Every year in the U.S., about 5.4 million basal cell carcinomas and squamous cell carcinomas are diagnosed in more than 3.3 million people, according to data from the American Cancer Society. And as it turns out, those numbers have been growing every year, partly as a result of people living longer and partly because we’re getting more sun exposure. Better techniques for detecting skin cancer — and detecting it earlier — could also be playing a role in those increasing numbers. Whatever the reason, one thing’s for sure: Skin cancers need to be treated to prevent them from becoming more serious and even life-threatening.
What is Mohs micrographic surgery?
Mohs micrographic surgery (or just plain Mohs surgery) is a tissue-sparing surgical technique pioneered by Dr. Frederic Mohs back in 1938. Since then, the technique has grown to become the most popular and most widely used surgical approach to treating both basal cell and squamous cell cancers, as well as other types of skin cancer.
So what it tissue-sparing surgery? It’s a technique that removes as much tissue as is necessary to get rid of all the cancerous cells — but no more tissue than is necessary. That means as much healthy tissue as possible is preserved so tissue damage and scarring are minimized. Since so many skin cancers tend to occur on the face and other visible areas of the body, using a technique designed to reduce tissue damage and scarring can go a long way toward preventing serious disfigurement that can make patients feel self-conscious and even unattractive.
How does Mohs surgery work?
Mohs surgery is a multistep process. During the procedure, Dr. Bailey removes the visible cancerous lesion — that is, the part that you can easily see. Then the tissue is carefully examined under a microscope, paying special attention to the borders or margins of the tissue. If the borders are clear — that is, if no cancerous cells are present along the edge of the tissue that’s been removed — that indicates all the cancer has been removed and the surgery is complete. But if there are cancerous cells along one or more areas of the margin, it’s an indication there may be more cancerous cells that haven’t yet been removed. The areas where cells are present are marked off and Dr. Bailey removes more tissue in those areas and then examines that tissue for cells along the border. Once the borders are completely free and clear of cancer cells, that means the entire cancerous lesion has been removed. The area is closed with sutures and the surgery is complete.
Although it may seem like a lot of steps to go through to remove a single lesion, by removing a small amount of tissue at a time and then examining it, the Mohs technique ensures all the cancer cells are removed while preserving as much of your healthy tissue as possible. Mohs surgery is especially useful in cancers with hard-to-define borders, for very large lesions and for lesions that have recurred following earlier treatments. The success rate of Mohs surgery is very high, and when you combine that with the fact the surgery keeps as much of your skin intact as possible, it’s easy to see why Mohs surgery is considered the gold standard for treating many types of skin cancer.
The Mohs procedure
Mohs surgery is performed as an outpatient procedure and typically takes several hours (the combined time of the surgery and the tissue inspection under a microscope). The surgery is performed under local anesthetic to numb the area so you stay comfortable and relaxed. When Dr. Bailey makes the initial excision, he removes the visible lesion as well as a small amount of tissue under and around the lesion margins. After each excision, a clean bandage is placed over the site to keep it clean and to control bleeding while the tissue is examined. Depending on how long your surgery takes, the local anesthetic can be readministered as needed.
Although basal cell carcinoma and squamous cell carcinoma are rarely deadly, they can be fatal if they're not caught and treated early. If you have an unusual skin lesion or a change in an existing mole, you should have the area evaluated right away. To learn more about skin cancer treatment or to schedule an evaluation, book an appointment online today.