At Boston Medical Center (BMC), the care of patients with melanoma is a collaborative, multidisciplinary process, offering the full spectrum of services for early to advanced stages of the disease and involving dermatologists, specialized surgeons (including neurosurgeons and thoracic surgeons), medical oncologists, and radiation therapists. BMC’s Cancer Care Center organizes its services around each patient, bringing together the expertise of diverse specialists to manage care from the first consultation through treatment and follow-up visits.

The Cancer Care Center is dedicated to providing treatment that is effective and innovative in curing and controlling cancer, while managing its impact on quality of life. The NCCN Guidelines for treatment based on stage of disease are fully supported. In addition, clinical trials of new agents or combinations of agents are offered to try to prevent recurrence and to treat metastatic disease. Melanoma molecular tests and genetic screening are being used routinely to help direct and personalize treatments.

As the primary teaching affiliate of the Boston University Chobanian & Avedisian School of Medicine, BMC combines personal, patient-focused care with the state-of-the-art-expertise and technological advances of a major teaching hospital. BMC is at the forefront of clinical practice, surgical expertise, and research in oncology.

To schedule an appointment or refer a patient, call 617-638-7420.

Conditions we treat

Treatments and Services

Diagnostics and Tests

Patient Resources

BMC offers a number of clinical trials specifically for patients with melanoma. Promising new techniques in the diagnosis, treatment, and care of patients with melanoma are tested in these studies. The number and types of clinical trials available are constantly changing. View an up-to-date list of ongoing trials here. Those interested in participating in any clinical trials at BMC should talk with their physician.

Treatments

Chemotherapy

Chemotherapy is a medication or combination of medications used to treat cancer. Chemotherapy can be given orally (as a pill) or injected intravenously (IV).

CyberKnife

CyberKnife delivers highly targeted beams of radiation directly into tumors, in a pain-free, non-surgical way. Guided by specialized imaging software, we can track and continually adjust treatment at any point in the body, and without the need for the head frames and other equipment that are needed for some other forms of radiosurgery.

Cytokines

Cytokines are proteins in the body that activate the immune system. Interferon and interleukin-2 (IL-2) are man-made versions of cytokines that are sometimes used to treat patients with advanced-stage melanoma. Interferon is injected intravenously or under the skin and can slow the growth of melanoma cells. It may be offered in addition to surgery for patients with melanoma that has spread to regional lymph nodes (Stage III disease) in order to help prevent further spread of the disease and help prolong survival.

Drugs that target melanomas carrying C-KIT gene mutations

Mast/stem cell growth factor receptor (SCFR) is a protein in humans that is encoded by the KIT gene. Active mutations in this gene are associated with a small percentage of melanomas. C-KIT mutations also help the melanoma cells to grow and divide more quickly. The mutations are commonly found in melanomas that originate on the palms of the hands, the soles of the feet, or underneath the fingernails (called acral melanomas); inside the mouth or other mucosal (wet) areas; and on parts of the body chronically exposed to the sun.

IMRT

Intensity-Modulated Radiation Therapy (IMRT) is a type of external beam radiation therapy that delivers beams of radiation customized to the shape and size of the tumor. Unlike 3D-CRT, which delivers the same amount of radiation to both the tumor and the surrounding tissue, the intensity of the beams can be adjusted (modulated) for IMRT, enabling the radiation oncologist to deliver different amounts of radiation to different areas of the tumor and the surrounding tissue. This allows the radiation oncologist to deliver the maximum amount of radiation to the tumor while sparing the surrounding healthy tissue.

Immunotherapy

For patients with advanced-stage melanoma, immunotherapy may improve the body’s natural immune response to cancer. Immunotherapy recruits the body’s own immune system and uses it to fight cancer all over the body, making it difficult for cancer cells to hide or develop defenses against it. Immunotherapy has the potential to keep working even after the patient has completed treatment.

Isolated Limb Perfusion

In rare cases, melanoma may spread as multiple deposits to the skin that are local to the original melanoma. Isolated limb perfusion is a localized form of chemotherapy used for treating these multiple metastatic melanomas that have spread to the skin on one arm or one leg. The treatment allows high doses of the chemo drug to be administered to the cancer site without endangering the rest of the body. It separates the blood flow of the limb with cancer from the rest of the body for a short period of time. During this period, high doses of the chemo drug are given into the limb.

Lymph Node Dissection

If the physician performs a sentinel lymph node biopsy, and cancer is found in the sentinel nodes, it is likely a lymph node dissection will be advised to remove the other lymph nodes in the area.

Melanoma Surgery

The most common treatment for melanoma is a surgical procedure called a wide local excision. During this procedure the melanoma is completely removed together with a margin of the surrounding healthy skin. How much healthy skin is removed depends on the depth of the growth. The margin is examined under a microscope for any remaining cancer cells. If no cancer cells are found, no further surgery is necessary. Many times, a wide local excision can cure early-stage melanoma.

Mohs Surgery

Mohs surgery removes less healthy tissue than excisional skin surgery. The Mohs surgeon cleans and numbs the area of skin to be operated on. Then he or she removes the visible portion of the tumor and a very small margin of healthy skin. The Mohs surgeon examines the tissue under a microscope for cancer cells. If part of the tumor is still present, the Mohs surgeon carefully maps out the area where the tumor remains and only removes additional skin in the area where the margin shows the tumor. The process is repeated until the tumor is completely removed. This type of surgery is typically reserved for melanomas on the face where it is beneficial to conserve as much healthy skin as possible during surgery.

Radiation Therapy

Radiation uses special equipment to deliver high-energy particles, such as x-rays, gamma rays, electron beams or protons, to kill or damage cancer cells. Radiation (also called radiotherapy, irradiation, or x-ray therapy) can be delivered internally through seed implantation or externally using linear accelerators (called external beam radiotherapy, or EBRT).

Reconstructive Surgery for Melanoma

If the surgeon is required to remove a large piece of skin in order to remove the melanoma in its entirety, a reconstructive surgical procedure may be required to close up the skin. This may involve removing skin from another part of the body, such as the upper thigh, to cover the site where the skin cancer was removed. This is called a skin graft. Alternatively, the surgeon may rotate a portion of skin from a neighboring area to cover the site. This is called a skin flap.

Targeted Therapy

Targeted therapy is a type of cancer treatment that uses drugs or other substances to precisely identify and attack cancer cells. Usually, targeted therapy does less damage to normal cells than other cancer treatments.

Departments and Programs Who Treat This Condition

department

Thoracic Surgery

The multidisciplinary team in the Division of Thoracic Surgery provides exceptional care and support for patients with diseases of the lung, chest, or esophagus, from diagnosis to…