Whether you are a patient or a healthcare employee, it is important to beeducated about one of the more common ways for treating skin cancer in 2011.With summer having passed us by, and many dermatology skin check appointmentson the schedule, understanding Mohs micrographic (Mohs) surgery will helpnurses both personally and professionally.
Mohs Surgery Simplified
Through this specialized surgery, common forms of skin cancer are excisedusing an effective, tissue-sparing technique. It provides a 97 to 99.8% curerate for basal cell carcinoma, the most common form of skin cancer, and aslightly lower cure rate for the more aggressive squamous cell cancer.
The Benefits
Mohs surgery is a cell-specific treatment that assures clean tissue marginsaround the tumor site before the wound is closed. Simply translated, all of thecancer cells are removed and healthy, non-diseased tissue is left around theoperative site.
The surgery is completed in one visit, albeit often a long one, with localanesthesia. In most cases, there is no general anesthesia or overnight hospitalstay, but keep in mind, there are always exceptions.
Basics of Mohs Surgery
Once a biopsy-confirmed diagnosis is made, it is most important to find aspecially trained Mohs surgeon. This task can be accomplished through theAmerican Society for Mohs Surgery, the American College of Mohs Surgery or thediagnosing dermatologist or surgeon via a referral.
Through this highly specialized surgical technique, the excision is done instages, essentially layers, until the entire tumor is removed. As little tissueas possible is painstakingly removed with each stage of surgery. Here is how itis done:
The diseased area is numbed with a sufficient amount of local anesthesia Thevisible tumor is excised and prepared on slides for analysis by an on-sitepathologist If there are clean margins around the excised tissue, the wound isclosed and the surgery is complete If tumor cells still remain, the patientreturns to the surgical suite for removal of another layer of diseased tissuewithin the wound The pathologist, again, analyzes the excised tissue and theprocess is repeated until clean tissue margins are confirmed The surgical siteis closed with cosmetic reconstruction by the Mohs surgeonThe End Result of Mohs Surgery
Dr. Frederic E. Mohs first performed this surgical technique, then calledchemosurgery, in 1936. At that time, a 20% zinc chloride paste was used on thediseased area overnight, causing painful erosion of the tumor; the area wasexcised the following morning. Seventy-five years later, the procedure has beendramatically refined and perfected.
In 2011, choosing this technique for skin cancer tumor removal allows tissuepreservation to be optimized and scarring to be kept to a minimum. This highlyeffective treatment might be the right option for you or your patient. Discussthis and all available treatment options with your health care provider to makethe best decision moving forward.
One more thing–regardless of the season, always wear sunscreen with SPF 15or higher to protect your skin from the sun’s harmful ultraviolet (UV)rays.