Measurement of the Partial Pressure of Oxygen in Cutaneous Tumors Using Electron Paramagnetic Resonance (EPR) Oximetry

All patients in this study will receive standard of care therapy for their cancer at the
discretion of their treating physician(s). All subjects will be assigned to one of the four
cohorts for which they qualify; there is no randomization and no stratification within the
cohorts.

Cohort 1 - Patients who will receive definitive surgery for a primary malignancy of the skin

Cohort 2 - Patients who will receive definitive radiation (+/- concurrent systemic therapy)
for a primary malignancy of the skin

Cohort 3 - Patients who will receive palliative radiation (+/- concurrent systemic therapy)
for any tumor involving the skin

Cohort 4 - Patients who will receive systemic therapy alone (without radiation) for any tumor
involving the skin

All patients enrolled in this study will undergo two initial measurements of their tumor
oxygen level. On the first day, a small metal disc (less than 1 cm in diameter) called a
SPOTChip will be placed on the surface of the tumor, and held in place using an adhesive. The
patient will then be positioned (lying down or sitting) between a set of two magnets that are
used to measure the oxygen level in the tumor. A small plastic oxygen detector will be placed
on the skin over the tumor. These devices will be used to take a measurement of the tumor's
oxygen level at baseline, then while breathing oxygen through a clear plastic facemask, and
then a final time after the oxygen facemask has been removed.

After the measurements are taken, a small amount (20-50 microliters) of India ink will be
injected into the tumor using a small (28-gauge) needle. The India ink will make a permanent,
dark blue/black colored mark on the tumor. The ink leaves a permanent tattoo in the spot
where it is injected, unless it is physically removed surgically.

The patient will return for another measurement, at least 2 days later. This measurement will
use the India ink that was previously injected (described above) and there will no longer be
a need to use the SPOTChip. For the India ink tumor oxygen measurement a small piece of wire
(called a loop resonator) will be placed over the tumor and held in place using medical honey
and saran wrap or tape. The Investigator will first take a measurement of the tumor's oxygen
level at baseline, then while breathing oxygen through a clear plastic facemask, and then the
mask will be taken the tumor's oxygen level will be measured as it returns to baseline.

Patients who have surgical excision of the tumor (cohort 1) will not have any further
measurements after this point.

Patients who are being treated with radiation therapy (cohorts 2 & 3), will come back for
weekly measurements of the tumor during treatment, followed by one additional measurement one
month after they have completed the course of radiation therapy.

Patients being treated with chemotherapy, immunotherapy, or other systemic therapies without
radiation (cohort 4), will come back for measurements every 3-4 weeks around the time of
their regular infusion, followed by one additional measurement one month after they complete
the course of systemic therapy.

Inclusion Criteria:

- Pathology-proven (histology or cytology) malignancy of any histology and site of
origin

- Visible tumor (primary or metastasis) involving the skin of at least 6 mm in diameter

- Negative serum or urine pregnancy test within 72 hours prior to registration for women
of childbearing potential

Exclusion Criteria:

- Implanted electric, magnetic or mechanically activated devices like a pacemaker,
defibrillator, nerve stimulator, cochlear implant or portable infusion pump. Also
individuals who have any non-MRI compatible implants

- Individuals who have a ferromagnetic foreign body located in their body

- Prior adverse reaction to a charcoal product (e.g., a local hypersensitive response
from a black tattoo or from ingestion of activated charcoal)

- Prior adverse reaction to gum Arabic, which is an ingredient in the India ink

- Prior allergic reaction to medical adhesives

- Psychiatric illness/social situations that would limit compliance with study
requirements

- Pregnant or lactating women. There is no known harm to the woman or her fetus from
participating; this is precautionary only