Imagine a scenario where you walk into a doctor’s office in the morning with skin cancer. During the next few hours you undergo a procedure that removes and examines every bit of the carcinoma, testing until it’s sure you are completely cancer-free. And you can drive home that afternoon.
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It happens every day. The procedure is called Mohs surgery, named for the surgeon who developed it in the 1930s. Mohs removes the cancer while preserving as much healthy tissue as possible, critical in carcinomas near the eyes, ears, nose, mouth, hands, feet and genitals.
The Mohs cure rate is spectacular for the most common skin cancers, basal cell and squamous cell carcinomas: 99 percent for basal cell, 97 percent for squamous cell.
“Mohs ensures that the cancer is removed with 99 percent certainty,” says dermatologist and Mohs surgeon Missale Mesfin, MD, of Twinsburg’s Family Health and Surgery Center. “It’s the only method that evaluates 100 percent of the margin.”
What happens during Mohs surgery
Dr. Mesfin says, “We tell our patients the surgery is easier than going to the dentist.”
You can see the similarity. You’re fully awake during the surgery. First the site of the cancer is numbed, then the cancerous tissue and its surrounding margins rapidly removed. The area is mapped, and the tissues and margins examined microscopically for cancer, all while you wait in the doctor’s office.
During the tissue examination “there’s lots of downtime when you can relax,” says Dr. Mesfin. She recommends her patients bring a book or device to pass the time.
What to expect after your procedure
If the margins are cancer-free the surgery is complete and the wound stitched up. If not, the process is repeated until the site is completely clear. A simple dressing is applied over the area and healing time is minimal, depending on the size of the wound. Large wounds may require the assistance of a plastic surgeon for repairs, done in conjunction with the dermatologist’s office.
“When they leave, they say, ‘Wow, this wasn’t so bad.’ They’re pleasantly surprised at how straightforward it is,” says Dr. Mesfin.
Is Mohs surgery right for you?
Not all skin cancers are treated with Mohs. Skin cancers are most common on the head and neck and often treated with Mohs, but those on the trunk and extremities are only treated with Mohs surgery under certain circumstances that your surgeon can determine, says Dr. Mesfin. And because of biological differences of melanoma, it isn’t usually treated with Mohs surgery.
Mohs surgery, though, is the single most effective technique for completely removing the most common kinds of skin cancer. Dr. Mesfin pinpoints the peace of mind that it brings.
“It’s a really fabulous way of getting the cancer out — and the patient knowing it’s out.”