Mohs is a surgical option that utilizes histology to micrographically remove only the cancerous parts of the skin. It is very precise and has a fantastic cure rate and has been in use for over 75 years.
What is Mohs Surgery and how does it work?
Step 1: The roots of a skin cancer may extend beyond the visible portion of the tumor. If these roots are not removed, the cancer will recur. Local anesthesia is used around the tumor site to numb the area. General anesthesia is not required for Mohs surgery.
Step 2: The visible tumor is identified. A thin layer of skin around the tumor is removed and divided into sections. The surgeon then color codes each of these sections with dyes and makes reference marks on the skin to show the source of these sections. A map of the surgical site is then drawn.
Step 3: If any section of the tissue shows cancer cells at the margin, the surgeon returns to that specific area, as indicated by the map, and removes another thin layer of tissue. The removed tissue is again mapped, color-coded, processed and examined.
Step 4: If cancer cells are found under the microscope, the surgeon marks their location on the map and returns to the patient to remove another layer of skin – but only from precisely where the cancer cells remain.
Step 5: Mohs surgeons, who have completed fellowship training in the procedure, are experts in skin reconstruction to preserve normal skin function and physical appearance. The best method of repairing the wound after surgery is determined after the cancer is completely removed. Stitches may be used to close the wound side-to-side, or a skin graft or a flap may be designed. Sometimes, a wound may be allowed to heal naturally.