Skin cancer treatment
VCU Massey Cancer Center offers tremendous advantages and expertise in the care of skin cancers. Our medical team is composed of specialists from multiple fields who all have expertise in skin cancer and collaborate to develop the most effective treatment plan for each patient. Many of our doctors are also active scientists, participating in cutting-edge research in our labs and through collaborative clinical trials offered only at National Cancer Institute-designated cancer centers like Massey.
Combined with a compassionate and patient-centered approach to care, this expertise and access to cutting-edge clinical trials and treatment options is why Massey is your best choice for the treatment of melanoma and other skin cancers.
Leading-edge care for melanoma and other skin cancers
Massey features an award-winning medical team dedicated to caring for patients with all forms of skin cancers, including melanoma, basal cell carcinoma, squamous cell carcinoma, Merkel cell carcinoma and other rare skin cancers. We offer a level of expertise and experience only found at the top 4 percent of cancer centers across the country recognized as National Cancer Institute-designated Cancer Centers. Massey is the only center in the Richmond area, and the first of only two in Virginia, designated by the NCI to lead and shape America’s cancer research efforts.
Benefits of Massey’s care:
- Rapid, accurate diagnosis and evaluation
- Comprehensive and state-of-the-art therapies such as immunotherapies and targeted therapies
- Cutting-edge clinical trials testing new and promising treatments, such as melanoma vaccines, novel interventions and adoptive cell-transfer therapies
- Customized treatment plans recommended by a multidisciplinary team of specialists collaborating and coordinating all aspects and stages of care
- Advanced imaging, including 3T MRI, PET, CT and advanced interventional radiology procedures
- Genetic testing, counseling and surveillance of high-risk stage 1 and 2 melanomas
- Survivorship care following treatment for long-term side effects
- A dedicated nurse navigator to guide you through care transitions
- Physical and occupational therapy and palliative care (pain and symptom management)
- A variety of integrative health, supportive care and social work resources for you and your loved ones
- Respectful, attentive and compassionate care
Progress against skin cancers
Exciting advancements have been made in the treatment of skin cancers, especially melanoma. Massey doctors are on the forefront of these developments, and many new treatments were made available as clinical trials prior to becoming approved for commercial use by the FDA. Thanks to new precision drugs and immunotherapies, long-term survival is now possible for patients with advanced skin cancers.
Massey offers the full range of treatment options for skin cancers led by the region’s largest and most specialized team of experts. We partner with VCU Health Dermatology for rapid, accurate diagnosis and evaluation, seamless coordination of care and long-term surveillance and follow-up for high-risk patients with early-stage cancers. Through genetic counseling we can help determine who is at the greatest risk for cancer recurrence and partner with those patient’s referring providers for active surveillance and preventative treatment.
A dedicated nurse navigator guides each patient through their care, helping to coordinate appointments and ensure smooth transitions. We also have a variety of resources available, including social workers, rehabilitation experts, occupational therapists and other integrative health and supportive care resources for patients and their caregivers.
Treatments for skin cancers may include:
There are several different surgical procedures that may be used to treat various forms of skin cancer. Some may be performed by a dermatologist with advanced training and some may be performed by a surgical oncologist, depending on the cancer type and stage of the disease. Types of surgeries include:
- Simple excision: In this procedure, the tumor is removed from the skin along with some additional tissue to ensure complete removal.
- Mohs micrographic surgery: A dermatologist with specialized training removes the tumor from the skin in thin layers. Throughout the procedure, the tissue is examined under a microscope to check for cancer cells. While sparing as much healthy tissue as possible, layers continue to be removed until there is no evidence of cancer.
- Shave excision: Add explanation
- Curettage and electrodesiccation: This procedure, also known as electrosurgery, uses a sharp, spoon-shaped tool called a curette to remove the tumor from the skin. An electrode then sends an electric current to the area to stop the bleeding and destroy remaining cancer cells. The process may be repeated to remove all of the cancer.
- Cryosurgery: Cryosurgery, or cryotherapy, uses liquid nitrogen or another solution to freeze and destroy abnormal tissue.
- Dermabrasion: This removes the top layer of skin using a rotating wheel or abrasive particles to rub away tissue.
- Laser surgery: This uses a laser beam to make bloodless cuts in tissue or to remove a surface lesion.
Targeted therapies use drugs or other substances to attack specific weaknesses in the cancer cell, usually a genetic mutation or specific molecules involved with cancer growth. These therapies typically cause less harm to healthy cells than chemotherapy or radiation therapy.
Several new targeted therapies have been approved for melanoma and other skin cancers in recent years, and scientists are constantly searching for new molecular targets that may eventually lead to clinical trials testing promising new drugs and other treatments.
Immunotherapy refers to a treatment that helps the immune system identify and attack cancer cells. There are a few different types of immunotherapies:
- Checkpoint inhibitors have been revolutionary in the treatment of patients with advanced skin cancers. It is difficult for the immune system to distinguish cancer cells from normal cells, so these drugs target molecules on immune cells that enable them to recognize and attack cancer cells. PD-1 inhibitors, such as Keytruda or Opdivo, for example, block the expression of a protein known as PD-1, which acts as a switch or checkpoint that helps keep T-cells from attacking other cells. These drugs “take the brakes off” the immune system and allow it to attack cancer cells.
- Cellular therapies are a different type of immunotherapy that modifies a patient’s own immune cells in a laboratory to attack cancer. An example of this type of therapy uses immune cells known as tumor infiltrating lymphocytes (TIL), which are immune cells that have been able to penetrate the tumor. These cells are collected from the tumor when it is removed, millions of copies are grown in the lab and then are injected back into the patient to help prevent recurrence or attack other tumors that aren’t surgically treatable.
- Cytokines, such as interferon-alfa and interlukin-2 (IL-2), are proteins that give an overall boost to the immune system. These drugs can help shrink tumors and are sometimes used in combination with other treatments. .
- Viral therapies, or oncolytic virus therapies, use viruses that have been modified to primarily infect and kill cancer cells and to alert the immune system to attack the cancer.
- Imiquimod cream (Zyclara) is a topical cream that stimulates a local immune response against cancer cells. This therapy is only used for very early cancers.
In most cases, chemotherapy works by targeting rapidly dividing cells and interfering with their ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. Chemotherapy may be used alone for some types of cancer or in combination with other treatments such as radiation or surgery. Often, a combination of chemotherapy drugs may be used, and certain chemotherapy drugs may be given in a specific order depending on the type of cancer it is being used to treat.
Radiation therapy uses highly focused doses of radiation to kill cancer cells. Massey’s Radiation Oncology Department is home to nationally renowned radiation oncologists, medical physicists and dosimetrists, as well as the latest technology and practices, all coming together to offer the best available care. Massey has even pioneered new radiation therapy techniques and devices that have become standard of care nationally.
There are two types of radiation therapy:
- External beam radiation therapy uses state-of-the-art linear accelerators to deliver a highly focused beam of radiation to the tumor. Massey utilizes the latest in MRI imaging technologies to destroy as much cancer as possible while sparing healthy tissue.
- Internal radiation therapy, also known as brachytherapy, uses radioactive substances inserted into needles, wires or catheters to kill cancer cells from directly inside the tumor or nearby the tumor. This form of radiation therapy can offer advantages such as higher dose rates and sometimes shortened treatment plans.
Experts in skin cancer
Massey’s skin cancers team has specialty training and experience in the diagnosis and treatment of all types of skin cancer. Our specialists collaborate in a multidisciplinary approach, which offers the tremendous advantage of one-stop consultations and highly coordinated care. A dedicated nurse navigator guides patients and caregivers every step of the way.
Our doctors are also engaged in clinical research and teaching, which means they are always working to find new and better ways to treat cancer and to share this knowledge with other health care providers to improve the field.
- Jennifer Peyton
- Patti Bragg
- Anna Nizinski
- Cheryl Wood
Clinical trials are research studies that help the medical community discover new and better ways to prevent, diagnose, treat and cure diseases. At VCU Massey Cancer Center, you’ll have access to the most cutting-edge therapies and the latest treatment technologies. Many of these treatments are only available through clinical trials at NCI-designated cancer centers such as Massey.
For example, Massey surgical oncologist Giao Phan, M.D., is leading a clinical trial for advanced melanoma patients that uses immune cells harvested from inside of the tumor to help fight the disease. These cells are isolated in a lab, and then millions of copies are made and injected back into the patient to fight the cancer and prevent recurrence. Learn more about this trial on our blog.
Additionally, medical oncologist Andrew Poklepovic, M.D., is heading up a stage 2 clinical trial testing immunotherapy after surgery to prevent cancer recurrence in melanoma patients.Find a Clinical Trial
At VCU Massey Cancer Center, we believe that treating the whole person, not just the disease, is the best way to care for patients and family members coping with cancer. We take a holistic approach to address not just your medical and physical needs, but also your psychological, emotional and social needs. We offer comprehensive cancer support services to care for you throughout your cancer journey that range from helping minimize symptoms and side effects to helping evaluate and cope with the emotional and psychological effects of cancer. These services include:
• Integrative health resources, including acupressure, art therapy, music therapy, pet therapy and tobacco cessation counseling. Complementary therapies are not substitutes for medical care but are used together with medical treatments to help patients alleviate stress and anxiety, reduce pain, manage symptoms and promote a feeling of well-being.
• Financial assistance for qualifying patients in need
• Genetic counseling by board-certified genetic counselors in Richmond’s only Familial Cancer Clinic
• Legal assistance for qualifying patients in need
• Lodging for qualifying patients in need
• Patient education, including libraries and health programming geared to cancer patients and their caregivers
• Pharmacy services, including in-hospital oncology pharmacies
• Psychological counseling
• Rehabilitation by one of the nation’s longest-running cancer rehabilitation programs with physical, occupational and speech therapy especially geared for cancer patients
• Spiritual counseling
• Social work for patients in need
• Transportation assistance for qualifying patients in need – ask your social worker for more information
• Wig salons that provide free hats, scarves and wigs as well as private head-wear consultation services