The Melanoma Team is led by James Grichnik, M.D., Ph.D. The clinic focuses on early detection through the use of dermoscopy and confocal microscopy.
Cases are presented at one of our five monthly tumor board conferences. The tumor board conferences are conducted by our physician-based teams at Scully-Welsh Cancer Center. A tumor board is a meeting where complex patient cases are discussed in significant detail by a multidisciplinary team of doctors. The physicians concentrate on patients with difficult tumors or patients who have previously received treatment and, for various reasons, now need a different treatment plan. The doctor teams also review participation in a clinical trial as an option for each patient at the cancer center in Vero Beach. Doctors from each discipline are involved in this meeting and may include nearly a dozen or more cancer experts. Each patient’s diagnosis is introduced, and the group reviews the patient’s scans, biopsies, lab results, and other records with the goal of coming up with the best treatment plan. The team includes other medical oncologists, radiation oncologists, surgical oncology, radiology, interventional radiology, pathology, patient care navigator, nutritionist, and behavioral health specialist.
Mohs micrographic surgery is a method used to remove skin cancer. The procedure was developed by Frederic E. Mohs, M.D. in the 1930s and has since been refined.Lilia Correa-Selm, MD, is the cancer center’s dermatology surgical director and is fellowship trained in confocal microscopy and Mohs surgery.
The Mohs procedure is most often used to treat basal cell and squamous cell carcinomas – two of the most common forms of skin cancer. However, there is also utility for other more rare, aggressive, skin and soft tissue cancers. Mohs surgery is particularly helpful for:
- Skin cancers near vital functional or cosmetically important areas, such as eyelids, nose, ears, lips, forehead, scalp, fingers, or genital area.
- Skin cancer that is 2 cm (approximately 1 inch) or larger on any area other than the face.
- Skin cancer with borders that are not clearly defined.
- Skin cancers in which other treatments have failed (i.e., the cancer comes back after treatment).
- Skin cancer in areas where scar tissue already is present.
Since the Mohs surgical technique only removes diseased tissue in the specific area in which it resides, more of the surrounding normal tissue can be saved. Another advantage of the Mohs technique is that the microscopic examination and removal method reveals the skin cancer down to its roots, allowing for complete removal of the cancer.
Mohs micrographic surgery has the highest cure rate of all treatments for basal cell and squamous cell skin cancers. According to the American College of Mohs Surgery (ACMS), the cure rate exceeds 99 percent for new skin cancers and 95 percent for recurrent skin cancers.