Associate Professor of Surgery (Plastic); Leader, Multidisciplinary Care, Melanoma Program
Melanoma and Skin Cancer
Meet Our Melanoma & Skin Cancer Faculty
- Dr. James Clune is an Assistant Professor of Surgery and Plastic and Reconstructive Surgery at the Yale School of Medicine. Dr. Clune specializes in the treatment of patients with melanoma, merkel cell carcinoma, sarcoma, and complex cutaneous malignancies. In addition to treating patients with cutaneous tumors he specializes in procedures for the treatment of tumors of the upper extremity, brachial plexus tumors, brachial plexus reconstruction and peripheral nerves. Research interests include targeted muscle reinnervation after tumor extirpation or amputation and isolated limb perfusion of the extremities for soft tissue tumors and understanding the tumor microenvironment of desmoplastic melanoma. Dr. Clune graduated from Wesleyan University and attained his medical degree from the George Washington University School of Medicine. He then completed a post-doctoral research fellowship at Children's Hospital Boston in craniofacial reconstruction. His specialty training in Plastic and Reconstructive surgery was completed at Yale with a special research focus in melanoma, followed by a fellowship in upper extremity surgery at the University of California and Shriners Hospital for Children Los Angeles with Dr. Neil Ford Jones where he focused on reconstruction of the upper extremity, soft tissue tumors of the extremities and peripheral nerve and brachial plexus reconstruction. After completion of fellowship in California additional training was completed in Madrid, Spain in adult and pediatric brachial plexus reconstruction at the Hospital Universitario La Paz with Dr. Aleksandar Lovic and reconstructive microsurgery in Santander, Spain with Dr. Francisco Pinal.
Overall, the treatment plan will depend on the type and stage of melanoma the patient has. Treatment might include: surgery, isolated limb perfusion and infusion, chemotherapy, radiation therapy, immunotherapy, or even experimental treatments.
We focus on the diagnostic and surgical aspects of the treatment plan as well as isolated Limb Perfusion and Infusion. The oncologist provides chemotherapy, radiation therapy, immunotherapy, and other ancillary care. If the patient has early-stage melanoma, they may need only surgery with no follow-up treatment.
Our faculty members offer the most current surgical procedures available to remove primary and metastatic melanoma from all parts of the body surface. Their goal is to treat melanoma while retaining the natural appearance of the affected area to the highest possible degree. Some melanomas on the skin of the head and neck can be removed with a technique called Mohs surgery. In Mohs surgery, the cancer is removed layer by layer to minimize the amount of healthy tissue that needs to be removed in order to reduce scarring or disfigurement.
In most cases where reconstruction is necessary, our faculty can perform all reconstructive surgery at the same time of the excision (removal) surgery.
Our faculty also removes cancerous lymph nodes and perform resection of the cervical, axillary, inguinal femoral, and iliac lymph node basins for metastatic melanoma. They use the most current surgical techniques, including minimally invasive (laparoscopic) surgery and robotic surgery. Robotic surgery allows for unmatched precision and requires significantly smaller incisions, which results in less pain, scarring, and recovery time for patients.
Isolated Limb Perfusion and Infusion
Patients with in transit metastases, an aggressive form of recurrent melanoma, of the arms and legs may find successful treatment with isolated limb perfusion and infusion. These patients have numerous melanoma nodules that often rapidly increase in size and quantity. Many patients with this form of melanoma can no longer undergo surgical removal of the nodules.
- Skin Cancer
At Yale Plastic and Reconstructive Surgery, our faculty and team of experienced professionals work in tandem with patients and their oncologists to create a customized treatment plan.
The surgical procedures to remove these tumors are performed by means of incisions along the natural skin creases to camouflage the healing scars. On occasion, the surgical wound may be large enough to require a skin graft, or a skin flap (skin and fatty tissue) from an adjacent area, to repair the surgical wound.
These operations are commonly performed by our faculty under local anesthesia or general anesthesia in the outpatient setting. Our faculty members offer the most current surgical procedures available to remove skin cancer from all parts of the body surface. Their goal is to treat skin cancer while retaining the natural appearance of the affected area to the highest possible degree.