Dr. Spitler is the Director of the Northern California Melanoma Center (NCMC) located at St. Mary s Medical Center in San Francisco. The mission of the NCMC is to offer expert consultation and provide information to patients with melanoma, their families, and the medical community. The NCMC serves as a consulting center it is not a primary facility for the diagnosis of melanoma. Patients come to the center having already been diagnosed with melanoma. The NCMC has a particular emphasis in providing not only information on the best standard therapy available, but also offering innovative therapies to patients through clinical trials. We continually seek the most promising clinical trials for patients with melanoma and make them available here. The strength of the NCMC lies in the Consulting Panel of physicians who meet weekly to discuss each new patient and combine their expertise in making recommendations for patient care. The Consulting Panel includes physicians from all specialty areas relevant to melanoma including Immunology (Dr. Lynn Spitler), Oncology (Dr. Robert Weber), Surgery (Drs. Robert Murray and Robert Allen), Radiation Oncology (Dr. Sarah Huang), Dermatology (Dr. Alice Do), and Integrative Medicine (Dr. Ruth Marlin), and also members of the Clinical Research Team. More than 5,000 patients have come to the NCMC for consultation regarding their melanoma. The patient s first consultation at the NCMC lasts most of the day. Its purpose is to provide the patient with information about melanoma and therapeutic options. In the morning the patient meets one of the Associate Directors who reviews the patient s medical history, all medical records, and performs a physical examination. This physician then presents the patient's case to the Consulting Panel. The Consulting Panel discusses the case and makes recommendations concerning any diagnostic measures needed, as well as the best therapeutic options. In the afternoon, Dr. Spitler meets with the patient and family and friends to inform them of the deliberations and recommendations of the Consulting Panel and answer any questions they may have. After the initial consultation, we encourage patients with melanoma to have regular follow up visits with the NCMC or with their oncologist. Should a problem arise, the patient's case will be discussed again by the melanoma Consulting Panel.