Diagnosis & Treatment


If your dermatologist thinks a spot may be melanoma or another type of advanced skin cancer, he or she will take a sample of the skin – a skin biopsy.

Skin biopsies are quick, safe and easy for dermatologists to perform, and can be done in a number of ways. Your physician will determine the best method based on the size and location of the area in question, and use a local anesthesia.

Types of biopsy include:

  • Shave biopsy
  • Punch biopsy
  • Incisional and excisional biopsies

These initial pathologies should be reviewed by specialty trained dermatopathologists, available through Hoag’s Melanoma/Advanced Skin Cancer Program.

In some cases, a biopsy in an area other than the skin may be needed. In these circumstances, a physician may utilize:

  • Fine needle aspiration biopsy
  • Surgical lymph node biopsy
  • Sentinel lymph node biopsy

Genetic Testing

Approximately 5-10% of melanoma is found clustered in families, due either to genetics, environmental factors or both. Features of hereditary melanoma include multiple individuals on the same side of the family with melanoma, people with more than one melanoma and younger age at diagnosis (under age 40-50). Genetic counseling and testing are available for interested individuals. Learn more about our Hoag Hereditary Cancer Program.

Treatment Options

Once melanoma or an advanced skin cancer is diagnosed, the Melanoma/Advanced Skin Cancer Team will discuss treatment approaches with you. Each physician specialist will help mold your treatment plan, to ensure the most successful approach, offering their extensive experience in the treatment of melanoma or advanced skin cancers.

Melanoma or advanced skin cancer is traditionally treated with surgery. Early melanomas or advanced skin cancers can sometimes be treated with surgery alone, however, if the cancer is more advanced you may be treated with multiple modalities. These complex treatment decisions are made collectively as a team through Hoag’s Melanoma/Advanced Skin Cancer Program multidisciplinary case conference, where patient’s cases are reviewed and treatment plans are discussed.

Treatment approaches for melanoma/advanced skin cancer include:

  • Surgery
  • Immunotherapy
  • Chemotherapy
  • Radiation therapy

Second Opinion Consultations

Melanoma and other advanced skin cancers should be handled by experienced, subspecialists who understand the complexity of the cancer and how to best treat it. For patients unsure about their current treatment pathway, Hoag’s Melanoma/Advanced Skin Cancer Program offers second opinion consultations.

To contact Hoag’s Melanoma/Advanced Skin Cancer Program, please call 877-494-3484.​