What is Mohs Micrographic Surgery?

Mohs at Rivergate Dermatology

It may have a funny sounding name; but Mohs micrographic surgery is currently the most precise and successful form of treatment for basal cell and squamous cell carcinomas (by far the most common skin cancers). Developed by Dr. Frederic Mohs in the 1930’s, the technique has gained substantial use and popularity over the last several decades due to its impressive track record. It offers cure rates of 98-99% for primary (previously untreated) tumors, and up to an astonishing 96% for recurrent tumors which have failed treatment with other methods. This is impressive for a technique that was barely known about and even aroused outrage in the medical community as little as 50 years ago when first announced as a skin cancer cure.

Mohs micrographic surgery allows even the most difficult and high risk skin cancers to be treated safely and cost effectively in the office setting. After a numbing shot, the cancer is removed piece by piece and examined under the microscope and with the aid of a detailed map or drawing of the color coded specimen (thus the term “micro graphic”) until all margins are clear while at the same time steering clear of healthy (uninvolved) skin. This not only leads to a quick and highly effective cure of the cancer; but it also preserves surrounding healthy skin and tissue. This is a very important and valuable aspect of Mohs surgery; as most skin cancers unfortunately involve the the delicate areas of the face such as the nose, ears, eyelids, and lips. Of course, these are the areas that receive the highest concentration of UV (ultraviolet) radiation, the biggest risk factor for skin cancer.

Of course, other treatments can and should be used to treat skin cancer as well. These include some quicker and less costly older forms of treatment such as curettage and electrodesiccation (“scrape and burn”) and standard (or simple) excision.  There is also an ever increasing selection of newer, although slightly more expensive, non surgical options. IMG_1996
These include topical chemotherapy creams and gels as well as light-based anti-cancer treatments usually done in an office setting using lasers and visible light systems (photodynamic therapy or “PDT”). However, none of these treatments offer cure rates as good as Mohs micrographic and should not be used for “higher risk” tumors. These are cancers even more likely to recur and include some aggressive subtypes of basal and squamous cell carcinomas, cancers on certain locations on the face and body, cancers that have already recurred, and cancers in immunosuppressed individuals. An evaluation by your friendly Dermatologist and possibly a biopsy will determine the best form of treatment for you.