Mohs Skin Cancer Surgery- Cancer/Oncology

What is Mohs surgery?

Mohs surgery is a specific surgical procedure for the treatment of skin cancer. The goal of Mohs surgery is to remove as much of the skin cancer as possible with negligible damage to adjacent healthy tissue and the smallest possible scar. This procedure removes all cancerous cells for the highest cure rate. It is generally performed by a surgical oncologist (surgeon who has specialized in surgeries for removing tumours).

Why is it required?

It is the most effective surgery for the treatment of two most common types of skin cancer (basal cell carcinomas and squamous cell carcinomas). It is useful for skin cancers which are large or aggressive, have a greater chance of recurrence, have hard to define borders, and are located near ears, nose, eyes, mouth, feet, hands, and genitals.

The procedure:

The procedure is done in one visit although in different stages and the patient is asked to wait between each stage. This surgery is done under local anesthesia. In the beginning, surgeon would use a scalpel to remove the visible part of the cancer along with a thin, underlying layer of tissue. A temporary bandage is placed on the incision. The surgeon would examine the tissue under a microscope in an on-site laboratory. During the analysis, the tissue sample is cut into sections and are examined under a microscope. If cancer cells are found in one piece of tissue, the surgeon knows exactly where to continue with the surgery without damaging healthy tissue around it. After removing another layer of tissue from that exact location, the process gets repeated till no cancer cells are found during the analysis.

Once all of the skin layers with cancer cells have been removed, surgeon would repair the wound. Depending on the extent of the procedure, the surgeon may select one of the following option to repair the wound:

• Healing by second intention: Let the wound heal on its own
• Primary closure: Use of sutures to close the wound
• Skin flap: Use of skin from an adjacent area to cover the wound
• Use of a skin graft from another part of the body to cover the wound
• Patient may be referred to another surgeon for reconstructive surgery if the surgical area is extensive or complex.

What to expect after the procedure?

The patient would be asked to have a follow-up visit with surgeon to monitor recovery and to make sure that the wound is healing properly. This surgery has a high rate of cure for skin cancer.

Sources:

• https://www.mayoclinic.org/tests-procedures/mohs-surgery/about/pac-20385222
• https://www.skincancer.org/skin-cancer-information/mohs-surgery

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