New treatments for skin cancer are appearing and evolving rapidly in recent years. However, one surgical technique has more than stood the test of time. Developed by Dr. Frederick Mohs in the 1930s, Mohs micrographic surgery has, with a few refinements, come to be embraced over the past decade by an increasing number of dermatologic surgeons for an ever-widening variety of skin cancers.
Today, Mohs surgery has come to be accepted as the single most effective technique for removing Basal Cell Carcinomas, one of the most common skin cancer. It accomplishes the nifty trick of sparing the greatest amount of healthy tissue while also most completely expunging cancer cells; cure rates for BCC are an unparalleled 98 percent or higher with Mohs, significantly better than the rates for standard excision or any other accepted method. Our Consultant Dermatologist is a specialist in Mohs surgery having been trained at a top centre in this technique. At LBPS we have the unique setting where our dermatologist works closely with a renowned plastic surgeon ensuring the best possible wound closure for any post Mohs wound.
The reason for the success is its simple elegance. Mohs differs from other techniques in that microscopic examination of all excised tissues occurs during rather than after the surgery, thereby eliminating the need to “estimate” how far out or deep the roots of the skin cancer go. This allows the Mohs surgeon to remove all of the cancer cells while sparing as much normal tissue as possible. The procedure entails removing one thin layer of tissue at a time; as each layer is removed, its margins are studied under a microscope for the presence of cancer cells. If the margins are cancer-free, the surgery is ended. If not, more tissue is removed from the margin where the cancer cells were found, and the procedure is repeated until all the margins of the final tissue sample examined are clear of cancer. In this way, Mohs surgery eliminates the guesswork in skin cancer removal, producing the best therapeutic and cosmetic results. With the rates for skin cancers continuing to skyrocket, Mohs surgery will play an ever more important role in the coming decades.