Skin cancer is the most common tumor disease of all. There is a difference between white skin cancer (basal cell carcinoma, prickle cell carcinoma) and black skin cancer, known as melanoma, and other rare skin tumors. Next to a genetic disposition, mainly determined by the skin type, the exposure to UV radiation also plays a major role in the development of skin cancer.

White skin cancer

Caused by the cumulative UV exposure—the sum of lifelong light-induced skin damage—, white skin cancer mainly occurs in areas often exposed to light, for example, the face. This is the reason why this tumor mainly occurs in people of 60 years of age or older. The problem about white skin cancer is the so-called field cancerization, which means that multiple skin tumors can occur independently and next to each other, because the light damage has affected the whole area equally. White skin cancer should therefore be treated as soon as possible, as long as large-area measures like immune modulators or photodynamic therapy can take effect. Once invasive tumors have occurred, they have to be excised, which can result in a difficult operation if multiple skin tumors need to be removed. In patients with a healthy immune system, the risk of developing metastases is very low with under 1%. In patients with suppressed immune systems, for example, after an organ transplant, the risk is considerably higher.

Black skin cancer (melanoma)

A much more aggressive form of skin cancer, melanoma can spread into the lymphatic and blood circulation even in the early development. Melanoma can develop from an existing birthmark (nevus), but also from completely normal skin. The intermittently high UV exposure is responsible for the development of malignant melanoma (except for the lentigo maligna melanoma), which can be roughly estimated by the number of sunburns. This is the reason why melanomas often occur in the torso and extremities where they can be found in areas that are rarely exposed to the sun and therefore prone to sunburn, for example during vacations.

However, some melanomas also occur independently of UV exposure, for example on the mucosa inside the nose, in the eyes, or on hands and feet. In case of malignant melanoma, the general principle is: the earlier it is detected, the better the prognosis, because an operation may already result in the cure. If metastasis has already occurred, generally the use of  medication will be necessary, with immunotherapies, targeted therapies, or chemotherapies.

For many years, the Heidelberg Skin Tumor Center has been a recognized center in the area of dermatologic oncology. Its focus is the treatment of patients with malignant melanoma and tumors of the mucous membranes, as well as cancer patients with side effects occurring on the skin. In the past years, an interdisciplinary cooperation with the other medical fields has been established for the benefit of all patients under one roof at NCT Heidelberg, which is a unique cooperation effort on a national level. The spatial and institutional connections of hte NCT Heidelberg and its outpatient clinics to the German Cancer Research Center (DKFZ) ensure a quick transfer of newly developed diagnostic and therapeutic procedures into the clinical setting. These innovations are made accessible to the patients through clinical trials even before their possible approval.

The care for our patients is comprehensive: prevention, treatment of primary tumors, and, if necessary, care during the advanced stages of the disease, as well as aftercare. The Skin Tumor Center and its subordinated and cooperating institutions offer all modern procedures for cancer diagnostics and therapy, and supportive care.

Range of services

• Guideline-based aftercare, treatment, and counseling for all kinds of skin cancer
• Consultation session for skin lymphoma
• Consultation session for side effects of skin cancer therapies
• Consultation session for organ transplantees and chronically immunosuppressed patients
• Center for second opinions
• Interdisciplinary case discussion within a tumor board meeting (which means that important therapeutic decisions are made after an expert team has considered the case)
• Innovative local and systemic treatment methods
• New therapies within clinical trials

Examination methods/diagnostics NCT Heidelberg

• Reflected light microscopy (dermoscopy)
• Lymph node sonography
• Determination of tumor markers in the blood

In cooperation with the Heidelberg University Hospital Department of Radiology/Nuclear Medicine and the German Cancer Research Center:

• Abdomen sonography
• X-ray examinations
• Computed tomography (CT)
• Magnetic resonance imaging (MRI)
• PET-CT
• Skeletal scintigraphy

Therapeutic procedures NCT Heidelberg

• Outpatient and inpatient surgical removal of primary skin tumors including sentinel node biopsy
• Further surgical interventions (lymph node dissections or organ surgery) carried out by the specialist departments of Heidelberg University Hospital (Department of Otorhinolaryngology, Thoraxklinik, Department of Surgery)
• Chemotherapies
• Immunotherapies
• Targeted therapies (such as BRAF inhibitors)
• Radiation therapies carried out by the Heidelberg University Hospital Department of Radiation Oncology
• New therapies within clinical trials

Aftercare NCT Heidelberg

The aftercare serves to identify cancer recurrence and secondary malignant tumors. Depending on the tumor type, its parameters, and the stage of the disease, our patients are examined regularly (clinically and partly also with imaging procedures such as CT/MRI, sonography, or X-rays). Furthermore, our patients are informed about risks for cancer development and adequate prevention measures.