Melanoma & Skin Cancer

Our approach to melanoma and skin cancer care

At UCSF Health, our melanoma and skin cancer experts meet regularly at tumor boards to review complex cases, make tailored treatment recommendations and plan follow-up care. You benefit from the coordinated input of a multispecialty team.

Advanced diagnostic testing for melanoma

We use the latest diagnostic tools to detect melanoma as early as possible, when treatment is more effective. Our specialized dermatopathologists focus solely on evaluating skin biopsies. This depth of expertise means they can more accurately diagnose and stage melanomas.

We use advanced molecular profiling to test melanoma cells for certain genetic changes (mutations), such as BRAF, NRAS and KIT. This information helps us offer targeted treatment for the type of cancer you have.

As a major research center for skin cancer, we also have extensive experience evaluating and treating uncommon melanomas not routinely seen at other centers, including:

• Acral lentiginous melanoma

• Mucosal melanoma

• Ocular or uveal melanoma

Melanoma surgery

Surgery is often the main treatment for melanoma that has not spread beyond the skin. Our dermatologic surgeons have expertise in all types of skin cancer surgery, including Mohs micrographic surgery and wide excision surgery.

Mohs surgery is a minimally invasive procedure that removes skin, layer by layer, until no cancer cells remain. It removes as little healthy tissue as possible, making it ideal for sensitive or highly visible areas, such as the face and hands. Because it's so precise, Mohs is often used for removing larger tumors.

We can also use wide excision surgery for melanoma. This means removing a tumor, along with a margin of healthy tissue around it. Wide excision may be appropriate for small or uncomplicated tumors in less visible areas.

In some cases, we may recommend surgery for melanoma that has spread to the lymph nodes, lungs, brain or other areas of your body. Surgery for metastatic melanoma is often combined with other treatments, such as immunotherapy or chemotherapy. Learn more about dermatologic surgery at UCSF Health.

Immunotherapy for skin cancer

At UCSF Health, our medical oncologists use the latest immunotherapies to treat advanced melanoma and other skin cancers. Immunotherapies are drugs that harness your immune system to fight cancer. You may receive immunotherapy as your only treatment or in addition to surgery.

Immunotherapy before surgery, called neoadjuvant therapy, can help shrink tumors so they're easier to remove. Immunotherapy after surgery, called adjuvant therapy, can help prevent cancer from coming back (recurrence).

TIL therapy for advanced skin cancer

At UCSF Health, we offer tumor-infiltrating lymphocyte (TIL) therapy for advanced melanoma that hasn't responded to other standard treatments. We're one of the few hospitals in the region offering this groundbreaking cellular immunotherapy.

TIL therapy involves close collaboration between our surgical and medical oncologists. After surgically removing a melanoma tumor, we remove cancer-fighting immune cells called lymphocytes from the tumor and multiply them in a lab.

Patients often have chemotherapy after this to prepare their immune system before we infuse lymphocytes back into their body. Infusing more lymphocytes into a patient's body helps their immune system fight cancer.

Other treatments for melanoma

We may recommend additional treatments, such as chemotherapy or radiation therapy, in combination with surgery or immunotherapy. Radiation therapy can be used to treat cancer or reduce the risk of recurrence. It can also help shrink tumors and relieve symptoms of metastatic melanoma, such as pain, headaches and fatigue.

At UCSF Health, we offer the latest advances in radiation therapy. This includes proton beam radiation therapy for ocular melanoma and stereotactic radiosurgery for metastatic brain tumors. Learn more about radiation oncology at UCSF Health.