With an abundance of sunlight and an aging population, it is no surprise that high-risk skin cancer and melanoma are increasingly common among residents of the Coachella Valley. In some cases these diseases may pose little risk of mortality, but significant risk of local invasion and deformity. In other cases, these represent diseases that can rapidly spread throughout the body. Modern management requires surgical skill at disease control, as well as suitable soft tissue reconstruction. It requires an appreciation of new therapies that can even cure some disease with distant spread. And like all serious problems, it requires a practice environment where physician and staff listen to patient concerns, and work to care for both their bodies and souls.