Mohs micrographic surgery (or Mohs surgery) provides the highest 5-year cure rate of all treatment options – about 99% for primary basal cell carcinoma and about 97% for primary squamous cell carcinoma. At the same time, it minimizes removal of healthy skin and optimizes cosmetic outcome.
How is a skin cancer cured?
A non-melanoma skin cancer is like a weed in your garden. It has an openly visible part, and it has roots. You don’t know which direction the roots run, or how far out they go, but you do know that they’re connected to the visible weed. You also know that you can make the weed go away for a bit by pulling the top off, but that it will come back if you don’t get the roots out, too. Likewise, curing skin cancer requires removal of BOTH the visible tumor AND its roots. The good news is that most of the time non-melanoma skin cancer grows contiguously, meaning that one cancer cell connects to the next, which connects to the next, and so on.
What happens in Mohs surgery?
Mohs surgery begins with excision (removal) of the visible tumor tissue. It is sent to the in-office lab to be frozen, processed, and examined under the microscope. The purpose of microscopic examination is to identify cancer cells remaining along the margins (edges) of the tissue. The physician determines whether the margins are now tumor-free, or whether and where cancer cells remain. This completes one “stage.” If cancer cells do remain, then further “stages” are required. This back-and-forth, excision-and-testing process continues until all margins are “clear” of cancer cells. In this way, Mohs surgery achieves precision removal of the tumor tissue, while leaving intact the normal tissue unaffected by skin cancer.
Once the margins are clear, reconstruction usually can take place right away. The reconstruction step is approached with thoughtfulness and a mind toward optimal cosmetic outcome. The treatment objective is a return to your pre-skin cancer aesthetic and appearance, given the extent of the original lesion. Attention to detail and exacting standards are a cornerstone that favor great results.
Experience counts, and patients and physicians alike have come to trust Dr. Gardner’s background and experience for skin cancer removal and reconstruction. Over the course of his training and career, Dr. Gardner has performed many thousands of Mohs surgeries and reconstructions, a majority of them for facial skin cancers. He takes a special interest in helping patients to look their best after surgery. The healing process includes patient participation, of course, as good post-procedure wound care, follow-up, and continuing skin care do improve the chances for an appealing cosmetic result.
If you would like to learn even more about Mohs surgery and skin cancer, you can find a wealth of information and a patient education video at the American College of Mohs Surgery.