Mohs Surgery

The Effectiveness of Mohs Surgery for Skin Cancer Treatment


Mohs surgery stands as the gold standard for treating the two most common types of skin cancer: squamous cell carcinoma and basal cell carcinoma. This highly specialized procedure is performed under local anesthesia and involves the precise, layer-by-layer removal of cancerous tissue. What sets Mohs surgery apart is its methodical approach; after each layer of tissue is removed, it is immediately examined under a microscope in real time. This meticulous process continues until only healthy, cancer-free tissue remains, ensuring that all cancerous cells have been effectively eradicated.


Why Mohs Surgery for Skin Cancer Treatment?


The effectiveness of Mohs surgery is unparalleled in the field of dermatologic oncology, with cure rates approaching 99 percent. This exceptional success is largely due to the procedure’s precision in targeting and removing all cancerous cells while preserving as much healthy tissue as possible. Unlike other treatments, which may rely on visual estimates of tumor margins, Mohs surgery provides a microscopic examination of the entire surgical margin, significantly reducing the likelihood of recurrence.

This high level of accuracy and thoroughness means that Mohs surgery not only offers the highest cure rates but also minimizes the need for additional treatments. Patients who undergo Mohs surgery benefit from the peace of mind that comes with knowing they have chosen a treatment with the best possible outcome for eradicating skin cancer.

What is Mohs Surgery?

Mohs surgery is an advanced treatment procedure for skin cancer, that offers the highest potential for cure – even if the skin cancer has been previously treated. This procedure is a state-of-the-art treatment in which the physician serves as surgeon, pathologist, and reconstructive surgeon. It relies on the accuracy of a microscope to trace and ensure the removal of skin cancer down to its roots.

This technique allows dermatologists, trained in Mohs surgery, to see beyond the visible disease, and to precisely identify and remove the entire tumor, leaving healthy tissue unharmed.

This procedure is most often used in treating three of the most common forms of skin cancer: melanoma, basal cell carcinoma and squamous cell carcinoma.
 

What are the Benefits of Mohs?

The cure rate for Mohs surgery is the highest of all treatments for skin cancer — up to 99 percent even if other forms of treatment have failed. This procedure, the most precise method of tumor removal, minimizes the chance of cancer regrowth and lessens the potential for scarring and disfigurement.

Mohs Surgery at The Skin Surgery

At Skin Surgery Center, our Mohs surgeons are board-certified and specialize exclusively in Mohs surgery and related dermatological procedures. This focused practice allows them to refine their skills and stay updated on the latest advancements in the field.

Our patient promise is dedicated to your care. Our Mohs surgeons undergo extensive training beyond medical school and residency to ensure you receive comprehensive skin cancer care.

Mohs Micrographic Surgery: Frequently Asked Questions

By using detailed mapping techniques and complete microscopic control, the Mohs surgeon can pinpoint areas involved with cancer that are otherwise invisible to the naked eye. Therefore, even the smallest microscopic roots of cancer can be removed. The result is:

  • The removal of as little normal skin as possible,
  • The highest possibility for curing the cancer.

No. Mohs surgery is performed in a pleasant outpatient surgical suite and you may return home the same day. Hospital facilities are available if necessary.

Yes. Any form of treatment will leave a scar. However, because Mohs surgery removes as little normal tissue as possible, scarring is minimized.

Usually one return visit is all that is needed to examine the healed surgical site or to remove your surgical dressings. Afterwards, you may return to your referring physician for routine check-ups. Lifetime annual check ups are considered essential. After having one skin cancer, statistics show that you have a higher chance of developing a second skin cancer.

The best protection from skin cancer is to avoid the harmful ultraviolet rays of the sun and wear sunscreen when you spend any time outside - or, in the sun. Even if you tan easily, the sun can contribute to skin cancer in two ways. First, the sunlight damages the genes that control cell growth, and second, sunlight damages the body’s immune system so that early cancers grow unchecked by normal immune defense.

From Our QualDerm Family of Providers: Mohs Surgery for Skin Cancer from Board-Certified Mohs Surgeon Dr. Paula Lapinski

What to Expect at Your During Your Mohs Procedure

The Mohs process includes a specific sequence of surgery and pathological investigation. Mohs surgeons examine the removed tissue for evidence of extended cancer roots. Once the visible tumor is removed, Mohs surgeons trace the paths of the tumor using a map of the excised tissue and a microscope.

Once the obvious tumor is removed, Mohs surgeons:
  • remove an additional, thin layer of tissue from the tumor site.
  • create a “map” or drawing of the removed tissue to be used as a guide to the precise location of any remaining cancer cells.
  • microscopically examine the removed tissue thoroughly to check for evidence of remaining cancer cells.
If any of the sections contain cancer cells, Mohs surgeons:
  • return to the specific area of the residual tumor indicated by the map
  • remove another thin layer of tissue only from the specific area(s) where cancer cells were detected
  • microscopically examine the newly removed tissue for additional cancer cells
If microscopic analysis still shows evidence of disease, the process continues layer-by-layer until the cancer is completely gone. Selective removal of only diseased tissue using Mohs Surgery allows the preservation of much of the surrounding normal tissue. This systematic microscopic search reveals the roots of the skin cancer which is why Mohs surgery offers the highest chance possible for complete removal of the cancer while sparing the normal tissue. Cure rates exceed 99 percent for new cancers and 95 percent for recurrent cancers.

How to Prepare for Mohs Surgery

On the morning of your surgery, please shower and wash your hair to reduce the risk of surgical site infection. Have your normal breakfast unless specified otherwise. Upon arrival, complete a medical history form, bringing a list of medications. Discontinue Erectile Dysfunction medication 72 hours before surgery, and aspirin, ibuprofen, or herbal supplements 10 days prior if not medically advised. Alcohol should be avoided 48 hours before surgery. Refrain from makeup, perfume, nail polish, and jewelry. Arrange transportation, as a mild sedative may be administered. Nursing home patients must bring a companion for assistance.

These are general recommendations. We recommend working closely with your specific provider to plan and prepare for your Mohs surgery.

Planning for Recovery after Mohs Surgery

After undergoing Mohs surgery, patients need to plan for a smooth recovery.
  • Firstly, arrange for someone to drive you home after the procedure, as you may feel groggy from any anesthesia used. 
  • Plan to take it easy for a day or two, avoiding strenuous activities.
  • And, follow your surgeon's post-operative care instructions diligently, which may include keeping the wound clean and dry. 
Usually, one return visit is all that is needed to examine the healed surgical site or to remove your surgical dressings. Afterward, you may return to your referring physician for routine check-ups. Lifetime annual skin exams and dermatological checkups are considered essential.

After having one skin cancer, statistics show that you have a higher chance of developing a second skin cancer. You should have your skin checked by your referring dermatologist at least once a year for four years not only to examine the treated skin cancer but also to check for new skin cancers.