Download Mohs Micrographic Surgery Offers Highest Cure Rate For Most Skin

Mohs Micrographic Surgery Offers Highest Cure Rate For
Most Skin Cancers
By Dr. Jeremy Youse, Dermatologist
“You have skin cancer,” is never a phrase that people want to hear from their doctor. Yet,
as the rates of skin cancer continue to increase at an alarming pace, it is a phrase that I am
uttering more and more often. As the only fellowship-trained Mohs surgeon and newest
board certified dermatologist in the Champaign-Urbana region, I diagnose and treat
patients with aggressive non-melanoma skin cancers every day.
Typically, when dermatologists discuss skin cancers, we classify them as either nonmelanoma skin cancer or melanoma. There are two basic types of non-melanoma skin
cancers—basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Non-melanoma
skin cancers are much more common and much less likely to spread to distant body sites
compared to melanoma skin cancer. Very few people die from BCC and SCC, but these
skin cancers can lead to significant problems when improperly treated or left untreated.
Untreated non-melanoma skin cancers can cause significant pain, non-healing ulcers, and
significant destruction of normal healthy tissue, skin, and cartilage. SCC’s, in particular,
are more likely to eventually grow and spread if left untreated.
There are many treatments available for patients diagnosed with non-melanoma skin
cancer. When the skin cancers are small and detected early, treatment may be as simple as
scraping away the abnormal skin or applying a topical chemotherapy cream. When the
skin cancers are more advanced, large in size, recurrent or previously treated, or in sensitive
areas, such as the face, the treatment of choice is often Mohs micrographic surgery. Mohs
micrographic surgery is a specialized technique of skin cancer treatment that is performed
for patients with higher risk non-melanoma skin cancers, particularly when the skin
cancers arise on cosmetically sensitive areas of the face, lips, ears, eyelids, or hands.
Traditional excision surgery treatments for these skin cancers can lead to unacceptably high
recurrence rates and unnecessary scarring and disfigurement. The Mohs surgery technique
is performed in the office using local numbing medicine. No general anesthesia is
required. The technique was developed over 50 years ago, by Dr. Fred Mohs and over the
past few decades, has become the treatment of choice for high risk non-melanoma skin
cancers.
Mohs micrographic surgery has several benefits compared to traditional surgery for skin
cancers. Mohs micrographic surgery allows the Mohs surgeon to evaluate the entire
peripheral and deep margin of the removed skin. This allows the Mohs surgeon to remove
a very narrow margin of skin around the skin cancer and check the edge under a
microscope for residual “roots” of skin cancer that extend to the margin. The skin cancer
roots are then precisely mapped and small additional amounts of skin are removed only in
the affected areas. This allows for higher cure rates, preservation of normal healthy skin,
and smaller defects. Once the skin cancer has been cleared with Mohs surgery, the Mohs
surgeon will determine the best way to help repair the skin to its normal appearance and
function, often repairing the treated area with stitches the same day.
In summary, Mohs micrographic surgery offers the highest cure rates for most skin cancers,
preservation of normal skin, and smaller scars. After completing my dermatology residency
and Mohs micrographic surgery fellowship at Mayo Clinic last year, I am proud to bring
this treatment option to patients with skin cancer in the Champaign-Urbana region.