Mohs Surgery
What is Mohs surgery?
Mohs micrographic surgery is a specialized and precise procedure for the microscopically controlled treatment of skin cancers. Initially developed in the 1930s by Dr. Frederic Mohs, this form of treatment combines the surgical removal of cancerous tissues along with same-day microscopic examination of the tumor and its underlying roots. This procedure is the single most effective technique for complete removal of basal and squamous cell carcinomas, in addition to other rarer skin cancers. Mohs surgery has a cure rate of up to 99% and remains the gold standard treatment for skin cancers located in cosmetically sensitive areas such as the face, head, and neck. Mohs surgery may also be utilized for recurrent cancers or after other treatment methods have failed. The goal of Mohs surgery is to meticulously remove all of the cancerous tissue while sparing as much normal, healthy tissue as possible. This layer-by-layer removal and microscopic identification technique allows the Mohs surgeon to most effectively remove all cancerous tissue.
What to Expect During Mohs Surgery
- The surgeon removes a piece of tissue just around the visible portion of the tumor on the skin surface.
- After removal, the tissue is immediately color-coated with dyes and is mapped. The tissue is then processed in the lab resulting in the creation of microscope slides.
- All of the tissue margins are then examined by the surgeon under the microscope to confirm complete removal. If residual cancer is detected, it is mapped out and the surgeon then removes another layer of the patient’s skin only where cancerous cells remain.
- If required, the sequence of layer removal, tissue processing, and microscopic examination is repeated until the margins of the cancer are completely clear.
- Following confirmed cancer clearance, the Mohs surgeon will repair the wound with sutures in a manner that will maintain function, minimize scarring, and achieve the optimal long-term cosmetic appearance.
Excision
Traditional excision of a skin cancer is often performed for cancers on the trunk, arms, or legs. Performed under local anesthesia, the cancerous tissue and a standard margin of normal skin is removed, and the resulting wound is closed with sutures. The tissue is then sent to a pathologist to ensure the entirety of the cancer has been removed.
Other Skin Cancer Treatments
Electrodessication and Curettage
Also known as a “scrape and burn” procedure, electrodessication and curettage (ED&C), is a quick and simple method of treating certain types of skin cancer. The tissue is first anesthetized with local numbing medication. Then, the provider scrapes the cancerous cells with a sharp spoon-like instrument called a curette, and then cauterizes the tissue with an electrical device. This type of procedure is typically performed for very superficial skin cancers that are located in less cosmetically sensitive areas, such as the trunk, arms, and legs.
Photodynamic Therapy
Also known as “blue light” treatment, photodynamic therapy (PDT) is a method for treating areas of diffusely sun damaged skin and precancerous lesions known as actinic keratoses. A liquid is first applied to the desired treatment area which makes the skin more receptive to absorbing the light rays. Then the patient sits under a specialized light for a controlled period of time while the light treats the sun damaged area. More than one treatment over a period of time may be beneficial in order to achieve optimal results.
Benign Skin Growths
Cysts
Cysts are common sac-like growths filled with fluid or other material that appear as a “bump” underneath the skin. While the majority of cysts are benign, they may continue to grow, become unsightly or uncomfortable, and even become inflamed or infected. Surgery under local anesthesia to remove the cyst is often the recommended treatment to prevent potential complications.
Lipomas
Lipomas are growths underneath the skin composed of clusters of fat cells. Though usually harmless, lipomas may cause pain or discomfort, affect function, and can be aesthetically bothersome. Lipoma removal surgery under local anesthesia is a safe and effective method to address these concerns.
Benign Moles
Most moles are common, harmless growths that can occur anywhere on the body. If your Dermatologist feels a particular mole may be suspicious, the mole may be removed via biopsy and sent for microscopic analysis. Benign moles can also be removed for cosmetic purposes.