Mohs surgery is the most effective and advanced treatment for skin cancer today. It offers the highest potential for cure – even if the skin cancer has been previously treated by another method. Mohs surgery treats skin cancer through a highly specialized and precise technique that removes the cancer in stages, one tissue layer at a time.
With the Mohs technique, physicians can precisely identify and remove an entire tumor while leaving the surrounding healthy tissue intact and unharmed.
- Ensuring complete cancer removal during surgery, virtually eliminating the chance of the cancer growing back
- Minimizing the amount of healthy tissue lost
- Maximizing the functional and cosmetic outcome resulting from surgery Repairing the site of the cancer the same day the cancer is removed, in most cases
- Curing skin cancer when other methods have failed
Other skin cancer treatment methods blindly estimate the amount of tissue to treat, which can result in the unnecessary removal of healthy skin tissue and tumor re-growth if any cancer is missed.
There are also human costs to be considered. Because Mohs surgery minimizes the amount of healthy tissue removed, it also reduces the impact to the surrounding area. The aesthetic outcome of the surgery is optimized. Furthermore, the psychological impact of being subjected to multiple procedures when cancer recurs can be significant. Patients usually find it reassuring to know that their cancer has been treated with a single procedure that gives them the highest possible chance of complete cure.
Surgeons usually perform Mohs micrographic surgery as an outpatient procedure in their office, which will have an on-site surgical suite and a laboratory for immediate preparation and microscopic examination of tissue. Typically, surgery starts early in the morning and is completed the same day, depending on the extent of the tumor and the amount of reconstruction necessary.
Local anesthesia is administered around the area of the tumor as the patient is awake during the entire procedure. The use of local anesthesia in Mohs surgery versus general anesthesia provides numerous benefits, including the prevention of lengthy recovery and possible side effects from general anesthesia. After the area has been numbed, the Mohs surgeon removes the visible tumor along with a thin layer of surrounding tissue. This tissue is prepared and put on slides by a technician and examined under a microscope by the Mohs surgeon. If there is evidence of cancer, another layer of tissue is taken from the area where the cancer was detected. This ensures that only cancerous tissue is removed during the procedure, minimizing the loss of healthy tissue. These steps are repeated until all samples are free of cancer. While there are always exceptions to the rule, most tumors require 1 to 3 stages for complete removal.
When the surgery is complete, the Mohs surgeon will assess the wound and discuss options for ideal functional and cosmetic reconstruction. If reconstruction is necessary, the Mohs surgeon will usually perform reconstructive surgery to repair the area the same day as the tumor removal.