Melanoma Program

The Northside Hospital Cancer Institute (NHCI) Melanoma Program offers comprehensive, multidisciplinary cancer care, sub-specialized clinical expertise and a personalized approach to cancer care. Our robust clinical research capabilities allow us to offer patient access to National Cancer Institute and pharmaceutical and industry-sponsored clinical trials close to home.

Rooted in compassion, dedicated to quality and excellence, and committed in being a true asset to this region, the NHCI Melanoma Program strives to deliver the highest level of care throughout the entire patient journey, from prevention to treatment and survivorship.

What Is Skin Cancer?

Skin cancer is the most common type of cancer and there are several different types of skin cancer including melanoma, squamous cell carcinoma, basal cell carcinoma, and merkel cell carcinoma. Squamous and basal cell carcinomas usually respond to skin cancer treatment and rarely spread to other parts of the body. Merkel cell carcinoma is a rare, aggressive skin cancer that has a high risk of recurring and spreading throughout the body. Melanoma is also one of the more potentially aggressive forms of skin cancer, and prevention and early detection are critical. If not diagnosed early, melanoma can spread to nearby tissues and other parts of the body.

Learn more about melanoma and other skin cancers.

Symptoms of Melanoma & Skin Cancer

A mole, sore, lump or growth on the skin can be a sign of skin cancer. A lesion or spot that bleeds or changes color may also be a sign of skin cancer. The ABCDE system can be used to remember possible signs and symptoms of melanoma and skin cancer:

  • Asymmetry – One-half of the abnormal area is different from the other half
  • Borders – The edges of the growth are irregular.
  • Color – Color changes from one area to another, with shades of tan, brown, or black, and sometimes white, red, or blue. A mixture of colors may appear within one lesion or spot.
  • Diameter – The lesion or spot is usually (but not always) larger than six millimeters in diameter, which is about the size of a pencil eraser.
  • Evolution – The lesion or spot changes appearance

Use this handy ABCDE System chart to look for melanoma warning signs.

Melanoma & Skin Cancer Risk Factors and Prevention

Risk Factors

Exposure to ultraviolet (UV) rays is a major risk factor for most melanomas. There are a number of other risk factors for melanoma and skin cancers, including personal and family history. The risk of developing melanoma increases with age. However, it is also frequently seen in young people.

You are more likely to develop melanoma or skin cancer if you:

  • Have fair skin, freckling, or light hair.
  • Live in sunny climates or at high altitudes.
  • Spent a lot of time in high levels of strong sunlight, because of a job or other activities.
  • Have had one or more blistering sunburns during childhood.
  • Have used tanning devices.

Other risk factors include:

  • Personal history of melanoma or skin cancer
  • Close relatives with a history of melanoma
  • Certain types of moles (atypical dysplastic) or multiple birthmarks
  • Weakened immune system due to disease or medication

Learn more about melanoma and skin cancer risk factors.

Prevention

There is no guaranteed prevention against melanoma or skin cancer, but there are ways for people to protect their skin and reduce the risk of developing skin cancer.

  • Schedule “outdoor time” for before 10 a.m. or after 4 p.m. when sun exposure is less harmful.
    When outside during “peak” hours, seek shade or a covered area, instead of being in the direct sun.
  • Always wear (and reapply) sunscreen.
    Choose a product that is labeled “broad spectrum” or “multi-spectrum” (to protect against UVA and UVB rays) with an SPF (sun protection factor) of at least 30. Apply at least 20 minutes before going outside and re-apply every two hours, especially when sweating or swimming. Wear sunscreen on overcast days as well, as UV rays still travel through clouds. Expand the use of sunscreen beyond the summer. Snow reflects up to 80% of the sun’s rays.
  • Be thorough with sunscreen.
    Remember that skin cancer can occur in places people don’t typically expect – for instance, on the backs of the hands and feet, eyelids, ears, in between toes and on the lips (lip balm should also have an SPF of at least 30). Adults need at least a shot glass full of sunscreen lotion per application. If using a spray sunscreen, be sure all exposed skin is coated. Always check the expiration date on sunscreen – expired products may not be effective.
  • Accessorize.
    Wear tightly woven, bright-colored clothing that covers most of the body. These are more effective at blocking the sun’s rays and preventing unnecessary exposure. Wear a wide-brimmed hat, long-sleeved shirt and long pants when in the sun. Choose wrap-around sunglasses that absorb 100% of UV rays to help protect the eyes and the surrounding skin.
  • Check your medications.
    Some medications, including acne treatment and birth control, can make skin extra sensitive to sun exposure. If planning to be out in the sun, people should check with their doctor to see if their medications may have such an effect.
  • Ditch the tanning bed.
    With or without sunscreen, tanning beds can damage the skin, putting people at an increased risk for cancer. Continued tanning exposure can cause wrinkles, brown spots, blotchiness and leathery looking skin.

Melanoma & Skin Cancer Screening and Diagnosis

Screening

Over the past five years, the NHCI Melanoma Program has screened close to 2,500 individuals for skin cancer. Regular skin cancer screenings and mole checks are pivotal to detecting melanoma and skin cancer early, when the disease is most treatable.

Self-Exam to Check Your Skin for Signs or Symptoms of Skin Cancer

It is important for everyone to check their skin each month to look for the signs and symptoms of skin cancer. A mirror should be used and it is helpful to have someone help examine hard to see areas. If anything suspicious is noticed, it is important for people to contact their doctor or dermatologist. Download our easy-to-follow guide to help you remember what to look for during your monthly skin cancer self-exams.

Skin Cancer Self-Exam Guide

Annual Skin Cancer Screenings

In addition to monthly self-exams, you should also have an annual skin screening performed by your physician or dermatologist. Your doctor will check your skin and look at the size, shape, color and texture of any suspicious areas. If your doctor is concerned about the possibility of skin cancer or a melanoma, a biopsy will be performed to remove all or part of the affected area. If the biopsy confirms cancer, a more aggressive operation may be necessary.

Community Skin Cancer Screening Events

Northside Hospital Cancer Institute hosts multiple skin cancer screening events for community members (adults 18 years of age and older) each year. Screenings take place in a private setting and consist of a brief skin assessment by a medical professional. Typically, only skin exposed areas such as arms, hands, neck and feet are examined.

Skin cancer screenings are not intended to take the place of annual comprehensive skin examinations. For a more in-depth examination, please schedule an appointment with your dermatologist.

Northside Hospital’s skin cancer screenings are free, but registration is required. Please call 404-531-4444 to schedule an appointment or for more information download our 2019 Screening Calendar below or view upcoming skin cancer screenings in the Community Calendar.

2019 Community Skin Cancer
Screenings (English)
2019 Community Skin Cancer
Screenings (Spanish)

Diagnosis

The only way to accurately diagnose melanoma or skin cancer is with a biopsy. During a biopsy, all or part of the suspicious mole or growth is removed, and a pathologist analyzes the sample. Biopsy procedures used to diagnose melanoma include a shave biopsy, punch biopsy, an excisional biopsy or an incisional biopsy.

Additional diagnostic tests and services that may be required include:

If you receive a diagnosis of melanoma, the next step is to determine the extent (stage) of the cancer.

We offer specialized care for all types of skin cancer including:

  • Melanoma - The most dangerous form of skin cancer, melanomas develop when unrepaired DNA damage to skin cells (most often caused by ultraviolet radiation from sunshine or tanning beds) triggers mutations (genetic defects) that lead the skin cells to multiply rapidly and form malignant tumors. These tumors originate in the pigment-producing melanocytes in the basal layer of the epidermis. Melanomas often resemble moles and some develop from moles. The majority of melanomas are black or brown, but they can also be skin-colored, pink, red, purple, blue or white. Melanoma is caused mainly by intense, occasional UV exposure (frequently leading to sunburn), especially in those who are genetically predisposed to the disease.

  • Basal cell carcinoma - The most frequently occurring form of skin cancer, basal cell carcinoma is an abnormal, uncontrolled growth or lesion that arises in the skin’s basal cells, which line the deepest layer of the epidermis (the outermost layer of the skin). Basal cell carcinomas often look like open sores, red patches, pink growths, shiny bumps, or scars and are usually caused by a combination of cumulative and intense, occasional sun exposure.

  • Squamous cell carcinoma - The second most common form of skin cancer, squamos cell carcinoma is an uncontrolled growth of abnormal cells arising from the squamous cells in the epidermis, the skin’s outermost layer. Squamous Cell Carcinomas often look like scaly red patches, open sores, warts or elevated growths with a central depression. They may also crust or bleed.

  • Merkel cell carcinoma - A rare, aggressive skin cancer that is at high risk of recurring and spreading (metastasizing) throughout the body, with most recurrences taking place within two years after diagnosis of the primary tumor. Merkel cell carcinoma most often arises on sun-exposed areas in fair-skinned individuals over age 50.

Team of Melanoma and Skin Cancer Specialists

The strength of the Northside Hospital Cancer Institute’s Melanoma Program is our multidisciplinary team of dedicated melanoma and skin cancer specialists and oncology support services team members. Our expert physicians work together every step of the way to provide individualized care for each patient diagnosed with melanoma or skin cancer. Northside’s Melanoma Program offers a comprehensive scope of medical services, the latest technology, leading-edge clinical research and compassionate care and support.

Our multidisciplinary team of melanoma and skin cancer specialists consists of:

  • Surgical oncologists
  • Plastic and reconstructive surgeons
  • Medical oncologists
  • Radiation oncologists
  • Dermatologists
  • Dermatopathologists
  • Radiologists
  • Pathologists
  • Certified genetic counselors
  • Melanoma and skin cancer nurse navigator

Rollover the graphic for more information

Multidisciplinary 1 2 3 4 5 6 7 8 9 10 11

Weekly multidisciplinary melanoma and skin cancer conferences provide a forum for cancer specialists to review radiology and pathology images, discuss the best Melanoma and Skin Cancer Treatment Options, including clinical trials, and agree upon an evidence-based treatment plan for each patient. By prospectively discussing melanoma and skin cancer cases during conference, patients get the benefit of not just one clinical perspective but more than a dozen expert opinions.

Melanoma & Skin Cancer Treatment Options

Northside Hospital Cancer Institute is committed to providing high quality melanoma and skin cancer treatment and making access to this cancer care as convenient as possible.

We treat every type and stage of skin cancer with the latest cancer treatments, including personalized therapies based on the cancer’s specific genetic makeup. Northside Hospital Cancer Institute’s skin cancer specialists and oncology support services team members work together to ensure all patients receive high quality, evidence-based care.

NHCI maintains ongoing access to promising National Cancer Institute (NCI) and industry-sponsored clinical trials, which include trials designed to determine the impact of multigene panel molecular tumor profiling in patient management as well as routine genetic mutational analysis for patients with early-stage melanoma.

Expand the content below for more information about melanoma and skin cancer treatments.

Surgery is the main treatment option for most melanomas, and usually cures early-stage melanomas. Typical surgical procedures to treat melanoma and skin cancer include:

Immunotherapy is the use of medicines to stimulate a person’s own immune system to recognize and destroy cancer cells more effectively. Northside offers several types of immunotherapy to treat melanoma.

Immunotherapy treatment options for melanoma include:

  • Immune checkpoint inhibitors
  • Cytokines (interferon-alfa and interleukin-2)
  • Oncolytic virus therapy

Learn more about our Immunotherapy Program

Immunotherapy - Questions to ask the doctor

Targeted therapy drugs target the parts of melanoma cells that make them different from normal cells. Targeted drugs work differently from standard chemotherapy drugs, which basically attack any quickly dividing cells. Sometimes, targeted drugs work when chemotherapy does not, and they can also have less severe side effects.

Northside offers therapies that target cells with BRAF gene changes and cells with C-KIT gene changes.

Targeted Therapy - Questions to ask the doctor

Radiation therapy is a treatment that uses high energy X-rays or radiation to kill cancer cells. Radiation may be used before the surgery to shrink a tumor or after surgery to kill remaining cancerous cells.

Northside offers external beam radiation therapy (EBRT), the type of radiation most often used to treat melanoma. EBRT focuses radiation from a source outside of the body on the cancer, using a sophisticated treatment machine (called a linear accelerator) that produces high-energy X-rays that shape multiple beams or arcs of radiation, carefully conforming to the shape or volume of the tumor.

Learn more about our Radiation Oncology services.

Chemotherapy (or “chemo”) uses medication to destroy cancer cells by stopping growth. Chemotherapy can be used to treat advanced melanoma, but it is not often used as the first treatment since newer forms of immunotherapy and targeted drugs have become available.

At Northside's infusion centers, chemotherapy is provided on an outpatient basis by registered nurses who are certified in chemotherapy administration.

Clinical trials are studies that involve people and are a critical part of oncology research. These studies test new ways to prevent, detect, diagnose and treat cancer. People who take part in cancer clinical trials have an opportunity to contribute to scientists’ knowledge of cancer and to help in the development of improved cancer treatments, while receiving state-of-the-art care from cancer experts.

Learn more about Cancer Clinical Trials and Research at Northside Hospital

Learn more about NHCI cancer treatment options.

Melanoma & Skin Cancer Support & Survivorship

Ongoing support is crucial when you are facing cancer. Northside Hospital Cancer Institute provides a full range of support and survivorship programs and services to address the unique needs of melanoma and skin cancer patients.

Melanoma and skin cancer treatment and recovery can be overwhelming, which is why our Melanoma Program offers patient access to oncology nurse navigators to guide them through every step of their cancer journey – from diagnosis and treatment to recovery. Our melanoma nurse navigator is a registered nurse with extensive knowledge and training in oncology. Nurse navigators are available to provide education and support to patients who are diagnosed and/or treated within the Northside Hospital system.

Our oncology nurse navigators facilitate access to Northside’s comprehensive portfolio of cancer patient support services including Nutrition, Behavioral Health and Social Work, Lymphedema Management and Clinical Research, to ensure each patient receives coordinated and personalized cancer care.

The melanoma nurse navigator supports each patient by:

  • Providing clinical information and education.
  • Answering questions about diagnosis, treatments and any side effects experienced.
  • Initiating and facilitating communication between the patient and their cancer care team.
  • Providing access to emotional and psychological support, including referrals to appropriate counseling services, our Melanoma Support Group and Network of Hope.
  • Monitoring each patient’s health and overall treatment progress.

To learn more about oncology patient navigation or to speak with an oncology nurse navigator, please call 404-300-2800 or email nurse.navigator@northside.com.

Learn more about all of our Northside Hospital Cancer Institute’s Cancer Support and Survivorship Resources.