Surgical tumor removal has long been a treatment used by doctors to combat skin cancer, but Mohs micrographic surgery—first developed in the 1930s—is a particularly sophisticated and rigorous approach to treating the disease. Today, Mohs surgery holds a five-year cure rate of 94 to 99 percent, depending on the nature of the cancer being treated, and whether it is the first occurrence or a recurrence. It is the highest cure rate of any treatment for basal or squamous cell carcinomas.
Mohs surgery is a surgical excision that is performed in stages at a single visit, as each layer of cancerous tissue is removed one by one. Cancer cells are not strictly limited to visible tumors, and may extend into the surrounding tissue, which can lead to further health problems if they remain present but unseen after a tumor is removed.
Mohs surgery at Albuquerque’s Western Dermatology Consultants involves a dermatologist removing a very thin layer of surrounding tissue along with the tumor. The procedure is typically performed under local anesthesia on an outpatient basis, and could last up to several hours depending on the size of the area to be treated. This will be determined during a consultation.
Each layer of tissue is excised, specially prepared, then taken to the lab to be examined minutely under a microscope to check for signs of cancer while the patient waits. This testing stage is usually what takes the majority of time.
If any malignant cells are detected, another layer is taken and examined. Part of the Mohs surgery is to map every area that a sample is excised from, so that the dermatologist knows where to continue (and which areas to leave out) if a cancerous layer is found. This goes on until the dermatologist finds nothing but cancer-free tissue samples. These are known as clear margins.
With more traditional forms of surgery (such as local excision), only about 1 to 3 percent of a tumor’s margins are actually examined, leaving room for some cancerous cells to be left behind. Mohs surgery allows virtually all percent of the tumor’s margins to be examined, thereby greatly reducing the chance for some cancer cells to be missed.
Because the layers are so thin and the Mohs process is so meticulous, the wound left behind after the tumor removal is only as big as it needs to be, and the cure rates are the best of any widely accepted treatment strategy.
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