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Skin Cancer

Mohs Surgery

Cancer is a concerning diagnosis regardless of type. Non–melanoma skin cancers, including basal cell carcinoma and squamous cell carcinoma, are the most common cancers for human beings. Fortunately, there is a time–tested approach to treatment, with a remarkable 98 percent cure rate for non–melanoma skin cancer: Mohs micrographic surgery. Living in Tucson, women and men generally experience high rates of sun exposure, which is a significant risk factor in the development of skin cancer. As such, Tucson-area residents can benefit from regular checkups with a dermatologist to ensure skin remains healthy.

Patients diagnosed with basal cell carcinoma or squamous cell carcinoma can benefit from the micrographic surgery method first developed in the 1930s by Dr. Mohs, and continuously refined in the decades since.

Mohs is a technique that enables the doctor performing the procedure to examine all surgical margins of cancerous tissue to ensure complete removal of cancerous cells, while simultaneously sparing the largest amount of healthy tissue. This makes Mohs a particularly good choice for cancer occurring on the head and neck, where cosmetic concerns make preserving healthy tissue a priority.

During a Mohs procedure, the doctor removes a single surgical layer at a time, examining the excised tissue with a microscope for the presence of cancerous cells at the edges of the tissue. Once all cancerous cells are removed, the procedure is complete, and repair of the surgical site is performed.

After a patient is diagnosed with skin cancer, there is a consultation with a Mohs surgeon to determine whether Mohs is the best approach to treatment. For most types of skin cancer, Mohs is the most effective treatment option, and if the surgeon and patient agree to proceed, an appointment is scheduled.

Your surgeon will provide a full list of instructions for what to do before surgery, but typically patients should avoid smoking and cease taking certain medications and over–the–counter supplements that might interfere with the procedure.

Mohs procedures take place in the office using local anesthesia, which helps minimize the risks and recovery time of the procedure. The surgery itself is relatively straightforward. The doctor will remove the visible tumor with a thin margin of surrounding skin, which is examined under a microscope for the presence of cancerous cells. If the layer is free of cancerous tissue, the surgery is complete. If cancerous tissue is present, the surgeon removes another layer, continuing the process until there is no longer evidence of cancerous cells. The entire process typically takes two to three hours, although the doctor may ask the patient to clear their schedule to ensure the procedure is thorough.

Following the procedure, the surgeon generally performs a repair with sutures the same day. In some cases, a plastic surgeon is utilized to repair more extensive defects. In other instances, the surgeon allows the site to close itself by a process termed secondary intention.

The healing process depends largely on the size, location, and extent of the tumor. Patients can return home following their procedure, though the doctor will provide patients with post–operative instructions. Full healing typically takes several weeks to months, and patients should expect a scar on the surgery site, which tends to become less visible with time.

Mohs surgery is considered a necessary medical procedure, and most insurance companies will cover most if not all of the costs. Patients should contact their insurance providers to determine their specific coverage for Mohs surgery.

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