Melanoma Center

The Melanoma Center at St. Luke's

Members of Our Team

Sanjiv Agarwala, MD 
St. Luke's Cancer Care Associates

Darius Desai, MD 
St. Luke's Cancer Care Associates

Roderick Quiros, MD 
St. Luke's Cancer Care Associates

 

What is It?

More than one million people are diagnosed with skin cancer each year. While melanoma accounts for less than five percent of all skin cancers, it is the most deadly of them. Melanoma occurs in the cells that color the skin. It may appear as a new growth or as a change in the size, shape or color of an existing mole.

Melanoma is the leading cause of skin cancer-related deaths, because it may spread to other areas of the body through the lymph or blood systems. Sixty to seventy percent of melanomas are discovered by the people who have them, so it is important to check the skin for moles that change in shape, size, color, or begin to itch or bleed. When discovered early, melanoma may be treated effectively with surgical removal.

Causes/Symptoms/Risks

The incidence of melanoma is rising in the United States. Melanoma usually is linked to sun exposure. With treatment, 95 percent of early malignant melanoma is curable.

Melanoma often starts as a small, mole-like growth. If you think a mole might be a melanoma, test its ABCDs.

  • Asymmetry – One half does not match the other half.
  • Border – the edges are irregular, ragged, notched or blurred.
  • Color – the color is not the same all over, but may have differing shades of brown or black, sometimes with patches of red, white or blue.
  • Diameter – the area is larger tan a pencil eraser (or is growing larger).

Risk factors also include being an adult, having a family history, being fair skinned or having sun sensitivity, and having a suppressed immune system.

Preventable Risk Factors

  • 90 percent of skin cancers are associated with ultraviolet (UV) radiation from the sun.
  • Exposure to UV-emitting indoor tanning beds can increase risk of skin cancer.

Prevention

Protecting ourselves for the sun's rays can prevent about 80 percent of skin cancers.

Skin cancer prevention guidelines include:

  • Limit sun exposure between the hours of 10 am and 4 pm when the sun's rays are the strongest.
  • Cover up when in the sun; wear long-sleeved shirts, long pants and a hat that shades your face, neck and ears.
  • Use sunscreen that protects against UVA and UVB rays and has a Sun Protection Factor (SPF) of 30 or higher.
  • Do not use sunlamps or tanning booths. They are as harmful to your skin as the sun.

Tests/Procedures/Treatments

The number of surgical, radiation and medical treatments for melanoma has greatly increased over the past 10 years. Treatment options include:

 

The Latest Diagnosis and Treatments at the St. Luke's Melanoma Center

Immunotherapy, or biological therapy – involves advanced cancer-fighting treatments in the form of vaccines and natural materials made by the body’s own immune system. These therapies work to fight cancer by boosting, directing or restoring the body’s natural defenses against the tumor. Immunotherapy has been helpful in treating melanoma patients at high risk of recurrence, even those with advanced disease. 

Interferon – is a natural protein made by the body’s immune system. Interferon stops the growth of viruses and cancer cells. Interferon has been shown to significantly prolong the life of high-risk melanoma patients.

Ipilimumab (ip-ee-LIM-uh-mab) - The Food and Drug Administration recently cleared the use of this breakthrough drug, the first skin cancer drug to extend life in patients with advanced melanoma. Ipilimumab is a fully human antibody designed to block the activity of CTLA-4 (cytotoxic T lymphocyte-associated antigen 4), sustaining an active immune response in its attack on cancer cells. St. Luke's became the first hospital in the region to offer ipilimumab to patients prior to FDA-approval as part of an extended access clinical research program.

High-dose Interleukin-2 (IL-2) – is a natural protein that stimulates the growth of cancer-fighting white blood cells. IL-2 has proven effective in prolonging life for melanoma patients with advanced disease. IL-2 is effective when used alone or after standard chemotherapy has failed. St. Luke's Melanoma Center is the only center in eastern Pennsylvania to offer IL-2 as a treatment for melanoma.

Sentinel lymph node biopsy (SNLB)  – Nuclear medicine and surgical procedure involves injecting dye around a tumor to identify a single lymph node at risk for the spread of cancer. Sentinel lymph node biopsy dramatically increases the accuracy of determining whether a tumor has spread.  SLNB reduces the need for major lymph node removal surgery by 70 percent for melanoma patients.

Radiation therapy  – St. Luke’s offers the most advanced radiation therapy program in our region and serves as a Varian Medical Systems show site. Radiation therapy may be used to help control melanoma if it has spread or recurred.

Promising new treatments and clinical trials When it is unlikely that standard treatments for melanoma will benefit patients, they are offered promising new treatments through clinical trials. More than 70 clinical trials currently are under way at St. Luke's Cancer Center. Several of the clinical trials offered specifically are for melanoma.

St. Luke's participates in national and regional trials for the diagnosis and treatment of melanoma, including Allovectin-7® for advanced melanoma; the AGENDA trial, a unique targeted therapy which compares DTIC to DTIC plus genasense; and ECOG Trial E 1697 which tests interferon as adjuvant therapy. St. Luke’s is at the forefront of research for melanoma and has expertise in the evaluation and administration of new and experimental therapies. Dr. Agarwala serves as investigator for these trials.

Support services – Our team works to coordinate the full range of services, including initial oncology consultations, immunotherapy treatment, surgery services, follow-up care, social services and counseling, nutritional counseling, symptom management, home health care, patient and family education and access to other necessary care.

Why Choose St. Luke's

The Melanoma Center at St. Luke's is a regional center of excellence and provides comprehensive care for patients with all stages of this disease. St. Luke's team is guided by internationally-recognized melanoma expert Dr. Sanjiv Agarwala and board-certified specialists who provide the latest diagnostic and therapeutic care for patients with all stages of this disease.