Skin cancer is one of the most common types of cancer worldwide, with millions of cases diagnosed each year.
For those facing a skin cancer diagnosis, finding the most effective treatment is crucial. Mohs Surgery has emerged as one of the most precise and successful procedures for treating certain types of skin cancer, particularly basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
This surgical technique offers high cure rates while preserving as much healthy tissue as possible. In this article, we will explore Mohs Surgery in detail, including its process, benefits, recovery, and what patients can expect.
Table of Contents
What is Mohs Surgery?
Mohs micrographic surgery, commonly known as Mohs Surgery, is a specialized procedure used to remove skin cancer with a high level of precision. It was developed by Dr. Frederic Mohs in the 1930s and has since become the gold standard for treating non-melanoma skin cancers.
Unlike traditional excision methods, Mohs Surgery involves removing cancerous tissue layer by layer while examining each layer under a microscope. This ensures that only cancerous cells are removed, preserving as much surrounding healthy tissue as possible. This meticulous process minimizes the risk of recurrence and results in smaller scars compared to conventional surgical methods.
How is Mohs Surgery Performed?
The Mohs Surgery procedure is typically performed in an outpatient setting under local anesthesia. Here’s a step-by-step breakdown of the process:
- Preparation: The surgeon marks the area and administers a local anesthetic to numb the region.
- Tissue Removal: A thin layer of the affected skin is removed.
- Microscopic Examination: The removed tissue is frozen, cut into sections, and examined under a microscope to check for remaining cancer cells.
- Additional Tissue Removal (if needed): If cancer cells are still present, another thin layer is removed, and the process is repeated until no cancerous cells remain.
- Wound Closure: Depending on the size of the removed tissue, the wound may be closed with stitches, left to heal naturally, or reconstructed using skin grafts or flaps.
Since each layer is examined in real time, patients receive immediate confirmation that all cancerous cells have been removed before leaving the facility.
Benefits of Mohs Surgery
Mohs Surgery offers several advantages over traditional skin cancer treatments, making it a preferred choice among dermatologic surgeons and patients alike:
- High Cure Rate: Mohs Surgery boasts a cure rate of up to 99% for primary basal cell and squamous cell carcinomas.
- Tissue Preservation: Unlike standard excision methods, Mohs Surgery removes only the cancerous cells, preserving as much healthy tissue as possible.
- Minimized Scarring: Since the procedure removes minimal tissue, the resulting scars are often smaller and less noticeable.
- Same-Day Confirmation: Patients receive immediate results since tissue analysis occurs on-site, reducing the need for additional surgeries.
- Effective for Recurrent Cancers: Mohs Surgery is highly effective for treating cancers that have returned after previous treatments.
Who is a Candidate for Mohs Surgery?
While Mohs Surgery is most commonly used for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), it is also suitable for certain melanomas and other rare skin cancers. Candidates for Mohs Surgery often include individuals with:
- Skin cancers located in cosmetically or functionally important areas (e.g., face, ears, nose, lips, hands).
- Large, aggressive, or recurrent tumors.
- Skin cancers with poorly defined borders.
- High-risk tumors that have a greater chance of spreading.
A dermatologist or Mohs surgeon will assess the patient’s specific condition and recommend the best treatment approach.
What to Expect During and After Mohs Surgery
Understanding what happens before, during, and after the procedure can help patients feel more prepared and comfortable.
Before the Procedure
- Patients should avoid certain medications, such as blood thinners, as advised by their doctor.
- It is recommended to eat a light meal before the procedure since Mohs Surgery can take several hours.
- Comfortable clothing and arrangements for transportation home should be planned in advance.
During the Procedure
- The procedure is performed under local anesthesia, so patients remain awake but pain-free.
- The surgeon removes tissue layer by layer, with each layer being examined under a microscope.
- The process continues until all cancerous cells are removed, which can take a few hours.
Recovery and Aftercare
- Patients may experience mild swelling, redness, and bruising, which usually subside within a few days.
- Pain is generally minimal and can be managed with over-the-counter pain relievers.
- Keeping the wound clean and following the surgeon’s aftercare instructions is essential for proper healing.
- In cases where stitches are used, they are usually removed within one to two weeks.
- Patients should follow up with their dermatologist for routine skin checks to monitor for any signs of recurrence.
Potential Risks and Complications
While Mohs Surgery is considered safe and effective, some potential risks include:
- Bleeding or infection at the surgical site.
- Temporary numbness or tingling if nerves are affected.
- Scarring, though often minimal compared to other surgical methods.
- Rare instances of incomplete cancer removal, requiring further treatment.
Discussing potential risks with a Mohs surgeon beforehand can help patients feel more informed and reassured.
Conclusion
Mohs Surgery is a highly effective and precise method for treating non-melanoma skin cancers, offering an unparalleled cure rate while preserving healthy tissue. Its ability to minimize scarring and provide immediate results makes it a preferred choice for skin cancer treatment, particularly in delicate areas such as the face and hands.
