WHAT IS MOHS SURGERY?

This type of skin cancer surgery is called Mohs surgery in honor of its’s creator, Fred Mohs, M.D.

Not all treatments for skin cancer are equal.  Some of the most common treatments for skin cancer preferred by many physicians are scraping and burning, freezing, radiation and routine excision.  While these remedies may be fine for many cancers, you should understand the advantages of Mohs Micrographic Surgery, a process that will remove all the cancer, minimize the risk of recurrence, and leave as little scarring as possible.

Mohs Micrographic Surgery is an advanced technique for treating skin cancer and is best performed by a highly trained and experienced surgeon.  You can be assured that members of the American College of Mohs Surgery have this training and experience.  This usually entails 1-2 years fellowship training after a dermatology residency.  Inquire whether or not a “Mohs surgeon” has completed a fellowship certified by The American College of Mohs surgery when choosing your doctor.

Mohs Micrographic Surgery is usually performed on an outpatient basis, in 2-3 hours, under local anesthesia.  The healing process is similar to that of most surgical procedures.  Of all treatments for skin cancer, Mohs Micrographic Surgery offers the highest cure rate (up to 99% for basal and squamous cell carcinoma) with minimal discomfort and the greatest preservation of normal tissue, thereby minimizing scarring.

THE MOHS SURGERY PROCESS

The roots of a skin cancer may extend beyond the visible portion of the tumor. If these roots are not removed the cancer will likely recur.

First, the visible portion of the tumor is surgically removed.

A thin layer of skin is removed around and under this and divided into sections.  The American College of Mohs Surgery surgeon then color codes each of these sections with dyes and makes reference marks on the skin to show the source of these sections.  A map of the surgical site is then drawn.

The undersurface and edges of each section are microscopically examined for evidence of remaining cancer.

If cancers cells are found under the microscope, the surgeon marks their location onto the “map” and returns to the patient to selectively remove another layer of skin-but only from precisely where the cancer cells remain.

The removal process stops when there is no longer any evidence of cancer remaining in the surgical site.  Because Mohs surgery removes only tissue containing cancer, it ensures that the maximum amount of healthy tissue is kept intact.

The reason for going to the trouble of doing Mohs surgery is the high cure rate (98-99%) and the fact that it preserves as much normal skin as possible.  This is often important for both cosmetic and functional reasons.