Go for the Gold: Mohs Micrographic Surgery for Skin Cancer

Mohs micrographic surgery — named after Frederic E. Mohs, a physician who practiced at the University of Washington – is acknowledged as the “gold standard” in treating common skin cancers. And Mohs’ reputation is well earned. Not only does it offer the highest cure rates today for basal and squamous cell carcinomas, it offers patients several serious advantages.

The Combination Factor

One way that Mohs differs from other treatments is that is combines your cancer surgery, the pathology process and the cosmetic repair into a single procedure.

When you undergo Mohs, your physician excises the area surrounding your biopsy site. That tissue is handed over to trained histology technicians who create “frozen section” slides that give physicians a 360-degree view around and underneath the visible site of your cancer. In as little as 20 minutes, your doctor is able to examine your tissue under a microscope and see if the edges are clear (woohoo, we got it all!), or if cancer cells remain at the edge.

If the doctor does see cancer cells, they simply remove a tiny bit more of the affected tissue, then test the edges again. Your dermatologist repeats the process until your skin margins are completely clear and cancer-free. This unique combination of steps is the heart and soul of Mohs and it’s why the procedure has a cure rate nearing 99%.

The Repair Factor

The second advantage of Mohs surgery is that it preserves the most healthy skin tissue possible. Instead of cutting into healthy tissue broadly to ensure they remove the skin cancer, Mohs surgeons are able to zero in on and treat the specific area affected by the skin cancer. The scar that you’re left with is minimal, which is really ideal for cancers that often grow on highly visible areas like the nose and the ears.

Because Mohs surgery preserves the healthy surrounding tissue, the space where your skin was removed is often smaller than it would be with other treatments. This, in turn, results in better cosmetic outcomes.

As soon as the affected area is declared cancer-free, your doctor will consider post-surgical options and choose the best repair for you such as:

• A small, simple wound may be allowed to heal on its own.
• A slightly larger wound may be closed with stitches.
• Larger defects or repairs in small, complex spaces (nose, ear, near the eye) may require a skin graft or a flap.
• If the tumor is very large or complex, another surgeon with special skills may be called upon to assist with reconstruction.

Importantly, all Midwest Dermatology physicians are trained in all manners of surgical repair and you and all our patients benefit from their experience in treating thousands of skin cancers over the course of their careers.

After the procedure, most patients will return to the office for quick and easy removal of stitches. Typically, our skilled nurses remove stitches at the Midwest Dermatology location most convenient to you.

The Location Factor

It might not be the first thing we think of, but a really big advantage with Mohs is that, in the vast majority of cases, we’re able to perform the surgery right in our office. This saves you time and money, and it also keeps your treatment in the hands of the caring team at Midwest Dermatology.

For larger skin cancers in difficult sites such as the eyes or ears, you may be referred to a hospital-based physician for treatment. But in the majority of cases, you can schedule Mohs surgery at our Omaha Midtown location, or at our offices in Bellevue or Norfolk.

Finally, Remember to Follow-Up!

Location also comes into play with regard to follow-up. Nearly 50% of patients with one skin cancer will develop another within five years. Follow-up is extremely important for early detection of any new lesions.

If you don’t already have something on the books, schedule your follow-up appointment when you check out from your Mohs surgery. Other convenient ways to schedule include booking an appointment online at midwestderm.com or calling (402) 933-0800 in Omaha or (402) 371-3564 outside of Omaha.