Melanoma/Skin Cancer Surgery Program
In collaboration with the Melanoma/Skin Cancer Program at Norris Cotton Cancer Center, D-H surgical oncologists work with skin cancer experts from dermatology, dermatopathology, radiation oncology and medical oncology to provide effective planning and treatment for skin cancers including basal cell carcinoma, melanoma and Merkel cell cancer.
Our patients are presented at a multidisciplinary tumor board. Together, this group of experts formulates a treatment plan for each patient based on evidence-based practices and emerging therapies available through clinical trials.
We provide personalized care for every patient. Our goal is to help patients live longer with the best quality of life.
Conditions We Treat
- Non-melanoma skin cancers including basal cell carcinoma and squamous cell carcinoma
- Rare forms of skin cancer including Merkel cell cancer
Treatments and Procedures
- Wide local excisions, and reconstruction with skin graft or flap if necessary
- Sentinel lymph node biopsy with lymphatic mapping
- Lymphadenectomy—removal of lymph nodes in a particular area
- Advanced dermatopathology, including molecular and genetic testing
Surgery is usually the best option to treat melanoma that has not spread (metastasized), and many times surgery is the only treatment required. The amount removed is based on how thick the tumor is, where it is located, and how removing the tumor will affect the patient’s appearance. In many cases, a skin graft is needed to replace tissue that has been removed.
For some melanoma patients, there is a risk that the tumor has spread. We may recommend a sentinel lymph node biopsy, which is the most sensitive way to “stage” the melanoma and determine if it has spread. This is done at the same time that the melanoma is removed.
Using a special injected dye, the surgeon identifies and removes the first lymph node or nodes to which melanoma likely has spread. Specialized pathologists then analyze the nodes very carefully to determine if cancer cells are present.
The results of the sentinel node biopsy determine the stage of melanoma, and whether or not further surgery or other treatments such as immunotherapy or radiation therapy are recommended. The additional treatments we recommend are based on multiple factors including the patient’s extent of disease (stage of cancer), overall health, tolerance for particular procedures and therapies, and preferences.
Many of our melanoma patients may be eligible for a clinical trial. As a part of our multidisciplinary tumor board, we discuss whether patients are eligible for a clinical trial. D-H surgical oncologists advance knowledge of treatment options and outcomes for skin cancer through research and clinical trials.