Melanoma Treatments

City of Hope’s approach to treating skin cancer starts with a coordinated, multidisciplinary care team whose main goal is offering you the best, most individualized treatment plan. Your plan includes the newest therapies — including immunotherapies — and innovative treatment combinations effective for even the most advanced melanoma patients.

We treat patients at all stages of disease, from initial diagnosis to advanced stages, including those with:

• Recurrent disease
• Metastatic disease
• Disease that has spread to lymph nodes

The goal for everyone we treat revolves around options, starting with the important opportunity to participate in clinical trials at every stage of your cancer. This provides you with leading-edge treatments and access to studies that will define the next generation of best treatments. Our treatment approach involves:

• Consultation with a specially trained comprehensive dermatology group
• A layered, thorough and accurate diagnostic process led by deeply experienced pathology staff
• Regular input from experts in various subspecialties at every stage of your treatment
• Near-constant refinement of therapies designed to adapt to changes in your disease
• Best-practice prevention and management of all treatment-related side effects

City of Hope’s skin cancer surgery team routinely performs complex and targeted surgeries for advanced skin cancers, using minimally invasive technologies like sentinel lymph node biopsy and pulmonary metastasectomy, which removes tumors that have entered the lungs. Our melanoma and plastic surgery teams frequently collaborate to reduce deformity and complications, restore appearance and preserve quality of life for our patients.

• In a group of lymph nodes, the sentinel lymph node tends to be the primary channel into which cancer will drain. Sentinel node biopsy is a robotic surgical procedure in which the sentinel lymph nodes are checked for cancer cells. If they test negative for cancer, the rest of the nodes can be left intact. However, if the sentinel lymph nodes show cancer cells, then the team removes them, along with nearby lymph nodes during this procedure.
• Lymph node dissection is surgery to remove lymph nodes when melanoma is found in the sentinel and other lymph nodes.
• Wide local excision involves removing melanoma, along with normal tissue surrounding it. If a large swath of skin is removed during the procedure, a skin graft may be required to replace it.

Radiation therapy uses high-energy radiation to kill cancer cells and shrink tumors. Radiation therapy is involved in melanoma treatment when:

• Surgery is not a good option.
• Melanoma is not completely removed by surgery.
• Lymph nodes have been removed, but the cancer is at high risk of returning.
• Melanoma returns and begins growing again on the skin or in lymph nodes.
• Pain or other symptoms can be reduced by radiation therapy.
• Melanoma has spread to the brain or spinal cord.

City of Hope offers advanced and highly targeted radiation treatments for melanoma. In addition to using techniques that direct radiation to tumor tissue while sparing normal tissue, our experienced radiology team works closely with surgeons, oncologists and others members of our multidisciplinary team to perform advanced procedures, such as isolated limb infusion and robotic sentinel lymph node biopsy.

City of Hope is the only center on the West Coast performing isolated limb infusion (ILI) for extremity melanomas — a focused method of delivering chemotherapy (isolated to the affected limb) that greatly reduces side effects common with whole-body chemotherapy. ILI is effective for melanoma patients with multiple tumors and/or recurrences in a specific limb.