How is Mohs Surgery Performed?

by: Thornwell H. Parker

Mohs surgery is the most advanced state-of-the-art technology available for the removal of skin cancer. It yields the highest cure rates for skin cancer removal while minimizing the amount of skin removed.

When is Mohs surgery recommended?

Mohs surgery may be recommended by your doctor if you have basal cell cancer, squamous cell cancer, or melanoma. It is usually recommended for patients with facial skin cancer as well as recurring, aggressive, or ill-defined skin cancer. The surgery yields a 99 percent cure rate in the treatment of most new skin cancers and a 95 percent success rate in curing cancers recurring after other types of treatment.

How is it different from other types of skin cancer treatments?

With traditional skin cancer removal, your physician removes the suspected skin cancer with an extra margin of surrounding skin, then closes the defect with sutures. The removed skin is sent to a laboratory for review by a pathologist and the results can take several days. If the results show that cancerous cells remain, your physician will have to remove more skin and you will have to repeat the process of waiting on the lab results. With Mohs surgery, the surgery and pathology results occur together the same day with the results typically ready in one to one and half hours. Further, you have a reduced risk of cosmetic damage since the surgery uses a precise technique to remove only the damaged skin cells.

How is it performed?

Mohs surgery, also called Mohs micrographic surgery, uses a unique mapping and microscope examination process to remove the cancerous cells layer by layer. After the visible cancerous growth is removed, the surgeon maps the skin cancer orientation. The surgeon takes the map and specimen to the lab for microscopic examination. Mohs surgery goes beyond just sampling the specimen, as is done in regular pathology, and instead allows for full examination of 100% of the margins. This process allows the surgeon to pinpoint the exact location of the cancerous roots and remove them layer by layer. This ensures the highest cure rates along with the least possible cosmetic damage.

What can I expect from treatment?

The surgery is a day procedure performed using local anesthesia. Your surgeon will numb the area where the surgery is to be performed, then commence the removal of the visible cancerous growth. After the wound is dressed you are free to go relax or get something to eat while your surgeon maps and microscopically examines the specimen. This can take up to an hour and a half. Once the surgeon calls you back into the treatment room, he will know whether all the cancer has been removed or if he needs to remove another layer. The treatment is complete when all margins are clean and no more cancer is seen. Depending on the depth of the cancer and the size of the wound, some reconstructive surgery (stitching) may be necessary.