Mohs Surgery offers the hightest chance of a cure (up to 98%) of some skin cancers, particularly Basal Cell Carcinomas (BCCs) while ensuring the amount of skin removed is kept to a minimum.
In the 1930’s, Dr Frederick Mohs, from Wisconsin USA, first conceptualized and then developed his treatment for skin cancer. The technique has since come to be known as “Mohs Surgery” as due recognition for Dr Mohs’ outstanding contribution to the field of skin cancer treatment.
What is Mohs Surgery?
Mohs Surgery is a highly specialized treatment for the total removal of skin cancers. The visible component of the cancer is surgically excised and then subjected to microscopic analysis whilst the patient waits. Any residual positive areas for cancer are identified and subsequently removed. This process continues until all the cancer cells are cleared. Mohs surgery allows for cancer cells to be fully and accurately tracked without guesswork until they are completely removed.
Why is it important that all cancerous cells be removed?
If cancer cells are left behind at the time of initial surgery, there is a very high chance that the cancer will recur. When this happens it will frequently grow for a substantial period of time hidden invisibly underneath the previous surgical scar. This makes the subsequent treatment of the recurrent cancer much more extensive and difficult.
When is Mohs Surgery recommended?
Mohs surgery is ideal when a skin cancer:
What at the advantages of Mohs Surgery?
The Mohs Surgery procedure.
The area to be treated is first numbed with local anaesthetic and the visible cancer is removed. A dressing is applied to the wound and the patient returns to a waiting area.
While the patient waits, the removed tissue is precisely oriented and then divided into small sections and the edges marked with colored dye and a tissue map is drawn. The tissue is then handed to the laboratory technician
Tissue processing and examination
The tissue is frozen and cut by the technicians, then mounted on to microscope slides and stained using highly specialized chemicals to identify the different cell types. The doctor then examines the tissue under the microscope to see whether any residual cancer cells can be identified.
If there is any residual cancer, the wound is re-anaesthetised and further tissue corresponding precisely to the area of positivity is excised and again microscopically checked. This process continues until the Mohs Surgeon is satisfied that no cancerous cells remain.
Once the cancer is shown to be completely removed the patient wound is repaired. There are many ways in which the post Mohs Surgery wound can be repaired including
Almost certainly following Mohs Surgery the cancer will be cured. The final functional and cosmetic outcome is usually excellent
Who performs Mohs Surgery?
Dermatologists who have undertaken post specialist Fellowship training in Mohs Surgery and who are officially sanctioned by the American College of Mohs Surgery and/or the Australasian College of Dermatologists.
REMEMBER- MOHS SURGERY OFFERS THE HIGHEST CHANCE OF CURE AND WITH SMALLER / EARLIER CANCERS THE MAXIMAL DEGREE OF NORMAL TISSUE PRESERVATION