New treatments for skin cancer have been evolving rapidly over the past few years. One procedure however, has withstood the test of time — Mohs surgery. Also known as chemosurgery, Mohs surgery is a microscopically controlled surgery procedure used to treat skin cancer. It is usually performed on areas of the body where tissue preservation is important such as the face, hands, feet, and genitals. This procedure was developed in the 1930s, and through refinements in techniques, is being used by an increasing number of surgeons as an effective method of treating skin cancer.
During the skin cancer removal surgery, tissue is taken out and examined for cancer cells. However, Mohs surgery is different from other surgeries because the examination for cancer cells in the tissue occurs during the procedure, rather than after. This eliminates the surgeon having to estimate how far the roots of the cancer go. It also allows the surgeon to take out all of the cancerous cells, while sparing the normal tissue.
During the skin cancer removal surgery, a thin layer of tissue is taken out and examined under local anesthesia. If it is found to be cancer-free, the surgery concludes. If not, additional tissue is taken out and the procedure is repeated until the samples are shown to be clear of cancer.
Mohs surgery in effect eliminates guesswork and produces excellent cosmetic and therapeutic results. The cure rate is between 97% and 99.8% for primary basal cell carcinoma, with similar cure rates for other cancers such as squamous cell carcinoma.
In the past, Mohs surgery was rarely selected to treat melanoma, because of the risk of missing some of the microscopic melanoma cells. However, improvements in the Mohs surgery procedure allow the surgeon to identify melanoma cells using special stains that highlight the cells.
Mohs surgery is also considered a more cost-effective option because there are no separate surgery and histopathological analysis costs.