A skin cancer diagnosis can be extremely scary for anyone at any age. Thankfully, many cases of skin cancer can be treated with a treatment called Mohs surgery.
To confirm the diagnosis of a skin cancer, often a biopsy is done prior to the surgical treatment. All our patients are encouraged to request a full skin exam so we can examine your entire skin surface and evaluate any abnormal lesions.
First, it is essential to determine the type of cancer a patient has before taking action.
COMPARING MOHS MICROGRAPHIC SURGERY TO CONVENTIONAL TREATMENTS
For many years, treatment for skin cancer involved removing the lesion and enough tissue around and underneath it for the surgeon to feel reasonably confident that no cancerous cells remained. In many cases, that resulted in a wound substantially larger than the visible cancer.
Mohs micrographic surgery takes the guesswork out of skin cancer removal. This precise treatment requires specialized training and equipment, expertise, and patience. Dr. Reed first removes the visible cancer and a thin layer beneath it. The patient remains in the treatment room while the specimen is stained and cryo-frozen, then carefully examined. Under high-power magnification, Dr. Reed looks at the entire edge and undersurface, and maps any remaining cancer cells. The process is repeated, taking only a cell-deep layer at a time, until no cancerous tissue exists.
If Dr. Reed determines Mohs is the best option for you, an appointment will be scheduled. You will stay awake during the procedure. While discomfort is typically minimal, Dr. Reed will apply a local anesthetic as the area to be treated is cleaned and marked.
This surgical approach revolves around the concept of progressively removing cancer, layer by layer. The removed tissue is then examined under the microscope. If cancer cells are present, another layer of tissue is removed. If cells are not present, no more tissue is excised.
The removal of the visible cancer and a thin layer of surrounding tissue is called “Stage 1.” You will wait as the tissue is being examined. That tissue is cut into sections, and very thin slices are placed on slides and stained so cells are precisely identified and pinpointed. If cancer is found, additional tissue will be removed. This is known as “Stage 2.” The process is repeated as many times as necessary to locate and remove cancerous areas within the tissue sample.
BENEFITS OF MOHS SURGERY
Effectiveness – The cure rate for Mohs surgery is higher than 99 percent for new skin cancers, and 95 percent for those that have recurred.
Reduced scarring – Because the method is so exact, there is little destruction of healthy tissue adjacent to the skin cancer.
Convenience – Treatment is completed in a single surgical session, in one day.
Minimal post-surgical discomfort – Every case is different, but many patients need nothing stronger than over the counter analgesics for a day or two following surgery.
Shorter healing time – The smaller wound left by Mohs surgery heals more quickly.
While Mohs surgery requires much less repair than other techniques, Dr. Reed understands the on-going impact that scarring can have on a skin cancer patient. Gurmander Kohli MD assists him in Mohs procedures. As a plastic surgeon, her focus is on repairs and wound closure for the least amount of scarring possible.