Pigmented Lesion and Melanoma Expertise
Cutaneous melanoma patients and individuals with atypical nevi (moles) are primarily managed in the Pigmented Lesion and Melanoma Clinic. This clinic was developed to follow patients at increased risk of melanoma based on mole pattern and family history as well as to provide initial evaluation and ongoing surveillance for patients with cutaneous (skin) and more advanced melanoma.
Patients with atypical mole syndrome are described as having over 50 to 100 moles with generally 5 or more showing clinical atypia (variation in color or irregular, asymmetric borders, and/or size greater than 8mm diameter). Affected individuals are estimated to have a 5-50-fold increased risk of melanoma depending on family history of melanoma.
Stanford is a participant in the National Cancer Institute/University of Arizona Phase I/II Cancer Chemoprevention Consortium, designed to prevent melanoma and other skin cancers in high-risk individuals at the outset.
Among the specialized treatments available to program patients are:
- State-of-art total body digital mole mapping for early detection of melanoma. A combined PET/CT scanner creates a fusion of diagnostic capabilities to deliver the most accurate and sensitive detection of melanoma possible.
- The sentinel lymph node biopsy (SLN) examines the regional lymph nodes for possible microscopic spread of melanoma. This advanced procedure sequentially combines preoperative lymphoscintigraphy and intraoperative mapping to provide a highly accurate means of identifying the sentinel lymph in malignant melanoma. Use of a novel gamma camera device to improve accurate SLN identification is underway through a collaboration between our melanoma surgeons and the Molecular Imaging Program at Stanford.
- Positron emission tomography (PET) is used to detect melanoma within the body as part of the staging work up. PET scanners do not use standard radiation, and reveal collections of melanoma cells in the body that may otherwise be clinically or radiologically undetectable. Stanford physicians were among the first in the nation to explore the use of PET for detection of metastatic disease in melanoma patients and routinely use the combined PET-computed tomography (CT) scanners for the most accurate staging and surveillance of patients with melanoma and other cancers.
- CyberKnife, a stereotactic radiosurgery technology developed by Stanford Neurosurgery almost 20 years ago is available for treatment of brain metastases.
- Immunotherapies, including ipilimumab and adjuvant high-dose interferon for metastatic melanoma patients
- Novel chemoprevention trials to prevent the development of skin cancer (both melanoma and nonmelanoma types) in high-risk individuals.