymph nodes (fluid-filled sacs that filter out harmful substances). If the cancer is at risk for spreading, eligible patients undergo a sentinel lymph node biopsy. We typically perform the biopsy during the same procedure as the wide local excision. Surgeons locate the lymph nodes likely to be affected and take a tissue sample.
• Lymph node dissection: If sentinel lymph node biopsy results are positive, we may use this procedure to remove them and possibly other nearby lymph nodes.
• Reconstruction: Sometimes, there is not enough healthy tissue after surgery to close the incision. Procedures can also affect your appearance if the cancer is on your head or neck. Sophisticated reconstructive procedures address these issues for eligible patients. Find out more about microvascular head and neck reconstruction.

Your care may include medical options if you cannot have surgery. These therapies may also be an option after surgery. Find out more about chemotherapy and other medical oncology. Non-surgical treatments for skin cancer may involve:

• Immunotherapy: This medical treatment works with your immune system to recognize and attack cancer cells.
• Isolated limb infusion: This treatment delivers cancer drugs (chemotherapy) directly to melanoma in the arms and legs.
• Clinical trials: You may be eligible to participate in skin cancer clinical trials testing new therapies. Explore cancer clinical trials and research.
• Targeted therapy: We perform genomic testing in patients who qualify to learn more about abnormal changes (mutations) in the cancer cells. Depending on the results, you may receive medications or other substances that stop cancer with that mutation.
• Radiation therapy: In some cases, we use radiation therapy to treat melanoma. This option uses beams of energy to break up cancer cells and prevent them from spreading. Read more about radiation therapy.

Advanced skin cancers typically require long-term follow-up care to check for signs of new cancers. In the weeks after treatment, follow-up visits are more frequent, so we can monitor your recovery. Your team creates personalized recommendations for follow-up care. After recovering from treatment, you may only need a yearly check-up. We may recommend more frequent follow-ups if:

• Sentinel lymph nodes were positive: We perform an imaging study (ultrasound scan) to check for new signs of cancer in the lymph nodes. The team includes radiologists and technicians with special training in detecting these cancers.
• A high likelihood exists that the cancer will return: Even if treatment is successful, certain skin cancers, like melanoma, often come back. We perform detailed imaging tests, in eligible patients, like positron emission tomography (PET) scans that detect cancer before you experience symptoms.