"I am simply so excited by how my life has changed and by what I learned about myself since being diagnosed." John Garner, Survivor
Getting treated for skin cancer at City of Hope gives you access to exceptional, coordinated care and makes you the focus of a team of world class doctors and scientists. Our team knows the newest and best treatments for melanoma and other skin cancers, and was involved in early studies for some of today’s most widely-used therapies.
City of Hope’s comprehensive care team, including dermatologists, surgeons, medical oncologists, surgeons, dermatopathologists and radiation oncologists are internationally recognized for their expertise and for shaping guidelines that are advancing the treatment of melanoma and other skin cancers.
If you have been diagnosed with skin cancer or melanoma or are looking for a second opinion consultation about your treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.
City of Hope is one of only a few dozen centers in the country that treat skin cancer and melanoma using a comprehensive approach — by a multidisciplinary team whose sole focus is treating this type of cancer. Your care includes regular interaction and input from a team that includes oncologists, surgeons, radiation oncologists, dermatologists and pathologists, along with nurses, social workers and specially trained support staff. This team brings together deep experience and diverse perspectives — shaped by seeing and treating skin cancer every day — to arrive at the ideal treatment for every patient.
City of Hope is internationally recognized for its research and breakthrough treatments, has been named one of America’s top cancer hospitals by U.S. News & World Report for more than 10 years running and is a National Cancer Institute-designated comprehensive cancer center.
City of Hope’s world renowned melanoma cancer care team uses the latest technology and innovation to treat cancer while providing compassionate care. Call 800-826-HOPE or request an appointment online.
Skin cancer is the most commonly diagnosed cancer and, in most cases, it is not life-threatening nor does it spread to other parts of the body. The exception is melanoma, the rarest and most aggressive form of skin cancer.
According to the American Cancer Society, more than 5 million nonmelanoma skin cancers (basal and squamous cell cancers) are diagnosed each year, while melanoma will be diagnosed in approximately 76,000 people. Although melanoma is potentially deadlier, if caught and treated early, it has a nearly 100 percent cure rate.
Basal cell carcinoma
Squamous cell carcinoma
Other skin conditions, such as actinic keratosis and squamous cell carcinoma in situ (meaning does not spread to other organs) are precancerous lesions. Early detection is critical to prevent them from becoming skin cancer.
Skin is an elastic organ — the largest in the body. Its main functions include protecting internal organs, controlling body temperature, shielding the body from ultraviolet (UV) radiation from the sun and helping the body make vitamin D. Skin cancer develops when abnormal cells in the skin’s layers grow uncontrollably — most commonly because of too much exposure to UV light from the sun or other sources, like tanning beds and sun lamps.
The most common types of skin cancer — basal cell and squamous cell carcinomas — tend to appear on areas of the body exposed to the sun, such as the face, neck, ears and hands.
Melanoma starts in cells called melanocytes, which are responsible for giving skin its color. This skin pigmentation functions as a shield against harmful ultraviolet (UV) light exposure from the sun, which can lead to mutations in DNA. With enough DNA damage in critical genes the cells of the skin, including melanocytes, begin to grow uncontrollably and spread locally and to distant organs.
Skin cancer stages depend on which structures are involved:
In early skin cancers, the tumors are small, contained within the top layers of skin and have not spread to distant organs. As the cancer progresses, the tumor grows larger and more deeply into the skin layers, spreading to lymph nodes and blood vessels and, potentially, distant organs.
Basal and squamous cell skin cancers are much less likely to spread to lymph nodes and distant organs than melanomas.
Things that put you at higher risk for getting skin cancer are called risk factors. The main risk factor for developing skin cancer is exposure to ultraviolet (UV) radiation from:
Other factors that may contribute to developing skin cancer include:
People with darker complexions have a much lower risk of most types of skin cancer. When they do develop melanoma, people with darker skin types are much more likely to have rare types of melanoma such as acral lentiginous melanoma, an aggressive type affecting the palms of the hands, soles of the feet and nail bed. Melanoma can also develop in nonsun-exposed area such as the membranes of the mouth, gastrointestinal tract and female genital tract.
Skin cancer signs and symptoms are different from person to person, and for this reason it is one of the more difficult cancers to detect. Most of the time melanoma has no symptoms, although itching may occur and, when it is advanced, so may bleeding.
The most important warning sign of skin cancer is a new spot on the skin, especially if that spot changes shape, color or size. Another potential symptom is a spot that looks different from all the others on your skin (known as the “ugly duckling sign”).
Other signs include:
If you notice any of these skin changes, contact your doctor.
UV damage is cumulative, meaning it begins building up in childhood, so prevention should start young. The best ways to lower your risk for skin cancer include shielding the skin as much as possible from UV radiation:
Skin cancer is a disease that is challenging to accurately diagnose and stage. City of Hope’s team of internationally trained dermatologists and dermatopathologists use their clinical experience and expertise, and leading-edge technology, to provide you with the most accurate diagnosis — and the most effective treatment.
This powerful combination of experience, technology and talent is why City of Hope is known for transforming melanoma patients with advanced disease and dire diagnoses — into survivors.
Skin exam, the first test to diagnose skin cancer, is a thorough check of the skin for moles, spots or bumps that appear to be abnormal.
Skin biopsy involves removing tissue that appears abnormal to be viewed later under a microscope by a pathologist. There are several types of skin biopsy, including:
Determining whether a growth is benign or cancerous is a subtle process, requiring a trained eye and deep experience. As part of the diagnostic process, our specially trained dermatopathologist performs wide-ranging molecular testing of most melanomas, for the most accurate diagnosis.
Testing for specific mutations — such as BRAF and KIT — may also be performed by molecular pathologists, leading to more specific and individualized treatment options.
"At least as important as the new drugs being developed is the much deeper understanding we now have of the biology of melanomas." Kim Margolin, M.D., medical oncologist
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 including those with:
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:
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.
City of Hope clinical trials include access to the latest drug therapies and combinations to treat melanoma. Many are based on the genetic changes driving tumors so that therapies may be tailored to specific mutations — others use unique combinations of immunotherapy agents.
City of Hope patients also benefit from our collaboration with various groups, providing access to the newest therapies and clinical trials, including the Cancer Immunotherapy Trials Network.
"Time is the most important thing so my patients understand that I have their best interests at heart. Once they understand I am their advocate, they don't have to question my motives and it is an easy path." Vijay Trisal, M.D., surgical oncologist
Surgery is the most common treatment for both melanoma and nonmelanoma skin cancer. The goal of surgery is to completely remove the cancer while trying to preserve healthy tissue.
City of Hope’s skin cancer surgery team routinely performs complex operations for advanced skin cancers — and uses advanced minimally invasive technologies, such as robotic sentinel lymph node biopsy, to accurately identify whether and how far cancer has spread.
And frequent collaborations between our melanoma and plastic surgery teams ensure that procedures are performed that minimize deformity and complications; restore appearance; and preserve quality of life.
For melanomas that have spread, our experienced surgical team performs minimally invasive procedures such as pulmonary metastatectomy, a robotic surgery procedure designed to remove tumors that have spread to the lungs.
Radiation therapy uses high-energy radiation to kill cancer cells and shrink tumors. Radiation therapy is involved in melanoma treatment when:
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.
The Skin Cancer Excision Clinic is located in the Women’s Center, lower level of the Geri & Richard Brawerman Ambulatory Care Center at the Duarte campus of City of Hope.
About Your Surgeon
A board-certified plastic and reconstructive surgeon based at City of Hope in Duarte, California, Wai-Yee Li, M.D., Ph.D., was born and raised in London, England, where she is a member of the Royal College of Surgeons of England. Dr. Li began her surgical training at The Royal Marsden cancer hospital in London.
A graduate of Keck School of Medicine of USC (integrated plastic surgery residency), Li also completed an additional year of fellowship training at the University of British Columbia. She obtained a Ph.D. in wound healing and craniofacial development at the Children’s Hospital Los Angeles. Li is fluent in Cantonese. She performs many types of reconstructive procedures including:
Arranging Your Visit
Once your dermatologist determines you need a surgical procedure, he or she should refer you to Dr. Li for a consultation. You may also call (626) 218-5015 to schedule a visit or (626) 471-7100, extension 88541.
Before your Procedure
Dr. Li will perform a complete history and physical exam to let you know whether or not you are a suitable candidate for same day excision. If you are, she will explain the procedure to you and you will be moved to another room for the procedure.
During your Procedure
After Your Procedure
A nurse will provide home care instructions. You will be given a follow up visit with Dr. Li or a member of her plastic surgery team within seven to 10 days for a wound check. The dressing may stay on during this time. A printed copy of your pathology testing report will be provided during this follow-up visit.
City of Hope’s world renowned physicians and researchers use the latest in technology and innovation to treat cancer — coupled with an enduring belief in providing compassionate care. If you have been diagnosed with gastrointestinal cancer, or are looking for a second opinion about your treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.
Getting treated for skin cancer at City of Hope means you are steps away from labs where new treatments for cancer are being developed every day. That proximity means you benefit from something unique in cancer care — bench to bedside treatment. “Bench to bedside” means innovative research we are conducting in our labs is moved quickly to the bedside to treat our patients.
Cancers are able to survive and thrive because of genetic abnormalities that keep them from being detected and destroyed by the body’s immune system. Research is revealing the specific mutations (problems within the DNA in a cell) causing these abnormalities and using that information to tailor therapies to specific patients’ tumor cells.
For example, with melanoma, recent advances have revealed specific genetic pathways that drive melanoma development. Our genetics team is on the forefront of new discoveries about why people develop melanoma — and precision medicine techniques allow them to target those problems within cells, and disrupt the process that leads to cancer.
Melanoma is a disease that can act many different ways in the body. Research at City of Hope — driven by patient-specific, individualized treatment strategies — is focused on those differences, and on designing therapies that affect how melanoma develops, progresses and spreads. Click here to learn more about clinical research at City of Hope.
When you come to City of Hope, you have access to a strong network of support services and staff to help you and your family along your cancer journey. That support includes everything from talk therapy to meditation to being paired up with a patient navigator. Learn more about the resources listed below at our Living with Cancer or Supportive Care Medicine sites.
Lymphedema, a condition involving abnormal swelling, may occur after procedures involving the lymph nodes. City of Hope has robust resources designed to minimize your risk of long-term lymphedema including:
Download our ABCDE Guide to Potentially Cancerous Moles infographic.
We deliver exquisite care at the leading edge of cancer treatment. It takes the help of a lot of caring people to make hope a reality for our patients. City of Hope was founded by individuals' philanthropic efforts over 100 years ago. Their efforts — and those of our supporters today — have built the foundation for the care we provide and the research we conduct.
For more information on supporting the skin cancer and melanoma program, please contact Donor Relations. Or, you can make a gift to support all the research at City of Hope by donating online.