Whenever we hear the words “skin cancer” come from our dermatologist’s lips during a diagnosis, the heart skips a beat. It’s important to remember, however, that skin cancer is among the most successfully treated cancers. One treatment that has made this favorable statistic possible is called Mohs Micrographic Surgery.
Mohs Surgery, as it is often called for short, is straightforward in its approach but brilliant in its simplicity. Created by Dr. Frederic Mohs all the way back in 1938, Mohs Surgery seeks to preserve as much healthy tissue as possible while simultaneously removing any and all cancer cells with an extremely high degree of certainty.
The procedure begins in the early morning, when a nurse applies local anesthetic to the site of the surgery. This is one element that separates Mohs Surgery from many other skin cancer procedures: except in special circumstances, the patient remains conscious throughout. The obvious advantage of avoiding general anesthesia is, of course, the chances of complications are reduced.
After the local anesthetic is applied and has taken effect, a team of qualified medical professionals—including a lead physician, assisting physician, nurse, and technician—begin the task of ridding your body of skin cancer.
The lead physician starts by using a metal instrument to scrape out the visible tumor site of its cancerous material. This process is followed by the lead physician removing an area of tissue immediately surrounding the tumor site within an extremely small margin. This tiny margin allows the physician to preserve as much healthy tissue as possible as the next stage of Mohs Surgery begins.
This stage is distinguished Mohs Surgery from other procedures. The area of tissue that is excised is separated into thin samples which are then examined under a microscope by the lead physician, who is looking for cancer cells that may have evaded the scraping process. If cancerous cells are found to be present, another area of tissue is taken, again extremely precise.
This next round of samples is examined in the same way. The process repeats itself usually 2 or 3 times at most. As you can imagine, the lead physician needs to be thorough in his or her examination process, hence the entire Mohs Surgery process can take a full day even though only about 20 to 30 minutes of that time is spent in actual surgery. The rest is spent waiting for the results of the examination.
When the lead physician is satisfied that all of the cancer cells have been removed, the surgery is complete. The patient will have a surgical wound that is usually no bigger than a small lesion, requiring stitches. Scarring is kept to a minimum; if at all possible, healing of the wound without the need for stitches is preferable for this reason.
Mohs Surgery has been around for over 70 years, and for a good reason. It is the safest, most effective (up to 99% success with many common cancers), and most one-and-done skin cancer treatment available, meaning the need for a second surgery is extremely low.
More than anything, Dr. Mohs was interested in preserving healthy tissue and curing the patient. His great success lives on in the continuing legacy of Mohs Surgery as a prime defense against skin cancer.