We have been talking about Mohs surgery here on Skin Cancer Connection because it is a very popular type of surgery for those who have certain types of skin cancer. It is most often done to remove Basal Cell Carcinomas or Squamous Cell Carcinomas , and particularly those lesions on the face.
The advantage of this type of surgery is that it is done as an outpatient procedure using local anesthesia, and the doctor will remove all the cancer while you are still in the office. You will not have to go home and wait for results from a biopsy, as the doctor will immediately look at the excised skin tissue under the microscope while you are still there. If the doctor sees more skin tissue which is cancerous, it will be taken out right then and there. The doctor will leave as much healthy skin surrounding the tumor as possible, minimizing scarring.
Probably the best advantage of Mohs surgery is the cure rate. According to The American Society for Mohs Surgery five-year cure rates approach 99% for new cancers and 95% for recurrent cancers. When you leave your doctor’s office after having Moh’s surgery you can feel fairly confident that your doctor has removed all of the cancer.
Perhaps your doctor has suggested Mohs surgery as a possibility for you. But before you have your surgery it is wise to do your own research to know more about this procedure as well as other options. It is also a good idea to prepare a list of questions for your doctor so that you understand what will happen during your surgery and more importantly, what you can expect afterwards. We are here to help you to become a more empowered patient by providing both information about Mohs surgery and also a suggested list of questions for your doctor.
- What are your credentials and what training have you had to perform Mohs Surgery? How many of these surgeries have you done?
You want to make sure that the doctor you are entrusting to do your Mohs surgery is the best person for the job. The American Society for Mohs Surgery has a surgeon locator where you plug in your zipcode to find a specialist near you. The American College of Mohs Surgery also has a surgeon locator on their web site. At the very minimum your doctor should be Board certified in dermatology by the American Board of Dermatology or the American Osteopathic Board of Dermatology. The American College of Mohs Surgery recommends that the surgeon have undergone at least one year of fellowship training beyond dermatology residency.
- Do I have any other treatment options for my particular skin cancer? What is the cure rate for these other options?
For some types of skin cancers topical chemotherapeutic creams may be used such as Aldara. For more information about this type of skin cancer treatment please read Dr. Kevin Berman’s article, "Efudex, Aldara and Other Skin Cancer Topical Creams ."
- What is the chance for my skin cancer to return? And if so, what do we do then?
Your doctor will not be able to predict the future with 100% accuracy but he or she should be able to quote you some statistics about the risk of re-occurrence for your particular skin cancer and also what you need to look out for to indicate that it has returned.
- What will my scar look like?
It is likely that there will be some type of scar from this procedure and you want to find out what factors are involved in minimizing the scar during the healing process. Our Doctor Kevin Berman attempts to answer this question in his post entitled, "Mohs Surgery: What Will the Scars Look Like? "
- Should I have a plastic surgeon on hand to close the hole after the tumor has been excised?
This may be an option you wish to consider especially if the amount of skin tissue to be removed is large or on the face.
- How long will it take for me to heal completely? What is normal and what is not normal to expect during the healing process?
You will want information about what to expect following your surgery as far as how long it takes to heal and what you may see as far as skin changes due to normal healing. You will also want information about potential complications such as an infection. You will want to ask your doctor when you should expect to return for a follow up visit after your surgery.
These are just some of the possible questions you may have for your doctor prior to your Mohs surgery. It is always good to be prepared and to make a list of questions you want your doctor to answer. This way you will feel more confident about undergoing the procedure. It can be anxiety provoking to undergo any type of surgery and knowing what to expect can ease that anxiety. If you have had Mohs surgery and would like to talk about it, please do share your experiences here. We absolutely want to hear from you
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