The Borstein Family Foundation Melanoma Program: A Center of Excellence

Through our multidisciplinary team approach, the Borstein Family Foundation Melanoma Program focuses on melanoma, skin and soft tissue tumors, combining state-of-the-art research with individualized and compassionate care that is well supported by clinical experts. Our goal is to restore wellness by applying innovative methods and best-practice models that demonstrate improved outcomes for patients. We are a comprehensive, multidisciplinary melanoma oncology provider with immediate access to scientific research programs.

Schedule An Appointment Saint John's: A Legacy of Care Excellence - 30 Major Healthcare Awards for 2022 and 2023 including Healthgrades' Surgical Care Excellence

Clinical Excellence and Improved Quality of Life

Our care team understands that each case is unique, while we treat every patient with dignity and compassion. We understand the challenges of coping with cancer and other life-changing decisions, and we are ready to guide you every step of the way. With an outcomes-based approach and our multi-disciplinary team, we work to develop the most optimal treatment plan for you based on your needs and the input of many of our oncologists, pathologists, and scientists. clinical excellence is our commitment to you.

Saint John’s Cancer Institute offers a comprehensive approach to melanoma treatment with extensive patient supportive services.

“I was able to talk to a melanoma surgeon and radiation oncologist the same day. Knowing my options made all the difference for me.” -J.R.

“Thank you Dr. Essner and Dr. Fischer. You put my mind at ease.” -J.G.

“Dr. Wollman is one of the best. My radiation treatment was exactly as he described and was really easy. The therapists are amazing.” -Rob

Our experience and research in melanoma are unmatched.

A History of Innovation and Collaboration

Cutaneous Research Team - Saint John's Cancer Institute — The Cutaneous Research Team at Saint John’s Cancer Institute works with our treating clinicals to promote care excellence.

With the support of the Borstein Family Foundation, our melanoma program has maintained clinical excellence for more than 40 years, pioneering melanoma treatment under the leadership of the late Dr. Donald J. Morton—renowned cancer surgeon and melanoma researcher. Now as The Borstein Family Foundation Melanoma Program, the legacy endures.

Clinical trials at Saint John’s Cancer institute are multi-national, involving dozens of academic and industry organizations that work together to develop solutions and therapeutics. With highly advanced translational laboratories on site, our researchers and scientists can quickly identify patterns of cancer recurrence at the genetic and molecular level, which gives our clinicians greater insight to develop the most optimal treatment plans. Additionally, our immunology program works to understand how cancer cells evade treatment, which helps to promote targeted therapies specific to the biology of the patient.

Your Multi-disciplinary Melanoma and Cutaneous Oncology Team

We are making a difference and we prove it every day.

Under the leadership of Dr. Kim Margolin, Medical Director of the Borstein Family Foundation Melanoma Program, Dr. Richard Essner, Co-Director, The Borstein Family Foundation Melanoma Program at Saint John’s Cancer Institute, and Maria L. Ascierto, Ph.D., Director or Translational Immunology, we welcome all your questions and concerns. As a multi-disciplinary team, we have successfully treated thousands of patients and look forward to providing you and your family additional information and support.

Richard Essner, M.D. FACS

Co-Director, The Borstein Family Foundation Melanoma Program at Saint John’s Cancer Institute

Dr. Kim Margolin - Medical Director of the SJCI Melanoma Program

Kim Margolin, M.D., FACP, FASCO

Medical Director of The Borstein Family Foundation Melanoma Program at Saint John’s Cancer Institute

Maria L. Ascierto, Ph.D.

Director of Translational Immunology

Ronnie M. Abraham, MD

Assistant Professor of Pathology

Trevan Fischer, M.D.

Assistant Professor of Surgical Oncology

Leland J. Foshag, M.D.

Professor of Surgical Oncology

Steven Kolker, MD

Assistant Professor of Pathology

David Krasne, MD

Professor of Pathology

Robert Wollman, MD

Assistant Professor of Radiation Oncology

Skin Conditions

The Borstein Family Foundation Melanoma Program at the Saint John’s Cancer Institute provides comprehensive and personalized treatment for patients diagnosed with invasive or non-invasive melanoma, carcinomas, and sarcomas. Our renowned doctors are supported by the most current knowledge of cancer genetics and world-class resources for cancer diagnostics and staging, which improves clinical outcomes. The conditions we treat include:

Basal Cell Carcinoma

Uncontrolled growths or lesions that arise in the skin’s basal cells. (See Basal Cell Carcinoma)

Open sores on the skin that will not heal
May appear as a red patch, pink growth, shiny bumps, or scars
Mostly appear in areas that are exposed to the sun
Can develop with tanning bed use
Recurrence of basal cell carcinoma is common

Merkel Cell Carcinoma

A rare and potentially aggressive form of skin cancer that arises in the cells on the outer layer of skin. (See Merkel Cell Carcinoma)

High cure rate when treated early
Can grow and spread rapidly
Growths are often flesh toned but vary in color and size
Cases appears more often in men
Increases among those with weakened immune systems

Melanoma Skin Cancer

A serious type of skin cancer that is becoming increasingly common. (See Melanoma Skin Cancer)

A biopsy is required to determine if cancerous
Caused by excessive exposure to the Sun and UV
Can be treated successfully with surgery if found early
Measured in stages which can escalate and spread to the lymphatic system and organs
Often presents with family history and having light colored skin

Soft Tissue Sarcoma

Rare tumors that arise from connective and supportive tissue of the body, including fat cells, muscle, nerves, bone, cartilage, vessels or fibrous structures. (See Soft Tissue Sarcoma)

Occurs in all parts of the body
Grows gradually as a painless mass
Generally found by touch vs. visual signs
Can be difficult to diagnose, requiring specialized techniques

Squamous Cell Carcinoma of the Skin

A common type of skin cancer that typically develops in areas of the body that are chronically exposed to the sun. (See Squamous Cell Carcinoma of the Skin)

Considered not as aggressive as melanoma
Can become disfiguring and sometimes deadly if allowed to grow
Occurs more often in men than women
Appear mostly after age 50 and significantly by age 70

Skin Treatment

Treatment Planning - Melanoma - Sentinel Node — Treatment Planning for Melanoma – Sentinel Node Imaging – Saint John’s Cancer Institute

Treating skin cancer may require one or more types of treatment, which are prescribed as appropriate to maximize curative effect and improve quality of life. For example, surgery may be followed by radiotherapy depending on the type and stage of the cancer. Additional treatment may include targeted therapy and immunotherapy (helps your immune system fight cancer).

Our goal is to determine the best possible care path for you based on the type and stage of skin condition you have, and your treatment preferences. We are here to support you every step of the way.

Chemotherapy

Medical treatment that addresses cancers that have or can spread to other areas (See Chemotherapy for Skin Cancer)

Chemotherapy is typically used for skin cancers that have metastasized
Reduces the speed of fast-growing cancer cells throughout the body
Encompasses systemic therapies, such as biologic, endocrine, and immunotherapy treatment
Can be utilized with other types of treatment

Completion Node Dissection

Removes all the Lymph Nodes in the region that the cancer drains into. (See Completion Node Dissection for Skin Cancer)

An operating room procedure that usually requires an overnight stay
A biopsy may be performed during the procedure
Side effect such as swelling, and sensitivity can be expected
A drain may be utilized temporarily after surgery to reduce fluid build up

Immunotherapy

Helps to fight cancers by helping the body defend itself (See Translational Cancer Immunology)

Immunotherapy is typically used for metastatic melanoma
Delivered medically throughout the body
Higher doses can be delivered directly to the tumor site (intra-tumoral immunotherapy)
Can help reduce the recurrence of cancer long after primary treatment
Can be utilized with other types of treatment

Radiation treatment for skin cancer — Radiation therapy can be delivered to a precisely targeted area – Saint John’s Cancer Institute

Radiotherapy

Focused beams of energy that disrupt tumor growth (See Radiation Oncology)

Used as an adjunct therapy for skin cancer after lymph node dissection or for cancer recurrence
Side-effects may include changes in skin color or gland functions when given near sensitive parts of the body
Used primarily for solid tumors and in difficult to reach areas
May require specialized imaging to determine the exact location of the tumor
Can be delivered via external beam or internally using specialized instruments
Can be utilized with other types of treatment

Sentinel Lymph Node Biopsy

A minimally invasive procedure involving injection of colored dye and radioisotope into the lymphatic system (See Sentinel Lymph Node Biopsy for Skin Cancer)

Pioneered by the late Dr. Donald Morton of Saint John’s Cancer Institute and used world-wide
Typically performed within one day
Helps to pinpoint which lymph nodes may be infected with cancer cells
Aims to reduce the extent of surgery and related complications
Involves pathologists who examine each lymph node for signs of cancer cells
Shown to improve patient survival

Surgery (Wide Local Excision)

Removal of the cancerous tissue as well as a small amount of normal tissues surrounding the lesion (See Surgery for Skin Cancer)

Performed after confirmation of cancer diagnosis
An outpatient procedure
Reduces cancer recurrence by removing cancer cells that may exist close the lesion
Recovery is expected within a few days

Targeted Therapy

Medical treatment that takes advantage of molecular changes within melanoma tumor cells (See Targeted Therapy for melanoma)

Used in late-stage disease such as sage IV and as an adjunct therapy for state III
Given in pill form and taken orally
Can be utilized with other types of treatment

The Melanoma and Cutaneous Oncology Team is ready to support you and your family. We welcome your questions and recommend coming in for an exam as soon as possible. We will discuss common conditions, treatment options, and offer additional details for each of our services based on your health, as well as other cancer support services.

Dr. Trevan Fischer examines a patient with melanoma skin cancer.

Speak to someone today and get answers to your specific questions.

Call 310-829-8317.

Our care team is available to answer your questions and can relay your question to one of our specialists and get back to you. Know that you are always well-supported and treated with compassion at the Saint John’s Cancer Institute and our health center.

Dr. Donald J. Morton - A Legacy of Melanoma Treatment Innovation

The late Donald J. Morton M.D., former melanoma program chief and co-director of the surgical oncology fellowship program – Saint John’s Cancer Institute

For a half-century, the late Donald L. Morton, M.D., who served as chief of the melanoma program and co-director of the surgical oncology fellowship program at the Saint John’s Cancer Institute (formerly the John Wayne Cancer Institute), developed renowned advancements in melanoma cancer research and treatment. Dr. Morton devised a procedure that has become the standard of care for melanoma and breast cancer around the world, referred to as sentinel node biopsy technique, while also pioneering the development of cancer vaccines. As an educator, he worked hard to mentor the next generation of surgical oncologists, training more than 135 fellows at the institute.

After graduating from UC Berkeley, he received his medical training at UC San Francisco Medical School. In 1960 he began his lifelong study of melanoma at the National Cancer Institute. The surgical oncologist was intrigued by reports of spontaneous recoveries from cancer, which suggested the body was mounting an immune response to fight off the malignancy. He felt that rallying the immune system using therapeutic vaccines could be a way of combating cancer. These keen powers of observation also led Dr. Morton to devise the sentinel node biopsy technique.

In the past, surgeons would remove all lymph nodes surrounding a cancerous tumor to see if a tumor had spread. Thanks to the innovations of Dr. Donald Morton, doctors now utilize his procedure, injecting a radioactive dye near the tumor to illuminate the drainage pathway of the tumor, thereby revealing the primary or sentinel drainage node. The identification of the primary node is now the focus of surgical removal, conserving the amount of surgery needed for effective treatment. Numerous clinical trials indicated that if the tumor was going to spread, it would have to go through that node.

Publications

Dr. Kim Margolin, Dr. Richard Essner, and Maria Ascierto, Ph.D. have published and co-authored hundreds of peer-reviewed publications. Select articles include:

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