What is Mohs surgery?

A number of treatment modalities can be used to treat skin cancer, including topical chemotherapy creams, electrodessication and curettage, surgical excisions, radiation therapy, and Mohs Micrographic Surgery, You want your skin cancer treatment to be performed with a trained Mohs surgeon.

Mohs Micrographic Surgery is a special tissue sparing technique used to treat skin cancer and is the most effective treatment for most types of skin cancer.  Dr. Friedrich Mohs first developed the technique in the 1930s, and is currently the most advanced precise and effective treatment for a variety of skin cancer types.

Mohs Micrographic Surgery is the only type of skin cancer removal where 100% of the surgical margin is examined, and consequently, the technique has a 98% cure rate for the treatment of basal cell carcinoma and squamous cell carcinoma, the two most common types of skin cancer. The technique allows the physician to precisely identify and remove the entire tumor while leaving the surrounding healthy tissue intact.

During Mohs Micrographic Surgery, the physician identifies the cancer or biopsy scar, and an initial thin layer of tissue is removed from around the area.  The tissue is then processed in the on-site lab and generates slides. The physician examines the slides under the microscope and maps out the position of any residual tumor, if any, to the respective location on the skin. If there is residual tumor, the surgeon removes another layer of tissue at the location of where they saw tumor, but leaving the healthy tissue intact.

This process is repeated until the cancer is completely removed. Once the cancer has been entirely removed, the Mohs surgeon performs reconstructive surgery to repair the area and minimize scarring. This entire process is completed in one outpatient appointment.

For more information, watch the Mohs Patient Education Video from the ACMS (American College of Mohs Surgery) About Mohs Surgery | American College of Mohs Surgery

Frequently asked questions about Mohs Micrographic Surgery

How do I know if I need Mohs Micrographic surgery?

• the cancer has developed on areas where preserving cosmetic appearance and function are important – such as the face, neck, shins, hands/feet, and/or genitals
• the cancer has been unsuccessfully treated or has been treated before and has recurred
• the cancer is located in scar tissue
• the cancer is large or has ill-defined borders
• the cancer appears to be growing rapidly

Why choose a fellowship trained Mohs surgeon?

Mohs surgery offers the highest cure rate among treatments for many types of skin cancer. For dermatologists with a special interest in skin cancer, there are specialized fellowships in Mohs surgery. Qualified applicants must undergo a highly competitive application and interview process. ACGME- (Accreditation Council for Graduate Medical Education) accredited and recognized Mohs fellowships require that a fellow log over 500 Mohs surgery cases and meet rigorous educational standards in pathology, surgery, and reconstruction. After completing a recognized fellowship, a Mohs surgeon is then eligible to apply for membership in the American College of Mohs Surgery (ACMS). The distinction is in the education, training, and experience.

Although many physicians can perform Mohs surgery, a fellowship is not currently required.  When finding a Mohs Micrographic Surgeon, look for the American College of Mohs Surgery.  To find out whether a physician is a fellowship-trained member of the ACMS, please visit http://www.mohscollege.org/surgeon-finder/disclaimer.php

Photo Credit from ACMS. www.MohsCollege.org