In the 1940s, a cancer doctor named Frederic Mohs realized that most skin cancer treatments of the day involved the removal of too much healthy tissue. Surgeons would excise large areas of tissue around the cancer site in the hope of “getting it all.” But all too often, the cancer would return because the surgeons were essentially guessing; healthy tissue had been taken while cancer cells had been left behind.
Dr. Mohs knew something had to be done. And he did it. Now, surgeons and dermatologists rely on the surgical procedure that now bears his name: Mohs Micrographic Surgery.
This ingenious procedure solved two problems: the unnecessary removal of healthy tissue, and the haphazard means of establishing that all of the cancer cells had been removed. Now, as much healthy tissue is preserved as possible, while the use of a powerful microscope—by the lead physician, no less—provides ocular proof that the cancer has been completely removed.
Prior to any Mohs Surgery procedure, the patient meets the team of qualified medical professionals who will be conducting the procedure. The lead physician, who must carry the appropriate medical subspecialty in order to serve in that capacity, meets with the patient and explains the process, along with the assisting physician and a nurse who will also be present during the procedure.
Another important member of the team, who the patient might never even meet, is the medical technician, who prepares the patient’s tissue samples for examination under the microscope.
On the day of the Mohs Surgery procedure, the nurse will make the patient comfortable and answer any last-minute questions before applying local anesthetic to the operation site.
After 30-45 minutes, the anesthetic will take effect and the surgery will begin. First, the lead physician uses a type of scalpel, referred to as a curette, to remove as much visible tumor material as possible.
Then, the lead physician removes an area of tissue from around the central cancer site with an extremely small and precise margin between cancerous tissue and ostensibly healthy tissue. This tiny margin, sometimes as little as 1mm, allows the physician to preserve as much of the nearby surrounding tissue as possible.
Then, the removed tissue is examined under a microscope for signs of cancer cells. If any are found, another, very precise incision is made around the main cancer site and more tissue is removed. The lead physician and his or her team repeat this process until the lead physician is completely satisfied that all cancer cells have been removed.
In this way, Mohs Surgery combines precision with modern technology. The microscopes of today, such as those at our clinic, are much more powerful than in Dr. Mohs’s day, leading to an even higher degree of certainty that he ever imagined possible.
This is why Mohs Surgery remains a mainstay in our battle against skin cancer, and why it might be exactly the treatment you need for minimum risk and maximum health.