Mohs surgery, also known as Mohs microphraphic surgery, is often used to treat both basal cell carcinoma and squamous cell carcinoma. According to the Department of Dermatology at the University of Maryland, it has a cure rate of between 95 and 99 percent. Before deciding if this type of treatment is best for you, it is important to discuss the benefits and possible disadvantages with your doctor. In addition, you should understand and learn as much as possible about what to expect before, during and after the surgery. The following are questions patients frequently ask about Mohs surgery.
What is Mohs surgery?
Mohs surgery is a specialized treatment which removes cancer in stages, one skin layer at a time. As each layer is removed it is examined under a microscope. If cancer is seen, another layer is removed. This method allows as much healthy skin as possible to remain.
Why is it called Mohs surgery?
Dr. Frederic Mohs, Professor of Surgery at the University of Wisconsin, developed this surgical technizue in the 1930s. Although the surgery has been improved and modified since then, it is still named after Dr. Mohs.
When is Mohs surgery recommended?
If you suspect skin cancer, the first step is to consult with a dermatologist, who may recommend having a biopsy done to confirm the diagnosis of cancer. Your dermatologist would be able to tell you whether you are a candidate for Mohs surgery, however, the University of Maryland Department of Dermatology indicates that Mohs surgery can be considered when:
- The skin caner is on the eye-lid, nose, lips or other areas that would require saving tissue around the cancer
- If your skin cancer has recurred after other treatments have been tried
- If your skin cancer is showing aggressive features
- When it is difficult to determine where the skin cancer ends and normal tissue begins
How is the surrounding tissue treated after surgery has been completed?
Because it is impossible to know how much tissue will be removed prior to surgery, there is no exact answer to this question. Once the surgery is completed, your doctor will determine the best way to allow your skin to heal. If only a small amount of tissue has been removed, this may mean natural healing or simply placing a bandage over the wound, without further treatment. When larger amounts of tissue are removed, you may require stitches. Your doctor will let you know when he needs to see you again for follow-up.
As with any surgical procedure, you will have a scar. The area of the surgery may be pink or bumpy for several months. Usually scars fade over time, however, if your scar does not, talk with your doctor to make sure no additional treatment is necessary.
What type of anesthesia will I need for the surgery?
This type of surgery is done with a local anesthesia. You are awake throughout the entire surgery. Some doctors may also provide a medication to help you relax during the surgery.
Where is Mohs surgery performed - in the doctor's office or in the hospital?
This would depend on your doctor. Some medical practices may have the ability to do this surgery within their offices, others use the outpatient departments of the local hospital. Talk with your doctor about where your surgery will be completed.
How long does the surgery last?
It is impossible to answer this with any accuracy because how long the surgery lasts depends on how many layers of skin must be removed. It is, however, a lengthy surgery and may take several hours to complete.
Do I need to stop medications before the surgery?
It is always important to tell your doctor about all medications, including vitamins, supplements and over-the-counter medications you are taking. Your doctor will discuss which medications should be stopped. It is always important to stop taking medications and herbal supplements that may thin your blood. These medications include:
- Vitamin E
- Fish oil or Omega-3 Fatty Acide
- Glucosamine chondroitin
Again, be sure to tell your doctor all medications you are taking and discuss which ones can be continued, which ones should be stopped and how long before and after your surgery you should avoid these medications.
What precautions do I need to take after the surgery?
Your doctor may recommend that you not participate in strenuous exercise for a period of time after your surgery. Based on how large your wound is, this may be a day or two or it could be several weeks. You will also have a bandage on your wound. Your doctor will give you specific instructions on taking care of the wound and changing the bandage. You should also have a time to visit your doctor for a follow-up to make sure the wound is healing properly.
It is usually suggested that you do not return to work the same day as the surgery but many people do return to work the following day or the day after that.
Does insurance cover Mohs surgery?
Yes, most health insurance companies will cover Mohs surgery because it is an accepted treatment for skin cancer. You may want to contact your insurance company first to make find out exactly what benefits you have under your policy as you may be required to pay deductibles or co-payments.
"Mohs Microphraphic Surgery FAQ," Date Unknown, Staff Writer, University of Maryland
"Patient FAQs," Date Unknown, Staff Writer, American Society for Mohs Surgery