May marks Skin Cancer Awareness Month, a time to shed light on preventive measures and advanced treatments like Mohs surgery. Mohs micrographic surgery, named after its pioneer Dr. Frederic Mohs, is a highly specialized technique designed to remove skin cancer with maximum precision while sparing healthy tissue. Unlike traditional excision methods, Mohs surgery meticulously maps and removes cancerous cells layer by layer, ensuring minimal damage to surrounding skin.
When Is Mohs Surgery Used?
Mohs surgery is primarily employed for treating two common types of skin cancer: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). These cancers often appear on sun-exposed areas like the face, neck, and hands. Mohs surgery is particularly advantageous in cases where the cancer:
- Is located in cosmetically sensitive or functionally critical areas.
- Has aggressive or ill-defined borders.
- Has recurred after previous treatment.
- Is large or has high-risk features.
The Unrivaled Benefits of Mohs Surgery
Mohs micrographic surgery (Mohs surgery) offers several distinct advantages over regular excision when it comes to treating these types of cancers.
- Maximal Preservation of Healthy Tissue. One of the most significant advantages of Mohs surgery is its ability to spare as much healthy tissue as possible while ensuring complete removal of cancerous cells. Traditional excision methods often rely on predetermined margins, leading to the removal of more tissue than necessary. In contrast, Mohs surgery allows for precise, real-time examination of tissue margins under a microscope, ensuring that only cancerous tissue is removed while healthy tissue is preserved.
- Superior Cure Rates. Mohs surgery consistently achieves high cure rates, often exceeding 99% for primary BCC and SCC. The meticulous examination of tissue margins during the procedure helps to ensure that all cancerous cells are removed, minimizing the risk of recurrence.
- Immediate Tissue Examination. Unlike traditional excision methods where tissue examination occurs after the surgery is completed, Mohs surgery involves real-time examination of tissue margins as they are being removed. This allows the surgeon to precisely identify and remove any remaining cancerous cells during the same procedure, reducing the need for additional surgeries or treatments.
- Cosmetic Outcome. By preserving healthy tissue and minimizing the size of the surgical defect, Mohs surgery often results in superior cosmetic outcomes compared to traditional excision methods. This is particularly important for tumors located on the face, neck, and other cosmetically sensitive areas, where minimizing scarring and preserving aesthetics are paramount.
- Highly Precise Mapping and Removal. Mohs surgery utilizes a systematic process of tissue mapping, removal, and examination, performed iteratively until all cancerous cells are eradicated. The surgeon removes small amounts of tissue and examines them under the microscope after each removal. Only when it is clear that no cancer cells are present is the surgery deemed complete.
- Optimized Healing and Recovery. Mohs surgery is associated with minimal discomfort and shorter recovery times compared to traditional excision methods. Patients typically experience less post-operative pain and swelling, and most are able to resume normal activities within a few days. Additionally, Mohs surgery allows for immediate wound closure once the cancer is completely excised, promoting optimal healing and reducing the risk of complications.
Mohs Micrographic Surgeons
Mohs micrographic surgery (Mohs surgery) is typically performed by dermatologists who have completed specialized fellowship training in Mohs micrographic surgery and cutaneous oncology after completing their dermatology residency. These Mohs surgeons possess board certification in dermatology, ensuring they meet rigorous standards of training and competency in the field. Through intensive hands-on training, Mohs surgeons develop expertise in the precise removal of skin cancer while preserving healthy tissue. They also acquire proficiency in surgical dermatology, allowing them to manage complex cases and complications effectively. Continuous education and maintenance of certification further ensure that Mohs surgeons stay updated on the latest advances and best practices in skin cancer treatment, providing patients with high-quality care and optimal outcomes. At Arizona Dermatology, all of our dermatologists are Mohs micrographic surgeons.
What to Expect During Mohs Surgery
● Step 1: Anesthesia. Before the procedure begins, the surgical site is numbed with local anesthesia to ensure your comfort.
● Step 2: Tissue Removal. The surgeon removes the visible tumor along with a thin layer of surrounding tissue. This tissue is then divided into sections, mapped, and meticulously examined under a microscope.
● Step 3: Tissue Analysis. Each tissue section is scrutinized for cancerous cells. If cancer cells are detected at the margins, the surgeon precisely identifies their location on your skin map.
● Step 4: Iterative Process: If cancer cells are found at the margins, the process is repeated, with targeted removal of additional tissue only from the areas where cancer remains.
● Step 5: Closure. Once the cancer is completely excised, the wound is carefully closed using various techniques to optimize healing and minimize scarring.
Recovery and Healing
Recovery from Mohs surgery is generally swift, with most patients able to resume normal activities within a few days. While discomfort and swelling are common immediately after the procedure, these symptoms typically subside quickly. Patients are advised to follow post-operative care instructions diligently, including keeping the wound clean and protected, avoiding excessive sun exposure, and attending follow-up appointments for wound assessment.
Mohs surgery has been a game-changer in the landscape of skin cancer treatment, offering unmatched precision, superior cure rates, and preservation of healthy tissue. Early detection and proactive management are key in the fight against skin cancer, so it is important to perform regular skin checks and see your dermatologist annually (more often if you’ve had skin cancer before). Stay vigilant, stay protected, and prioritize your skin health this Skin Cancer Awareness Month and beyond.
