Intermountain Cancer Center’s multidisciplinary team of dermatologists, surgical, medical, and radiation oncologists, and dermatopathologists provide specialized treatment for melanoma and other skin cancers including advanced basal cell and squamous cell carcinomas, Merkel cell carcinoma, and other rare tumors of the skin. Our fellowship-trained surgical oncologists have expertise in resection of primary tumors occurring anywhere on the skin, sentinel lymph node biopsy, and lymph node dissections, working closely with plastic surgery colleagues when reconstruction is needed.
Treatments and Procedures
The first step in skin cancer treatment is the removal of the cancer, and the standard method of doing this is by excisional surgery. Excisional surgery involves a physician using a scalpel to remove the entire skin tumor, along with a surrounding border of seemingly normal skin.
Mohs micrographic surgery is appropriate treatment for some skin cancers. Mohs surgery is performed by specialty-trained dermatologists using a scalpel or curette (sharp, ring-shaped instrument) to remove one thin layer of tissue at a time. As each layer is removed, the edges are studied under the microscope for the presence of cancer cells. If the margins are cancer-free, the surgery is ended. If not, more tissue is removed, and this procedure is repeated until the margins of the final tissue examined are clear of cancer.
Melanoma, especially as it grows deeper in to the skin, can spread to nearby lymph nodes. A technique called sentinel lymph node biopsy allows for early recognition of melanoma in the lymph nodes, when the tumor is too small to be seen by the naked eye or felt on physical examination. If melanoma is found in a sentinel lymph node biopsy, removal of the remaining lymph nodes at that site is recommended.
Plastic surgeons are an important part of the treatment team in reconstructing complex surgical wounds and restoring both cosmesis (appearance) and function. Techniques ranging from simple scar revision to complex transfer of tissue flaps from other areas on the body are used in skin cancer surgery reconstruction.