About 96 percent of the 1.3 million new cases of skin cancer diagnosed each year in the United States is basal cell or squamous cell carcinoma. When treating these cancers, Mohs micrographic surgery has typical cure rates of more than 99 percent for new skin cancers and 95 percent for recurrent skin cancer.
Mohs is especially useful in treating large tumors, tumors where the edges are not well-defined, tumors in certain locations (such as on or near the nose, eyes, ears, forehead, scalp, fingers and genital area) and those that have come back after other treatments. However, it’s also usually more complex and time-consuming than other methods.
When is Mohs Microscopic Surgery Indicated?
Although the concept of Mohs micrographic surgery was developed over 50 years ago, relatively few dermatologists were trained in its use until recently. Only in the last few years has the technique become widely available and used by dermatologists throughout the country. Mohs micrographic surgery is now universally recognized as a precise method for treating skin cancers. It is especially effective in cancers of the face and other sensitive areas, because it can eliminate all the cancer while causing minimal damage to the surrounding normal skin.
Mohs micrographic surgery is also ideal for the removal of recurrent skin cancers – tumors that reappear after treatment and can plague a patient repeatedly. While skin cancers are easily visible to the patient, individual cancer cells are microscopic and any cells left behind can cause the tumor to reappear. The tumor may spread beyond its obvious external margins, with “nests” of cell growing in unpredictable areas. With the Mohs technique, all tumor nests can be identified and removed with a high degree of accuracy, so that extremely high cure rates, as high as 95 percent, are possible even when the cancer is recurrent.
A dermatologist is best trained to determine when this technique should be used rather than the other effective procedures also available for treating skin cancer.
How Mohs Surgery Is Performed
The Mohs surgical process involves a series of excisions followed by microscopic examination of the tissue to assess if any tumor cells remain. Some tumors that appear small on clinical exam may have extensive invasion below normal-appearing skin. In many cases, it is impossible to predict a tumor size until all surgery is complete. As Mohs surgery is used to treat complex skin cancers, about half of the tumors require removing two or more layers of tissue for complete excision.
“The fact that cure rates for Mohs surgery are so high is an advantage for both patients and physicians. Offering a proven procedure to my patients that will eradicate their skin cancer is very gratifying.”
– Jessica Scruggs Dorsey, MD, FAAD, Fellowship-trained Mohs Surgeon, Board-Certified Dermatologist, Dermatology Associates of Central Texas, Georgetown
Why Choose Mohs Surgery?
Because the cure rates for Mohs surgery are so high and the technique produces the smallest possible wound in the removal of any given tumor, it is a much sought-after treatment. The smaller the wound, the greater the chances are for a good cosmetic result after the wound has completely healed, particularly on the face.
The majority of tumors can be totally removed in one Mohs treatment session, due to the preciseness of the surgery and microscopic inspection. While the Mohs surgery is a technically demanding procedure, it is also highly cost-effective because fewer return visits to the dermatologist’s office are needed for treatment of a recurring lesion.
Your Mohs Surgeon’s Qualifications
Physicians performing Mohs surgery should have specialized skills in dermatology, dermatologic surgery, dermatopathology and Mohs surgery. Basic and advanced training in Mohs surgery is available through selected residency programs, specialized fellowships, observational preceptorships and intensive training courses. In addition, the Mohs surgeon must have the required surgical and laboratory facilities and must be supported by a well-trained Mohs nursing and histotechnological staff. Your Mohs surgeon can provide you with detailed information regarding his or her training in the above disciplines, as well as all applicable professional affiliations.
High cure rates for Mohs makes the procedure an appealing choice for skin cancer treatment. However, it’s important to discuss your health history and other factors with your Mohs surgeon, dermatologist or physician to be certain that Mohs surgery is right for you. There are other skin cancer options if Mohs surgery is not best for you.