What You Need to Know About Mohs Surgery

by Anne Windermere Patient Advocate

One of the most popular topics here on Skin Cancer Connection is about Mohs Surgery.

For example, the post entitled, "Mohs Surgery:
What will the scars look like?"
resulted in over 160 comments by members, some of whom have been coming to post their comments over the months and years about their experiences with this type of surgery.
One of those members is "Gemma" who has been dutifully reporting about her recovery process from her Mohs Surgery which took place in September 2009.
Gemma graciously agreed to do an interview with us to tell her story which you can find here:
"What it is like to have Mohs Surgery."

Due to the increased interest in this type of surgery, it seems wise to give you more information about Mohs Surgery.
This post will attempt to answer to some of the more commonly asked questions about this type of surgery.

What is Mohs Surgery?

Mohs micrographic surgery is named after Dr. Frederic E. Mohs who first developed it at the University of Wisconsin in the 1930's to remove certain types of skin cancer.
What was once a painful procedure often taking days, Mohs surgery is now is done as an outpatient procedure under a local anesthetic while the patient is still awake, usually within the span of a few hours.
The American College of Mohs Surgery
describes this type of surgery as: "... one of the most advanced and effective treatment procedures for skin cancer available today."
The surgeons who do this type of surgery are very specialized and are supposed to have a three-year dermatology residency and at least one year of post-residency fellowship training in Mohs surgery.
The popularity of Mohs surgery is due to the fact that you leave your doctor's office with confidence that they got all the cancer.
The surgeon will remove the entire tumor and examine it while you are still there.
If any more excision is necessary they will do it there and then.
The surrounding healthy skin tissue is left intact.
The method is precise and is quite often used for skin cancers of the face.

What is the success rate for Mohs Surgery?

The Skin Cancer Foundation
cites cure rates of 95-97 percent.
The American Society for Mohs Surgery
states that:
"Clinical studies have demonstrated that Mohs surgery provides five-year cure rates approaching 99% for new cancers and 95% for recurrent cancers."
The American College of Mohs Surgery
share the same statistics from clinical studies showing success rates of up to 99 percent.
These are very good odds considering that other methods of skin cancer removal have much lower cure rates.

What types of skin cancers are treated by Mohs Surgery?

Your doctor or dermatologist may recommend Mohs Surgery for the following reasons:

  • You have basal or squamous cell carcinomas

  • The cancer is in a sensitive area where you want to maintain the best cosmetic and functional results such as eyelids, nose, ears, lips, hairline, fingers, toes and genitals.

  • You had cancer which was treated but it came back.

  • The cancer is aggressive and growing at a rapid pace.

  • You have skin cancer containing scar tissue.

  • You have large skin cancers.

  • You have skin cancers with borders which cannot be easily defined.

Your doctor will look at a number of factors to determine if Mohs surgery is right for you.

What are the advantages of having Mohs Surgery?

  • Some skin cancers can have roots extending far below the skin which are not obvious upon prior removal using another procedure. These roots can grow deep under scar tissue. Mohs surgery will remove these cancerous roots.

  • Mohs surgery will remove only cancerous tissue while normal healthy tissue is spared.

  • Mohs surgery has a high cure success rate.

  • This procedure is performed on an outpatient basis using only local anesthesia. The Skin Cancer Foundation reports that: "Since the mortality rate is almost zero, elderly patients in poor heath can be treated safely. Most patients do not have to be hospitalized and can be managed on an outpatient basis. The surgery can usually be completed in half a day or less."

  • Because Mohs surgery is so precise, it can minimize the chance for the cancer to come back and also lessens the potential for scarring or disfigurement.

We will be talking more about Mohs Surgery in the weeks to come.
If you have had Mohs Surgery or if you are a dermatologist who has performed Mohs surgery and you would like to be interviewed, please contact me through a comment here or through on-site email under my profile.
Thank you to all the members of Skin Care Connection who share their story with others.
It really does help.

References and Resources:

American College of Mohs Surgery

American Society for Mohs Surgery

Skin Cancer Foundation

Anne Windermere
Meet Our Writer
Anne Windermere

These articles were written by a longtime HealthCentral community member who shared valuable insights from her experience living with multiple chronic health conditions. She used the pen name "Merely Me."