Florida’s year-round sun exposure contributes to one of the highest rates of skin cancer, particularly melanoma, in the country. Today, physicians are seeing more complex cases, including patients with advanced disease or multiple risk factors. As treatment options continue to grow, deciding when to operate, when to start chemotherapy or immunotherapy, and how to sequence treatment has become equally complex. Skin cancer treatment is no longer routine; it is evolving toward a more integrated, multidisciplinary model that is reshaping how and when specialists collaborate.
Skin cancer treatment is no longer a simple progression from diagnosis to surgery to recovery. Today’s treatment pathways often require early decisions about surgical approach, lymph node evaluation and the timing of systemic therapies, such as immunotherapy. In some cases, systemic therapy may be initiated before surgery, further underscoring the importance of early coordination. For more advanced or high-risk presentations, delayed alignment between specialties can limit treatment options and affect outcomes.
Leading care models now prioritize multispecialty evaluation from the outset. At TGH Cancer Institute | Cancer Center of South Florida (CCSF), surgical and medical oncology work in close alignment early in the care process, helping to ensure coordinated, timely and appropriate treatment strategies for each patient’s clinical presentation.
The recent addition of surgical oncologist Dr. Kimmerle “KC” Cohen and medical oncologist Dr. Sanjay Awasthi strengthens this collaborative approach. Dr. Cohen has extensive experience in complex skin cancer surgery, including sentinel lymph node biopsy, management of advanced and high-risk lesions, and multiple reconstructive options. Her role is central to determining if surgery is appropriate, how extensive it should be and when it should occur within the overall treatment plan.
Dr. Awasthi specializes in melanoma and systemic therapies, including immunotherapy and targeted treatments. His expertise helps guide whether these therapies should be used before or after surgery, or solely on their own without surgery.
Together, their coordination, supported by additional TGH Cancer Institute | CCSF team members, enables more precise sequencing of care and earlier alignment on treatment strategy, particularly for patients whose disease may not follow a straightforward path.
“The timing of surgery relative to systemic therapy can significantly influence outcomes,” said Dr. Awasthi. “Aligning these decisions earlier allows us to tailor treatment more effectively for each patient.”
TGH Cancer Institute | CCSF’s multispecialty model streamlines complex decision-making and reduces fragmentation in care. Through regular tumor boards, specialists review cases collaboratively, often early in the diagnostic process and before making definitive treatment decisions. Defined care pathways and direct communication between providers help minimize delays, reduce unnecessary duplication and improve continuity across phases of treatment.
Referring physicians remain connected throughout the process, with timely updates and clear points of contact. This level of communication can be especially important in complex cases where treatment plans evolve. Shared access through the electronic medical record (EMR) system, Epic, further supports coordination, particularly for providers already within the system, helping ensure continuity both during and after specialty care.
When to Refer for Multidisciplinary Evaluation
Early referral can help expand treatment options and improve coordination, particularly in the following scenarios:
- Suspected or confirmed melanoma
- Large, deep or rapidly evolving lesions
- Recurrent disease
- Evidence of lymph node involvement
- Cases where systemic therapy may be indicated
- Situations where the treatment approach is unclear
Early engagement allows surgical and medical oncology to align on treatment strategy from the outset, supporting more efficient, coordinated and effective care.
As demand for complex skin cancer care continues to grow in South Florida, TGH Cancer Institute | CCSF is expanding its capacity to meet this need. The addition of Drs. Cohen and Awasthi enhances both surgical and systemic expertise, reinforcing a coordinated approach to melanoma and other high-risk skin cancers.
Backed by academic medicine and nationally recognized for cancer care, Tampa General Hospital provides referring physicians with access to integrated, multispecialty expertise — an approach that can be particularly valuable in the management of complex skin cancers.
For more information about the referral process at TGH Cancer Institute | CCSF, please call (561) 253-3980.