Skin Cancer Surgery
Mohs Micrographic Surgery is a safe and effective treatment for skin cancer that thoroughly excises the tumor while only mildly disturbing surrounding tissue. It is the only skin cancer treatment available that targets only cancerous tissue through comprehensive microscopic examination of the affected area.
Designed by Frederic E. Mohs, M.D., in the 1930s, Mohs Surgery excises not only the visible tumor but also any "roots" that may have extended beneath the surface of the skin. Five-year cure rates have been demonstrated up to 99 percent for first-treatment cancers and 95 percent for recurring cancers.
This procedure is most commonly used for the treatment of basal and squamous cell carcinomas, the two most common types of skin cancer, although it can also be used to treat melanoma and other types of cancer. Mohs surgery is often recommended for recurring cancer because its results are so thorough. It is also ideal for treating cancer in cosmetically and functionally prominent areas such as the nose, eyelids, lips, hairline, hands, feet and genitals.
Mohs Surgery Procedure
Mohs surgery is performed on an outpatient basis in your doctor's office. It may be performed by a team of highly trained specialists who each focus on different parts of treatment, or one experienced Mohs surgeon well-equipped to perform the entire procedure. During the Mohs surgery procedure, the affected area is numbed with a local anesthetic. Small layers of skin are removed and then the area is closely examined to see if the cancer has been thoroughly eradicated. This process significantly reduces damage to surrounding tissue while effectively removing all traces of cancer.
Most Mohs procedures can be performed in three or less stages, which usually takes less than four hours to perform. Some cases may take longer, as there is no way of predicting the extent of cancer growth before treatment begins. Patients should arrange for someone to take them home following surgery.
Recovery and Results from Mohs Surgery
After Mohs surgery, patients may experience mild discomfort, bruising and swelling around the treated area. Prescription pain medication is available for patients if needed, although most only require Tylenol for pain relief.
There will be scarring after Mohs surgery once the area is healed, although the scars from this procedure are often smaller than those from other excision procedures. For patients concerned with the appearance of their skin after treatment, reconstructive procedures are available to reduce or even eliminate the appearance of the scar using skin flaps, skin grafts, collagen injections and more. These procedures may be performed at the same time as Mohs surgery or at a later date. Your surgeon may also utilize certain techniques to reduce visual scarring, including placing stitching in the skin's natural crevices or out-of-sight areas.
Compared to other skin cancer treatments, Mohs Surgery has a very high success rate. Basal cell carcinomas have a 97-99 percent cure rate, while squamous cell carcinomas are cured 94 percent of the time.
Risks of Mohs Surgery
Although Mohs surgery is considered safe for most patients, there are certain risks involved with any type of surgical procedure. Some of these risks may include numbness, muscle weakness, tenderness, itching, pain and failure of skin grafts. These risks are considered rare and, if they do occur, are usually mild and temporary. Patients can reduce the risk of complications by choosing an experienced Mohs surgeon to perform their treatment, and by following the surgeon's instructions after the procedure.
Drs. Mehrel & Weissmann are certified fellows of the American Society of Mohs Micrographic Surgery and perform Mohs surgery.