Skin cancer can be stressful and scary, but it doesn’t have to put your life on hold. Mohs micrographic surgery is a procedure that can safely remove cancerous cells without damaging the surrounding skin.
Mohs surgery is a tried and true procedure that can treat a variety of skin cancers. It is named after Dr. Frederick Mohs, who developed the process more than 50 years ago. In most cases, Mohs micrographic surgery can be performed by a Mohs trained and licensed dermatologist in their office. The surgery is usually performed over the span of hours, but in rare cases multiple sessions over the course of several hours or days are required. For some complex surgeries, you may need to be admitted to a hospital. For almost all Mohs surgeries, however, your dermatologist can do the procedure without the use of general anesthesia.
Before undergoing surgery, your dermatologist will inject the affected area with a local anesthetic. Once the anesthetic has taken effect, your dermatologist will remove the visible cancerous skin. Next, the layer of surrounding skin is removed. Your dermatologist will analyze the second layer for traces of cancerous cells using a microscope or similar tool. If cancer cells are detected, they will remove the next layer and re-analyze it until no trace of cancer is detected.
If you do need to undergo more than a few rounds of this process, your doctor may apply dressing to the wound and have you come back the next day. This is usually only the case for deeper or wider spread lesions. This might sound like a lot of skin to lose, but thankfully, that’s not the case. Very thin layers can be excised from the affected area thanks to the pinpoint accuracy of the procedure.
After Mohs surgery, your dermatologist may or may not apply stitches to the wound. Because it is minimally invasive, a lot of Mohs surgeries don’t require stitches and the treated skin heals naturally with minimal to no scarring. The cure rate for Mohs surgery is around 95% and the process is only improving.
There are a lot of different types of cancers that Mohs treats well, most notably basal and squamous cell carcinoma. The surgery is most often recommended for instances of these types of skin cancer when the lesions are large or aggressive, or if skin cancer has recurred. Since Mohs surgery is minimally invasive, it is often recommended when cancer appears on sensitive areas of the face, such as the eyelid or lip.
There are other kinds of skin cancer that have responded to Mohs treatment, including rare forms of cancer like dermatofibrosarcoma protuberans (DFSP) and Merkel cell carcinoma (MCC).
DFSP forms in a deeper layer of the skin, and does not spread quickly. At first, it looks like a rough patch of skin, or perhaps a small pimple. Given time, it can become enlarged and grow to a large bump that can crack and bleed. If treated quickly by Mohs surgery, DFSP can have a positive prognosis, but taking too long to get treated can let it spread.
Mohs surgery is also an effective way to treat Merkel cell carcinoma, which is a rare and aggressive form of skin cancer. MCC looks like a pimple or cyst that quickly grows out of control. Due to its aggressive nature, Mohs treatment is often administered alongside chemotherapy to treat MCC.
Mohs surgery has also been used to treat a common, and possibly deadly form of cancer most of us are familiar with: melanoma. If lentigo malignant melanoma is detected early, Mohs is a great treatment option. Since lentigo malignant melanoma appears close to the surface of the skin but is inclined to spread rapidly, Mohs surgery can often stop it in its tracks.
Mohs micrographic surgery offers people suffering from skin cancer a safe and effective treatment option. If you suffer from or have dealt with skin cancer before, explore your Mohs surgery options with your New England dermatologist.
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