Fellowship-Trained Mohs Surgeons
If you have been diagnosed with skin cancer, it is important to understand all of your treatment options. While Mohs surgery is not always needed, it provides the highest of cure rates while leaving the smallest surgical scar. Regardless of what you choose, the fellowship-trained Mohs surgeons at Braun Dermatology & Skin Cancer Center are here to help you make the right decision.
What is Mohs Surgery?
Approximately 70 years ago Dr. Frederic Mohs in Madison, Wisconsin developed this highly specialized technique for the removal of skin cancer. In short, Mohs surgery is a way of removing the cancer one layer at a time and examining the tissue, while you wait, to make sure the entire cancer has been removed.
Mohs surgery is performed under local anesthesia. Once the area is numb, all of the visible tumor is removed along with a narrow margin of normal appearing skin. The tissue is then processed by the lab in the office and then evaluated under the microscope by the Mohs surgeon. If the tumor is found at the margin, then more tissue is removed precisely where the tumor was found. The process is repeated until the cancer is removed completely.
Mohs surgery has two advantages over other methods of treatment of skin cancer. First, it has the highest cure rate of any method of treatment, and we consider this the most important advantage. Second, the technique of Mohs surgery limits the amount of normal skin that is removed, which means that the wound is the smallest possible wound, while still ensuring that the cancer has been removed. One disadvantage to using Mohs surgery is the amount of time that is required. Because it is more technically difficult than other methods of treatment, it takes longer. We ask our patients who are undergoing Mohs surgery to dedicate the entire day to being with us. While the surgery may not take all day long, we cannot predict how long it will require (because we cannot predict how extensive the cancer may be).
Why Use Mohs Surgery?
After a skin cancer is diagnosed, there are multiple factors that are considered when choosing which method of treatment is most appropriate. The type, size, location, clinical appearance of the cancer, and whether the cancer is recurrent or primary are all considered.
Mohs Micrographic surgery has two distinct advantages over other methods of treatment. First and most importantly, Mohs surgery provides the highest cure rate of all skin cancer treatments. Second, Mohs surgery only removes cancerous tissue and leaves the normal skin in place. This results in the smallest possible wound. This is important when the cancer is located in an area where we would like to minimize scarring, such as the face or in areas where removing it with a wider margin (standard excision) would make the wound difficult to repair.
Mohs surgery is not always necessary. Smaller cancers in other areas of the body, such as the arms, legs, and trunk may be removed without difficulty by an excision. This procedure involves taking a standard "safety" margin around the tumor.
Every skin cancer is different, and the decision on which method of treatment is most appropriate for your skin cancer is one that should be made by you and your dermatologist. If you have a skin cancer and are trying to figure out how it should be treated, please speak with your dermatologist about the different options. Obtaining a second opinion from other dermatologists is certainly a reasonable expectation. If you would like to speak with us about Mohs surgery, we encourage you to make an appointment so that we can evaluate your cancer and give you our honest opinion.