NEBRASKA MELANOMA CENTER ®: Midwestern Values Nebraska Focused
Your Cutaneous Oncology Medical Home
Clinically integrated melanoma prevention, early diagnosis and care is finally here!
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Don't settle for less than "one-stop" comprehensive, clinically integrated skin cancer care!
When facing invasive melanoma, a fraction of a millimeter can make a world of difference!
'Tell me and I forget. Teach me and I remember. Involve me and I learn." Benjamin Franklin
The ABCDEF method (see photo above) may help detect melanoma: A (most early melanomas are asymmetrical); B (borders of melanomas are uneven); C (color; varied shades of brown, tan, or black are often the first sign of melanoma); and D (diameter; early melanomas tend to grow larger than common moles, greater than 6 mm in diameter), E (elevation or enlargement, areas of melanoma may be elevated above the level of the adjacent skin and appear as small nodules, itch, ulcerate, or bleed), F (funny looking skin lesion which is enlarging or changing shades of color).
Melanoma primarily affect the skin, but, like many neoplasms, both benign and malignant, melanoma may present itself in many guises such as in the eye (ocular and periocular melanoma), skin (cutaneous melanoma), internally (mucosal melanoma), hands or feet (acral melanoma), fingernail or toenail unit (subungual melanoma), etc. Skin cancer does not care where it occurs, but we do!
Skin cancer is the most common cancer in Nebraska. Because Nebraskans work outdoors in the farm and ranch businesses, sun exposure may be excessive, especially if protective measures are not taken. Over a lifetime, pre-neoplastic conditions (actinic keratoses, lentigo maligna) and cancers of the skin may occur in sun damaged parts of the body. NEBRASKA MELANOMA CENTER ®'s products and services "center" on our committment to patients by enabling primary healthcare providers to make better medical decisions to improve and save skin cancer "at risk" patient's lives. Certain cancers of the skin (melanoma, mycosis fungoides, Kaposi's sarcoma, Merkel cell carcinoma) can be clinically aggressive and may be life threatening. A very worrisome trend is the incidence of malignant melanoma increasing markedly across the United States, including Nebraska. Merkel cell carcinoma incidence is also increasing.
NEBRASKA MELANOMA CENTER® 's mission is to decrease the incidence of melanoma, increase life expectancy, reduce melanoma morbidity, decrease premature mortality (years of potential life lost and premature mortality rate) through its efforts to modify individual behavior: (1) sun protection to decrease UV light exposure (protective clothing and eyewear, time of day, sun blocks, duration of UV exposure, avoidance of tanning booths), (2) perform periodic skin self-surveillance and self-evaluations and (3) integrating preventive and interventional skin cancer care into the realm of primary healthcare providers. When you are a patient at NEBRASKA MELANOMA CENTER ®, you enter a clinically integrated health care network with access to primary and specialty care. Specialists include surgeons, radiation oncologists, medical oncologists and nurses who work together in an integrated, coordinated and cooperative manner to determine, then recommend specific personalized treatments for you. NEBRASKA MELANOMA CENTER ® only partners and collaborates with institutions and other caregivers who are "additive" to the quality and safety of your care.
NEBRASKA MELANOMA CENTER ®, a division of Pathology Services, P.C., is a multidisciplinary, clinically integrated melanoma and skin cancer (cutaneous oncology) center created to provide information, guidance and care to allow you to make your best choice of treatment at all stages of these complex diseases. A recent article validates the concept that comprehensive family physician-led care leads to cost savings. The conclusion of the study is: "Increasing family physician comprehensiveness of care, especially as measured by claims measures, is associated with decreasing Medicare costs and hospitalizations." (Annals of Family Medicine, May-June, 2015 pages 206-213). Your primary care doctor or healthcare provider is ALWAYS an integral part of your care with NEBRASKA MELANOMA CENTER ®.
We believe melanoma surveillance, prevention, early diagnosis and treatment should remain in the realm of primary care healthcare providers. If you do not have a primary healthcare caregiver, NEBRASKA MELANOMA CENTER ® will assist you to find a primary caregiver...not just for melanoma and skin cancer BUT all your healthcare needs. When you are a patient at NEBRASKA MELANOMA CENTER ®, you enter a clinically integrated health care network with access to primary and specialty care. Specialists include surgeons, radiation oncologists, medical oncologists and nurses who work together in an integrated and cooperative manner to determine, then recommend specific personalized treatments for you. Ongoing national research furthers our efforts to continually improve skin disease diagnosis and treatment for Nebraskans.
NEBRASKA MELANOMA CENTER ® currently has its home office and "place of service" in North Platte. However, to provide convenient access for Nebraskans to NEBRASKA MELANOMA CENTER ® services, it is the intention of NEBRASKA MELANOMA CENTER ® to offer "outreach" presence on-site or through NEBRASKA MELANOMA CENTER ®'s affiliation with TELANOMA ®, to many Nebraska communities in the Pathology Services, P.C. network. Skin cancer does not care where it occurs, but we do!
NEBRASKA MELANOMA CENTER ® clinics offering local services are planned for Scottsbluff, Kearney, Grand Island, Lincoln, and Omaha.
Visits are structured to utilize the most current evidence-based medicine to improve outcomes and to deliver high value melanoma care by consolidating services on one campus....park your car only once ("one-stop") to see our healthcare providers and consultants. We collaborate and care deeply about addressing fear, answering your questions, reducing anxiety and providing reassurance to patients and their families.
NEBRASKA MELANOMA CENTER ® Network: You can be a new team member, facility or healthcare provider!
Get access, get convenience, get high quality skin cancer care.
Stop once! Then, experience coordinated, high quality, patient-centered, multidisciplinary skin cancer care!!
Frequently Asked Questions
1. Where in Nebraska can I find NEBRASKA MELANOMA CENTER ® offices or services?
NEBRASKA MELANOMA CENTER ® currently has its home office and "place of service" in North Platte. However, to provide convenient access for Nebraskans to NEBRASKA MELANOMA CENTER ® services, NEBRASKA MELANOMA CENTER ® offers "outreach" presence on-site or through NEBRASKA MELANOMA CENTER ®'s affiliation with TELANOMA ®, to many Nebraska communities in the Pathology Services, P.C. network. Larger NEBRASKA MELANOMA CENTER ® clinics offering local services are planned for Scottsbluff, Kearney, Grand Island, Lincoln, and Omaha.
2. Does NEBRASKA MELANOMA CENTER ® work with, collaborate and coordinate my care with my current healthcare provider?
NEBRASKA MELANOMA CENTER ® is committed, always in collaboration with your primary care provider, to offering, coordinating and navigating you through comprehensive, multidisciplinary skin cancer care services including:
Prevention and Screening
Our healthcare providers educate patients and family members about the prevention and early detection of melanoma. They examine the skin for any suspicious lesions: atypical moles, pre-cancers, etc. Patients who have non-neoplastic skin conditions are referred back to the patient's primary care providers for evaluation, treatment, if needed, and followup.
Cancer Risk Analysis
Counseling helps you learn about your risk or your family's risk of cancer. Genetic counseling and molecular diagnostic testing is available for patients at higher-than-normal risk for skin cancers.
Dermatoscopy: Dermatoscopy is a "visual biopsy" of a skin lesion using polarized and non-polarized light and a magnifying lens. Worrisome lesions can be identified and biopsies or excisions can be performed to detect skin cancer early.
Histopathologic Diagnosis and Review
Diagnose melanomas and other skin tumors as well as provide professional second opinions. Melanoma invasion into the underlying dermis is measured in millimeters. Greater depth of invasion, as measured in millimeters, is associated with poorer prognosis. When facing melanoma, a fraction of a millimeter of invastion can truly make a world of difference in life expectancy and survival. Diagnostic biopsy, removal of moles or melanomas, and re-excision of biopsy proven melanomas are services we and our partners offer. If necessary, plastic surgeons will be part of your skin cancer care team.
Early detection of regional disease
Surgeons who take part in this program perform sentinel lymph node biopsies, pioneered by Donald Morton, M.D., to detect microscopic amounts of tumor that may have spread to lymph nodes. The sentinel lymph node biopsy technique, when indicated, is a procedure that is an integral part of the pathologic staging and treatment of melanoma as well as other cancers, such as invasive carcinoma of the breast.
Multimodality and Adjuvant Treatment of Regional Disease
Surgeons and oncologists treat patients who have melanoma already in the lymph nodes by surgery, targeted therapy, immunotherapy and radiation therapy. These specialists are part of the team at NEBRASKA MELANOMA CENTER ®
Treatment of Recurrent and Metastatic Disease
Medical and radiation oncologists treat disease with conventional and experimental regimens of targeted chemotherapy, radiation, or immunotherapy for widespread disease.
Remote Second Opinion (ROS) services: Healthcare providers around the world can access NEBRASKA MELANOMA CENTER ®, Pathology Services, P.C. and our partners through our affiliate internet service: TELANOMA ®. Second opinions on all aspects of skin cancer diagnosis and care can be obtained through our growing network of skin cancer care specialists.
Numerous barriers exist for cancer patients on their journey to understand their disease, its short-term and long-term implications, obtain support, etc. These barriers include: financial barriers, communication and information barriers, medical system barriers, geographic travel barriers, and emotional barriers such as depression or fear leading to procrastination of care or delay in diagnosis. MELANOMA NAVIGATOR ® is licensed physician directed navigation "guiding" services to patients who have melanoma, their families or caregivers.
Patient advisory council
Patients, through an advisory council, help NEBRASKA MELANOMA CENTER ® attain two primary goals: best patient experience and best patient outcomes. Helpful comments and ideas from patients and their caregivers are always considered and appreciated.
Patient survivorship planning
The NEBRASKA MELANOMA CENTER ® supports the Institute of Medicine, National Coalition for Cancer Survivorship, and the NCI Office of Cancer Survivorship in the idea that “an individual is considered a cancer survivor from the time of cancer diagnosis through the balance of his or her life." A physician team member or advanced practice partner will be responsible for creating and discussing a survivorship care plan with the patient and individuals authorized by the patient.
This interdisciplinary team of NEBRASKA MELANOMA CENTER ® provides expertise in treating the pain, stress, and depression of serious and life-threatening skin cancers. The goals of care are to assure comfort, dignity and quality of life, while helping the patient remain as active as possible.
The food that you eat can play a major role in your cancer treatment. As you receive your specific therapy, it is possible that you will encounter side effects that may alter your normal eating habits. A dietitian can help you choose food that will nourish you and keep you strong before, during and after treatment.
Exercise has been shown to improve the quality of life in cancer survivors as well as help the human body fight the cancer. Treatment of skin cancer is stressful to the human body. Being in the best mental, emotional and physical condition helps in the treatment of your skin cancer.
Social workers are licensed mental health professionals who provide support for the many issues that may affect patients and their families during cancer diagnosis, treatment and recovery. They accomplish this support through a unique combination of counseling and direct connection with a network of hospital and community resources.
Chaplains have specialized skills in assisting you and your family to draw on your particular spiritual resources for healing. Services are available to persons of all faiths and to those who have no religious affiliation through our affiliate network.
3. How do I become a patient of NEBRASKA MELANOMA CENTER ®?
NEBRASKA MELANOMA CENTER ® prefers to work through your local healthcare provider to coordinate your skin cancer prevention, early detection and treatment. But NEBRASKA MELANOMA CENTER ® is realistic in acknowledging that many people do not have a primary healthcare provider. In these difficult situations, NEBRASKA MELANOMA CENTER ® will, through "best efforts", try to help people find a healthcare provider.
If a primary healthcare provider can not be found, then NEBRASKA MELANOMA CENTER ® will accept patients directly without a need for a healthcare provider referral to NEBRASKA MELANOMA CENTER ®. Please email NEBRASKA MELANOMA CENTER ® or call 308-532-4700. Patients will receive NEBRASKA MELANOMA CENTER ®'s prompt attention.
4. How do I pay for NEBRASKA MELANOMA CENTER ® services?
You are primarily responsible for all charges and your bill at NEBRASKA MELANOMA CENTER ®. If NEBRASKA MELANOMA CENTER ® has elected to contract with a patient's insurance plan and the plan has a co-payment, coinsurance or deductible, then NEBRASKA MELANOMA CENTER ® will collect these monies from you at the time of service.
NEBRASKA MELANOMA CENTER ® is a public-private effort in healthcare services related to educating Nebraskans about proper skin care as well as the prevention, diagnosis and treatment of skin conditions, especially benign skin growths and skin cancers. Ongoing national research furthers our efforts to continually improve skin disease diagnosis and treatment for Nebraskans.
NEBRASKA MELANOMA CENTER ® has a growing network of talented licensed healthcare professionals who deliver coordinated, high quality, cost effective skin cancer diagnosis and treatment across the State of Nebraska as well as healthy skin and skin cancer prevention programs. These professionals include primary healthcare providers, dermatopathologists, pathologists, surgeons, medical oncologists, and radiation therapists, pharmacists, and others. Primary healthcare providers are the first line of defense against skin cancer, esp. in Nebraska. Early detection of melanoma by primary healthcare providers saves lives!
If your primary healthcare provider or surgeon performs a skin biopsy, the skin biopsy specimen may be sent to NEBRASKA MELANOMA CENTER ® and its affiliate, Pathology Services, P.C. for processing, evaluation, diagnosis, and inclusion in its database. Having your skin biopsy specimen(s) sent to Pathology Services, PC. is not required to avail yourself of the resources of NEBRASKA MELANOMA CENTER ® .
If your primary healthcare provider sends your skin biopsy specimen elsewhere, NEBRASKA MELANOMA CENTER ® would appreciate a copy of your pathology report to include its diagnosis in its Nebraska cancer registry and for our medical records should you choose to use our services for additional evaluation and followup.
Nebraskans may contact Healthy Nebraska, Inc. to request additional information about skin care and skin diseases as well as obtain an appointment for skin cancer screening by licensed healthcare professionals in our NEBRASKA MELANOMA CENTER ® network in Nebraska.
Byron L. Barksdale,
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