Mohs Skin Cancer Surgery

Skin cancer begins in cells, the building blocks that make up the skin. Normally, skin cells grow and divide to form new cells. Everyday skin cells grow old and die, and new cells take their place.

Sometimes this orderly process goes wrong. New cells form when the skin does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor, which can be benign (non-cancerous) or malignant (cancerous).

Two common forms of skin cancer include Basal cell carcinoma and squamous cell carcinoma. The most serious type of skin cancer is melanoma.

If skin cancer is detected, Dr. Levine will compile a tissue sample (biopsy) which will be examined microscopically and if cancer is confirmed, he will remove it with the Mohs surgery.

The Mohs procedure involves a layer-by-layer removal of skin that contains cancer cells. The steps of the procedure are as follows:

  1. The skin around the cancer cells is numbed with an anesthetic.
  2. Any visible, raised area of the tumor is removed.
  3. A thin, circular layer of tissue is removed first.
  4. The tissue is marked in a manner to identify right and left as well as top to bottom sections.
  5. The entire bottom side and outter edges of the removed tissue layer are examined under a microscope immediately in the doctor’s office.
  6. If any cancer cells are seen under the microscope, its location is identified (according to the marked section) and an additional thin layer of tissue is removed only from the identified section where the cancer cells remain.
  7. The process of microscopic examination and removal of additional layers of tissue continue until no more cancer cells are seen under the microscope.

Advantages of Mohs Micrographic Surgery

  • Procedure performed from the start to finish by a skin cancer expert
  • Highest cure rate available for skin cancer
  • Visualizes 100% of margin of excision vs. the 1% with normal pathology
  • Smallest amount of normal skin is removed
  • Preserves cosmetics and function of treated areas
  • Smallest possible defect results in smallest possible scar
  • Reconstruction performed immediately after tumor is removed
  • All done under local anesthesia in office.

What types of cancer can be removed with Mohs Surgery?

Basal cell and Squamous cell carcinoma are two of the most common skin cancers and also the two that Mohs surgery treats. But it is also helpful for:

  • Skin cancers near vital functional or cosmetically important areas such as near eyes, eyelids, nose, ears, lips, forehead, scalp, fingers, or genital area
  • Skin cancer that is large(1 inch) or larger on any area other than the face.
  • Skin cancer with borders that are not clearly defined
  • Skin cancers in which other treatments have been tried and failed (cancer comes back)
  • Skin cancer in areas where scar tissue is already present

The cure rate for basal and squamous is close to 100% when detected and treated at an early stage. That is why a yearly professional skin cancer exam is highly recommended. In between the yearly exams, once a month examine your skin from head to toe and focus on the ABCDE’s (comparing to melanoma forms of skin cancer since it is the most serious form).