Tina J. Hieken, M.D., surgical oncologist: Patients with melanoma of all stages, from early to late, can really benefit from care here at Mayo Clinic. Individualizing care is really important and really considering the whole patient, and that is something that we're really adept at.
Alexander Meves, M.D., M.B.A., dermatologist: We have a nice culture of innovation where people come together and they have this sort of win-win mentality and they want to really build something new for patients.
Dr. Hieken: We're really fortunate here to have this multidisciplinary, integrated clinical and research practice with access to the latest treatments, clinical trials that are testing what we know to be the best against what may actually be better and perhaps less toxic to patients, adopting ways of being more precise in our care for patients.
Jeffrey E. Johnson, M.D., surgical oncologist: When we meet patients, they get a full skin exam. We look at everything from head to toe and make sure we're not missing anything. That initial pathology is what really determines the first steps in treatment. After that, you meet with a surgeon and we talk about the options for surgery. And that's usually the first step in treatment for melanoma is surgery.
Dr. Hieken: Here we have surgeons who are really specialized and have a lot of expertise in doing melanoma surgery and doing it in a way that minimizes short-term complications and improves the cosmetic or aesthetic outcomes of surgery.
Dr. Meves: We recommend a procedure we call a wide local excision, which means we cut around the biopsy site, but we go a little deeper than usual. We take out all the fat tissue. We go down to the so-called fascia of the muscle. So we go deep. That's the minimum amount of surgery that we think people should get if they have a melanoma. Then the question is, do we need to do more than that? Do we need to take out lymphatic tissue, for example.
Dr. Hieken: We have adopted technical advances in the practice, such as minimally invasive techniques, vein-preserving techniques that we know really improve long-term outcomes, and other methods that we have for decreasing complications of surgery in the short term, with a real attention to technical advances in care.
Dr. Johnson: Intralesional therapy is a way to target specific lesions as they develop in the skin. It's a way to harness the body's immune system to attack those lesions. And so, we can often, for patients with advanced melanoma that's spreading through the skin or through the tissues right below the skin or through the lymph nodes, we can inject that with therapies that help the body attack the melanoma. And it not only attacks those lesions, but hopefully attacks other melanoma developing in the body.
A melanoma diagnosis is never the end of the road. We have such good options, whether it's early stage melanoma. There are really good medical options for even late stage melanoma that we haven't had until recent years. So for every single patient, there's hope.