Mohs surgery is a microscopic surgical procedure used in the treatment of skin cancer. Developed by Dr. Frederic Mohs at the University of Wisconsin, the procedure is very effective in removing basal cell carcinomas and squamous cell carcinomas – two of the most common types of skin cancers.
What Does Mohs Treatment Entail?
The surgeon removes the visible part of the tumor surgically. He studies the margins of the removed skin tissue under a microscope and looks for the presence of cancer cells. If the margins contain cancerous cells, the surgeon again removes a thin layer of tissue from the area where the malignant remains are present. The procedure is repeated until the removed skin tissue is free of cancerous cells.
How is Mohs Surgery Different From Other Procedures?
In a standard surgical excision, the visible tumor and a small part of the healthy skin tissue are removed at the same time. The tissue margins are microscopically examined only after the surgery. If cancerous cells are found, a second surgical procedure is often required.
In Mohs microscopic procedure, only the visible tumor is removed first. The surgeon examines the margins of the removed skin tissue and looks for cancerous cells. He removes another layer of skin tissue only if there are cancerous cells found in the area. If the margins of the skin tissue are cancer-free, the surgery ends immediately.
In a standard surgical procedure, the loss of healthy skin tissue is unavoidable as both the visible tumor and a small part of the healthy skin are removed all at once. There is a little bit of guesswork involved as the surgeon has to estimate how far or deep the roots of the tumor have gone.
In Mohs surgery, the skin tissue is removed one thin layer at a time. There is no guesswork involved as each layer is carefully examined for the presence of malignant cells. The surgery ends as soon as the cancer is removed. This makes it possible for the surgeon to remove the cancerous cells completely while preserving as much healthy skin tissue as possible.
How Effective and Safe is Mohs For Skin Cancer Treatment?
The cure rate varies from 97% to 99.8%, which makes Mohs treatment one of the most effective methods to treat skin cancers. The procedure is extremely thorough and there is very little tissue loss. So, it is used to treat cancers that have a high risk of occurrence and even cancers that have been treated unsuccessfully before.
Mohs was not used to treat melanomas in the past, but the recent advances in medical technology have made it possible for Mohs surgeons to identify and remove melanomas successfully. So, the procedure is now used to treat melanomas as well.
The surgery is very safe and effective. It is done on an outpatient basis. You will be given local anesthesia prior to the surgery to make sure you do not feel any pain or discomfort. The surgery itself takes only a few minutes, but the surgeon takes the tissue margins to the lab and examines them for cancer cells. This part of the procedure usually takes some time.
While the surgeon examines the tissue margins, you can rest in the waiting room. The entire procedure takes anywhere from two to four hours. Local anesthetic is re-administered if deemed necessary by the surgeon.
After Mohs surgery, the surgeon usually creates a follow-up schedule for you. Follow-up skin exams are necessary to monitor your recovery and to ensure your wounds heal properly.
The thoroughness of the procedure and the fact that there is very little tissue loss involved makes the procedure safe for people of all ages. In fact, the American Academy of Dermatology states that Mohs treatment is safe even for people who are 90 or older.