Understanding if Mohs Surgery is Right for You: FAQs
Overview
What is Mohs Surgery?
Mohs surgery, named after Frederic E. Mohs, is a precise surgical technique used to treat skin cancer. It is known for its high cure rate and tissue-sparing approach, making it a popular choice for removing certain types of skin cancer. The Mohs procedure involves the methodical removal and microscopic examination of thin layers of tissue at the tumor site until the cancer-free margin is achieved.
By minimizing the removal of healthy tissue, Mohs surgery aims to maximize the preservation of surrounding healthy skin and achieve optimal cosmetic and functional outcomes. This makes it an attractive option for patients seeking effective cancer treatment with minimal impact on their appearance and daily life.
What types of cancers are removed with Mohs?
Mohs surgery is primarily utilized for the treatment of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), the two most common types of skin cancer. These types of skin cancer are often found on areas of the body that are frequently exposed to the sun, such as the face, ears, and neck. Due to their location and potential for rapid growth, BCC and SCC can pose challenges in complete removal while preserving the surrounding healthy tissue. Mohs surgery is particularly effective in addressing these concerns, as it allows for precise removal of cancerous cells while sparing the maximum amount of healthy tissue.
In addition to BCC and SCC, Mohs surgery may also be recommended for the treatment of other less common skin cancers, such as dermatofibrosarcoma protuberans and certain types of melanoma in situ. The decision to undergo Mohs surgery for these less common skin cancers is typically made based on the specific characteristics of the tumor and its location, as well as the individual patient’s medical history and treatment goals.
The Mohs procedure is commonly recommended for skin cancers that have a high risk of reoccurrence or those located in cosmetically sensitive or functionally critical areas, such as the face, ears, and hands.
About the Procedure
Where do you get MOHS surgery?
Mohs surgery is usually performed in an outpatient setting, such as a dermatologist’s office or a specialized surgical facility equipped with the necessary resources for the procedure. The use of specialized equipment and on-site pathology services enables the surgeon to efficiently perform the Mohs procedure and analyze the tissue samples during the same visit. This streamlined process allows for real-time assessment of the tissue margins, ensuring that the cancerous cells are completely removed while minimizing the impact on the patient’s time and convenience.
What happens before the surgery?
Prior to undergoing Mohs surgery, patients will typically have a thorough consultation with the Mohs surgeon to discuss the procedure, review their medical history, and assess the specific characteristics of the skin cancer. During this consultation, the surgeon will evaluate the size, location, and type of skin cancer to determine the most appropriate treatment approach. In some cases, additional imaging or diagnostic tests may be recommended to assess the extent of the cancer and plan for the surgical procedure.
Patients will also receive detailed preoperative instructions to prepare for Mohs surgery, which may include guidelines for medication management, dietary restrictions, and skincare practices. It is essential for patients to follow these instructions closely to ensure the optimal conditions for the surgical procedure and promote smooth postoperative healing. Additionally, patients may be advised to arrange for transportation to and from the surgical facility, as well as plan for a designated caregiver to assist with recovery, if needed.
How is the procedure performed?
Mohs surgery is a highly specialized and meticulous procedure that involves several key steps to ensure the complete removal of skin cancer while preserving healthy tissue. The process begins with the surgical removal of the visible tumor and a thin margin of surrounding skin. The removed tissue is precisely mapped and labeled to correspond with its original location on the skin.
Next, the tissue is processed and examined under a microscope in an on-site laboratory. The Mohs surgeon evaluates the tissue margins to identify any remaining cancerous cells. If cancer cells are detected at the margin, another layer of tissue is precisely removed from the corresponding area and examined. This process is repeated until the tissue samples indicate a cancer-free margin, indicating that the cancer has been completely removed.
The meticulous nature of Mohs surgery allows the surgeon to precisely target the affected tissue, minimize the removal of healthy skin, and confirm the complete removal of cancerous cells during the procedure. This approach not only maximizes the effectiveness of the treatment but also enhances the cosmetic and functional outcomes for the patient.
Will I need reconstruction of the wound?
Reconstruction after a successful procedure is not medically necessary, but many people will opt to schedule the procedure if they have been left with a large wound or depression. Discuss the best method of managing your wound with your surgeon. The options include:
- Stitches/sutures.
- A skin flap (using tissue from surrounding skin).
- A graft (using tissue from another site on your body).
- Visiting a plastic surgeon to improve the appearance after a significant tumor.
- Letting your wound heal independently.
Efficacy of the Procedure
What is the success rate of the procedure?
Thankfully, Mohs surgery has the highest cure rate for both basal cell and squamous cell skin cancers. The cure rate is up to 99% for new basil cell carcinoma cases and up to 94% for recurrent cases. For squamous cell carcinoma, the cure rate is 95% to 99% for new cases and 90% for recurrent cases.
What are the advantages of having the procedure?
Mohs surgery offers several distinct advantages for patients facing skin cancer treatment. One of the primary benefits of Mohs surgery is its high cure rate, which exceeds that of standard excision or other treatment methods for certain types of skin cancer. The meticulous examination of tissue margins during the procedure ensures that the cancerous cells are completely removed, reducing the risk of re-occurrence and promoting long-term success in treating skin cancer.
Another significant advantage of Mohs surgery is its tissue-sparing approach, which minimizes the removal of healthy skin while effectively targeting the cancerous cells. This can be particularly beneficial for skin cancers located in cosmetically sensitive or functionally critical areas, as well as for patients concerned about preserving their appearance and quality of life. By preserving healthy tissue, Mohs surgery aims to minimize scarring and maximize the cosmetic and functional outcomes of the treatment.
In addition to its high cure rate and tissue-sparing approach, Mohs surgery is associated with a lower likelihood of the need for additional treatments or surgeries. The real-time assessment of tissue margins during the procedure allows the surgeon to confirm the complete removal of cancerous cells, reducing the likelihood of further interventions. This can lead to a more streamlined treatment process and improved patient satisfaction with the overall outcome of Mohs surgery.
Are there risks associated with Mohs?
While Mohs surgery is generally considered safe and effective, like any surgical procedure, it carries certain risks and potential complications. Some of the common risks associated with Mohs surgery include bleeding, infection, and adverse reactions to anesthesia or medications. However, these risks are typically low and can be minimized through careful preoperative evaluation, meticulous surgical technique, and postoperative care.
In rare cases, complications such as nerve damage, poor wound healing, or cosmetic changes may occur following Mohs surgery. The likelihood of these complications can be influenced by factors such as the size and location of the skin cancer, the individual’s overall health, and their ability to follow postoperative care instructions. It is important for patients to discuss any concerns or potential risks with their surgeon and adhere to the recommended guidelines for preoperative preparation and postoperative recovery.
Despite the potential risks, the benefits of Mohs surgery in effectively treating skin cancer and preserving healthy tissue often outweigh the associated concerns. By choosing a qualified and experienced Mohs surgeon and following the recommended preoperative and postoperative care, patients can minimize the risks and maximize the success of their surgery.
Conclusion
Mohs surgery has emerged as a highly effective and widely utilized treatment option for skin cancer, offering patients a meticulous and tissue-sparing approach to removing cancerous cells. The procedure’s high cure rate, emphasis on preserving healthy tissue, and potential for optimal cosmetic and functional outcomes make it a compelling choice for individuals facing skin cancer treatment. With the increasing prevalence of Mohs surgery and the expanding expertise of dermatologic surgeons, patients have greater access to this specialized procedure and the potential for successful outcomes.
For individuals considering Mohs surgery, it is essential to consult with a qualified and experienced surgeon to discuss the specific characteristics of their skin cancer and determine the most appropriate treatment approach. By understanding the process and advantages of MOHS surgery, patients can make informed decisions about their skin cancer treatment and pursue the best possible outcome for their health and well-being.
Will I be awake for the surgery?
Yes, most people will stay awake during Mohs surgery. Your surgeon will first numb the area with anesthesia injections. Though you may feel pressure there should be no pain, and you’ll rest comfortably in the waiting room or in the operating room while they analyze your tissue.
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