There is no doubt the rates of skin cancer are increasing. People are refusing to accept the need to be careful when they are in the sun. While having skin cancer can cause you to be anxious, you need to put your fears aside. Research and technology are finding improved, safer and more effective ways to help you not only “deal with it” but get rid of the cancer forever. While skin cancer rates are on the rise, the surgical procedures designed to fight against this disease are improving as are the survival rates.
A number of different types of surgeries can help you get rid of skin cancer. Your doctor or specialist will provide you with some of the more familiar choices. These include various types of surgical and non-surgical procedures. Among the most common procedures for certain types of skin cancer you will always find Mohs surgery.
What is Mohs surgery?
Mohs Surgery, formally referred to as Mohs Micrographic Surgery or MMS, is named after its originator, Dr. Frederick Mohs (1910 – 2002). He is credited with its origination at the University of Wisconsin in 1936.1 He published the results of this new way of treating cancer in 1941. Since then, this highly specialized procedure has become refined and improved in both technique and tools.
MMS is not an everyday practice by surgeons. In fact not all physicians and surgeons can perform MMS. It involves a specialized team of medical professionals. During the process, your specialist may call upon others to help.
What is the Procedure?
The procedure can best be described as a cut, remove, examine and cut again. The surgeon anesthetizes the actual skin tumor and the area surrounding it. He or she then begins the removal of the tumor tissue. This is done layer by layer.
After the removal of each layer, a diagrammatic map is created of the entire region. The removed tissue is then frozen. The layer is next sent off to a pathologist. He or she examines the skin tissue under a microscope for the presence of cancer cells. If the tissue is cancerous, the specialist continues to remove another layer. The procedure of cut, remove and microscopic analysis only halts when the pathologist finds the layer is healthy – entirely free from any cancer cells.2
Who Best Benefits?
Your doctor will not recommend this type of surgery for you unless it will prove beneficial. Moreover, Mohs surgery is not the method for everyone who has skin cancer. It is a very selective procedure. You may be chosen for Mohs surgery if you fit into the following criterion:3
- Primary or recurrent basal and squamous cell carcinomas
- The tumor is a large one
- These types of skin cancer are located on the head or neck where retaining tissue is of particular importance
- You have a difficult tumor this is due to size, type or even its location
- Other techniques have failed to be successful at removing and preventing a recurrence
According to some surgical specialists, Mohs surgery for non-melanoma skin cancers, particularly if they are found on area of your head or neck is the “golden standard.”4
Success Rates
From the beginning, Mohs surgery has been remarkable for its high success rate. This is particularly true of its ability to remove effectively and permanently large, high-risk, basal cell carcinomas tumors. Moreover, it does so while preserving as much of your normal skin tissue as is possible.5 According to some statistics, the success rate for this particular procedure ranges from between 95 and 97 percent for localized and recurring non-melanoma skin cancers.6 The rate seems to be higher for primary basal cell carcinoma than for squamous cell carcinoma.
The success rate for Mohs is significant, although being called recently into question. Nevertheless, this procedure seems to be the most successful at not only removing skin cancer of a specific type but also at preventing it from returning.
Advantages and Limitations
If you have Mohs surgery, you require an experienced and trained surgeon. Under such guidance, you have a better chance of obtaining the greatest advantages that are possible. Mohs surgery offers the following benefits.
- High rate of success in removal and cure
- Maximum capability or removing the cancerous tissues and tumor
- Low rate of waiting to hear about results
- Minimum damage to the surrounding skin tissues that are healthy
- An outpatient treatment performed the same day
- Requires only a local anesthetic
- Greater chance of removal of the entire tumor
- Minimal scarring7
Yet, Mohs surgery does have its limitations. Your doctor will only recommend it, as noted above, in very specific cases of non-melanoma skin cancer. The surgical procedure also requires a very specific type of trained and experienced surgeon. You may have to consider going elsewhere for the specialized treatment. As a result, depending upon where you live, your mobility and ability to go to the clinic or centre providing the procedure, you may have to eliminate this surgical choice as an option. Yet, overall, the advantages outweigh the disadvantages or limitations.
It is important when considering your options that you realize Mohs surgery is not a universal option. It is not the right answer or even the only answer for treatment of your skin cancer. In fact, your physician may actually tell you that chemotherapy, cryosurgery, electrodessication and curettage, radiation, topical treatment and conventional surgery may be a better method of treating your cancer than Mohs.
REFERENCES
1 Mohs Surgery – Definition (2011). Mayo Clinic. Retrieved from:. www.mayoclinic.com/health/mohs-surgery/MY01304
2 MD Anderson Cancer Clinic (2011). “Diagnosis and Treatment.” Retrieved from www.mskcc.org/mskcc/html/5443.cfm
3 Women’s College Hospital (2011). “Mohs Centre.” Retrieved from www.womenscollegehospital.ca/programs-and-services/dermatology-program452/mohs-centre455
4 Maciel, Lane (2010). “Specialized Treatment for Skin Cancers: The Gold Standard.”Retrieved from www.mdanderson.org/publications/conquest/issues/2010-fall/mohs-surgery.html
5 MD Anderson Cancer Clinic (2011). “Diagnosis and Treatment.” Retrieved from www.mskcc.org/mskcc/html/5443.cfm
6 Mayo Clinic, op. cit.
7 Mayo Clinic, op. cit
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