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Mohs Surgery

Reasons to Have One, What to Expect, Associated Risks & More

5 Reasons Why You Would Need Mohs Surgery

1. Basal cell carcinoma

Mohs surgery is often a recommended treatment for common skin cancers like basal cell carcinoma (BCC). Basal cell carcinoma is usually caused by sun exposure in areas that normally get a lot of it, like the head, back of the hands, arms, or neck. It can grow slowly, but when it becomes aggressive, Mohs surgery can be the best option for a quick, effective treatment.[2]

2. Squamous cell carcinoma

This is another common type of skin cancer that can require Mohs surgery. It usually develops on skin that has been damaged by frequent and large amounts of sun exposure, such as that of the head, back of the hands or legs, arms, and neck. The condition is curable if it is treated quickly, but it can spread to the rest of the body if it is not.[3]

3. Melanoma

Mohs surgery isn’t as commonly used to treat melanoma as it is to treat the other, less serious types of skin cancer, but it can still be an option. When Mohs surgery is used as a treatment for melanoma, it must be for the lentigo malignant melanoma type or early-stage melanoma. This is because this type of melanoma stays close to the surface of the skin for a long time.[1]

4. Cancer that has been treated before

If you had a kind of common skin cancer like those above that was treated through a different method, disappeared, and then returned, it might be necessary to have Mohs surgery to remove it once and for all.[1]

5. Large areas of cancer

If you have a large area on your body where cancer is developing, have cancer that is aggressive or cancer that is spreading rapidly to other parts of the body, Mohs surgery may be necessary as well. It is a more aggressive treatment for a more aggressive cancer.

6. Location of the cancer

If cancer appears in an area with little tissue beneath it, it can be necessary to use Mohs surgery to remove it as quickly as possible.[1] These specific areas can include hands, feet, ears, nose, eyelids, and genitals.

Understanding Mohs Surgery

Mohs surgery entails removing the cancerous cells from the skin.[4] It has the highest success rate for skin cancer treatment and leaves the smallest scar possible. Surgeons and pathologists are both involved in the treatment, as the surgeon removes the tissue and closes the wound, restructuring the area if necessary, and the pathologist analyzes the specimens collected through lab testing.

First, the spot where the biopsy was done is examined by the doctor, who marks it in order to know where the removal will take place. The doctor may ask you to sit up or lie down, depending on which option will make it easier for them to get to the affected area. You will be awake throughout the entire procedure since you only need a local anesthetic.

The surgeon then uses a scalpel to remove the visible cancerous tissue.[5] Next, the lab work is done in order to determine if you have more cancerous tissue beneath the visible part. You can relax during this part of the procedure.

After the lab results are in, the surgeon will let you know if you need more tissue removed. The tissue is then studied again to find out if any more cancerous cells remain, and more tissue is removed as many times as necessary to remove it all. After all the cancerous cells are removed, the surgeon may close the wound with stitches, do reconstructive surgery, or leave it open to heal, depending on its intensity.

Risks of Mohs Surgery

1. Surgical risks

The common risks associated with all surgeries are also risks associated with Mohs surgery. These can include pain, bleeding, and infection.[6]

2. Other possible risks

Most of the other risks associated with this surgery are uncommon, but they are nonetheless possible. You might experience numbness or weakness in the area, and this may or may not be permanent.[6] Severe pain in the area of the surgery can also occur, as can a large scar known as a keloid. However, these issues do not arise frequently, because the surgery is extremely precise.

What to Expect with Mohs Surgery

1. Longer removal

In some cases, complete removal can be done with the first surgery, but in others, it can take more time to remove every part of the cancerous tissue. However, Mohs surgery is still the safest, most effective way to treat these types of skin cancer.

2. Outpatient treatment

Though you may be at the clinic for several hours, you should be prepared for an outpatient setting. You may not even have to change into a gown if the surgery will be performed in an area that does not require it.

Questions to Ask Your Doctor About Mohs Surgery

  • What is the success rate of Mohs surgery?
  • Are there any risks associated with the procedure?
  • How long should I expect to be in your office?
  • Will I need any follow up appointments or treatments?
  • Can you let me know the likelihood that cancer might return?
  • How should I prepare for the surgery? Are there any medications I need to take?
  • Is there anything I need to stop taking or should I stop smoking, drinking, etc., before the surgery?
  • Should I expect to have a scar after surgery?

Mohs Surgery May Also be Known as:

  • Mohs micrographic surgery
  • Dilated Mohs Surgery



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