Mohs surgery: A precise approach to treating skin cancer

A skin cancer diagnosis can feel overwhelming, especially when the cancer is located on a highly visible area, such as the face, ears or nose. Fortunately, advances in skin cancer treatment have made it possible to identify and remove cancer cells with remarkable precision while preserving as much healthy tissue as possible.

One procedure that does exactly that is Mohs micrographic surgery, often called Mohs surgery.

"Mohs surgery is the gold standard for skin cancer treatment because it provides the highest cure rates,” says Dr. Wesley Yu, a dermatologist and Mohs surgeon with Sharp Rees-Stealy Medical Group.

What is Mohs surgery?

Mohs surgery is a specialized procedure used to treat skin cancers, such as basal cell carcinoma and squamous cell carcinoma. During the procedure, a dermatologist with specialized training in Mohs surgery and reconstruction removes the cancer and examines the skin under a microscope. The process continues until no cancer cells remain.

Unlike traditional surgical removal, Mohs surgery allows the surgeon to examine tissue immediately. This approach helps ensure all cancer cells are removed while preserving as much healthy tissue as possible.

“Examining tissue carefully as we go ensures that we remove all of the cancer while conserving as much normal tissue as possible,” says Dr. Yu.

Who may benefit from Mohs surgery?

Mohs surgery is often recommended for skin cancers that:

• Are located on the face, ears, nose, lips or around the eyes

• Have a higher risk of returning

• Have unclear borders

• Are large or growing quickly

• Have come back after previous treatment

The treatment can be especially beneficial in sensitive areas where appearance and function are important.

What happens during the procedure?

Mohs surgery is usually performed as an outpatient procedure. Patients remain awake during the procedure, but the treatment area is numbed to help keep them comfortable.

The surgeon first removes the visible cancer along with a margin of surrounding tissue. That tissue is then processed and examined under a microscope. If cancer cells remain, the surgeon removes another layer only from the affected area. This process is repeated until all the cancer has been removed. Most procedures are completed in a single day.

"We are methodical and meticulous in surgery because we are often operating in sensitive areas,” Dr. Yu says. “Patience pays off though, because it yields the best results.”

What happens after the cancer is removed?

Once all cancer cells have been cleared, the surgeon discusses the best option for repairing the wound. Depending on the size and location of the treatment area, the site may be closed with stitches, reconstructed using nearby tissue, or allowed to heal naturally.

Because Mohs surgery preserves more healthy tissue than many other treatment approaches, it often results in smaller wounds and favorable cosmetic outcomes.

What should patients expect during recovery?

Most people go home the same day and can return to many normal activities within a few days, although recovery depends on the size and location of the surgical site. Some swelling, bruising and tenderness are common during the healing process.

Your care team will provide instructions on wound care, activity restrictions and follow-up visits to help ensure proper healing.

“We support patients every step of the way to make sure they heal as well as possible,” Dr. Yu says.

Why early detection matters

For many patients facing skin cancer, Mohs surgery can offer confidence that the cancer has been removed and reassurance that healthy tissue has been preserved whenever possible. Still, experts say the best outcomes often begin with early detection.

Any new, changing or concerning skin lesion should be evaluated by a primary care doctor or dermatologist. Identifying skin cancer in its earliest stages can simplify treatment and may limit the size and extent of surgery needed.

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