Monthly Article for August 2013
MOHS Surgery
Written By: Aparna Tamirisa, M.D.
Edited by: Karan Sra, M.D.
Mohs surgery is a state of the art and highly effective treatment of skin
cancer that has been continuously refined for the past 70 years. It is a
highly precise surgical technique used to excise cancerous tissue while
leaving surrounding healthy tissue intact and unharmed. The Mohs procedure excises not only the
tumor seen from the external skin, but also any hidden “roots” that extend beneath the surface. As the
most exact and precise method of skin cancer removal, it minimizes the chance of recurrence and allows
for an optical cosmetic result. Data from recent medical literature states that five year cure rates are
98% or higher for first time treated skin cancer and 95% for recurring cancer. It is unlike conventional
surgery in that the cancer is carefully mapped out, removed, and examined microscopically until the last
margins of cancerous cells have been excised. This differentiates Mohs surgery from other surgical or
medical options for skin cancer treatment as the Mohs surgeon microscopically verifies that all cancer
cells have been removed the day of the procedure. This decreases the need for additional treatments or
surgery.
At Dermatological Association of Texas (DAT), Mohs surgery is performed by a board certified
dermatologist, fellowship trained in Mohs surgery and Procedural Dermatology. Your physician will
serve as both the reconstructive surgeon and the pathologist examining tissue under the microscope.
Mohs surgery is commonly used for basal cell and squamous skin cancer. Mohs surgery is ideal for areas
such as the face, hands, feet, and genitals as the dermatologist only removes the cancerous tissue,
leaving normal skin intact. This allows for a better functional and cosmetic outcome for patients.
What happens the day of surgery?
The Mohs procedure begins with a local anesthetic that is applied to the area of interest. The skin
around the cancer is completely numbed. General anesthesia is not required. A small layer of skin is
then removed and examined under the microscope by the dermatologist. A map of all tissue removed is
created and any areas with remaining cancer are plotted on the map. Thin layers of cancerous skin are
serially removed and examined under the microscope. This process is repeated until all cancerous cells
are excised. At completion, the repair process begins. DAT dermatologists are highly experienced in
cosmetic reconstruction of the cancer removal site. The wound is bandaged and patients leave the
same day of the procedure.
Mohs surgery is the most advanced treatment for skin cancer and it eliminates the need for more
invasive surgery. As with any surgical procedure, there are risks involved. There is a small chance of
bleeding at the surgical site, infection, and pain. Small nerves may be cut leaving temporary or
permanent numbness at the surgical site. Although remission rates are high, follow up visits with your
dermatologist are needed for monitoring. Please see your board certified dermatologist at
Dermatological Association of Texas for more information on the procedure.