City of Hope takes a multidisciplinary approach to the treatment of skin cancer which may include surgery, chemotherapy, and immunotherapy. Discover the wide range of progressive treatment options at City of Hope that are designed to meet the individual needs of each patient.

Basal Cell and Squamous Cell Carcinomas
Treatment of basal cell carcinoma and squamous cell carcinoma may include:

• Excisional skin surgery   
  After numbing the area, a specially skilled surgeon removes the growth and the border of skin around the growth with a scalpel.
• Electrodesiccation and curettage 
  Typically a fast and simple process, this is often used to remove small basal cell skin cancers. The doctor numbs the area to be treated, removes the cancer with a sharp tool called a curette, and then sends an electric current to the site to kill any remaining cancer cells.
• Mohs micrographic surgery
  This means removing a skin cancer one layer at a time, with immediate examination by the pathologist under the microscope. The surgeon continues to have layers of skin removed until no cancer cells are seen under examination.
• Radiation Therapy
  This procedure uses high-energy rays to kill cancer cells.
• Laser surgery
  This surgery uses a narrow beam of light to remove or destroy cancer cells. Cryosurgery Often used for people who are not able to have other types of surgery, it uses extreme cold to treat early stage or very thin skin cancer.
• Topical chemotherapy
  Chemotherapy uses anticancer drugs to kill skin cancer cells. When a drug is put directly on the skin, the treatment is topical chemotherapy. It is most often used when the skin cancer is too large for surgery.

Melanoma
City of Hope takes a multidisciplinary approach to the treatment of melanoma.  The departments of General Oncologic Surgery and Plastic and Reconstructive Surgery provide primary surgical management and sentinel node biopsy procedures for melanoma patients. A medical oncologist works as part of the team from the earliest stages to ensure comprehensive care.

• Surgery
  Like basal cell and squamous cell carcinomas, treating melanoma begins during the staging process, with surgical excision.
  
  Lymph nodes near the tumor may be removed because cancer can spread through the lymphatic system. If the pathologist finds cancer cells in the lymph nodes, it may mean that the disease has also spread to other parts of the body.
• Sentinel lymph node biopsy
  Surgeons have recently discovered a method that may help determine whether small, normal appearing lymph nodes may contain melanoma cells, called "sentinel lymph node biopsy." This biopsy technique uses radioactive particles and/or colored dyes injected into the previous melanoma biopsy site. This test often can determine which lymph node may be involved with tumor (i.e., the sentinel lymph node), thereby limiting the number of lymph nodes removed and significantly reducing the chance of unnecessary surgery.

Surgeons have recently discovered a method that may help determine whether small, normal appearing lymph nodes may contain melanoma cells, called "sentinel lymph node biopsy." This biopsy technique uses radioactive particles and/or colored dyes injected into the previous melanoma biopsy site. This test often can determine which lymph node may be involved with tumor (i.e., the sentinel lymph node), thereby limiting the number of lymph nodes removed and significantly reducing the chance of unnecessary surgery.

If the sentinel lymph node does not contain tumor cells, additional lymph nodes are not removed. Alternately, if the sentinel lymph node contains melanoma it is presumed that other lymph nodes in the area may also be contaminated with melanoma cells; in which case all nearby lymph nodes are removed (therapeutic lymph node dissection).

• Radiation Therapy for Melanoma Radiation therapy uses high-energy X-rays or other types of radiation to destroy cancer cells, or keep them from growing.  City of Hope was the first center in the western U.S. to provide treatment for melanoma using the Helical TomoTherapy system.  This system combines radiation delivery with real-time imaging, allowing doctors to create a higher dose of energy that more precisely targets the cancer. TomoTherapy not only provides more effective treatment, it reduces the unwanted exposure of normal tissues and reduces potential complications.  
• Chemotherapy for Melanoma Chemotherapy drugs destroy cancer cells by interfering with their growth and multiplication. There are several methods by which these cancer-fighting medicines are delivered. Some involve an infusion of drugs through an IV.
•  Immunotherapy for Melanoma City of Hope is a leader in the use of immunotherapy, which employs the body’s own defense system to fight the cancer cells.