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Skin Cancer Mohs Surgery

Updated on August 25, 2016
Basal cell carcinoma
Basal cell carcinoma | Source
Squamous cell carcinoma
Squamous cell carcinoma | Source

Just recently I noticed a strange raised spot under my left eye. Another was just above my left eyebrow. I was not too concerned, since I have had a few precancerous growths removed by my dermatologist without them growing back. My skin is very fair, and as a teenager, I remember laying out in the sun during the hot months of the summer to get a golden tan. Also, I have lived in the South Pacific Islands for the last forty years, and I am exposed to the sun almost year round. However, these spots were a bit different.

I visited my dermatologist and showed her the areas on my face that looked unusual. She looked carefully and decided to burn them. This involves taking a metal instrument and zapping the suspicious area, or using liquid nitrogen, both of which hurt. Since the spot is so close to my eye, it made my tears start to flow (I was not really crying!). After about six weeks, I returned to my dermatologist to show her that both growths had reappeared. She then informed me that she would do a biopsy to see if it was indeed cancerous.

This was the first time I had a growth that came back after "burning" it. I then was told about Mohs Micrographic Surgery. It is the latest advancement in health technology for those with squamous cell or basal cell carcinoma.

I used to work in a Pathology Department of a hospital. I was aware of skin biopsies and knew the histologist well. He would take the biopsy, freeze and slice the specimen, and then mount it on a slide for the Pathologists to inspect. They would then make a diagnosis depending on the pattern of the cells found in the tissue. This old way of handling skin cancer often took several days for results before treatment could begin, and if any cancer was missed - another surgery had to be done. With the Mohs method, the physician can potentially get all of the cancerous cells the first time. Also, they are trained in the best way to treat the area after surgery for less scarring.

Who discovered Mohs Surgery?

Dr. Frederic Mohs developed this technique in the 1940s, but it has undergone many improvements and refinements to become an effective and efficient way to treat skin cancer.

The tissue is removed in layers and examined carefully. The edges of the tissue are dyed and mapped out and processed onto slides. While the patient is still waiting, the specimen is studied carefully under a microscope to determine if all of the cancer cells have been removed. If the edges show any malignant cells, another layer of skin is taken, and the process repeated until no more cancer cells are detected. The surgeon leaves as much healthy skin as possible.

Training for Mohs Surgery

Doctors who train for this technique undergo at least a year beyond their dermatology residency to learn this specialized process. They are trained specifically in:

  • Removing skin cancer
  • Mapping and analyzing microscopic tissue
  • Repairing the wound and reconstruction to minimize scarring

What is Success Rate?

Mohs surgery patient have 99 percent cure rate for those with basal cell carcinoma and 95 percent cure rate for those with squamous cell carcinoma.

Who can benefit most from Mohs Surgery?

  • Skin cancer that is on the eyelids, nose, ears, fingers, toes, lips and genitals is best treated with Mohs to preserve function and appearance.
  • Those with recurring skin cancer
  • Those with large skin cancers or those with scar tissue within cancer area
  • Those with rapidly growing or uncontrollable skin cancer (sclerosing or infiltrating).

I am glad that I live in a time where technology has improved for those with skin cancer. If my diagnosis is positive for carcinoma (which I am not hoping for), I will have the chance to tell you my personal experience with Mohs Micrographic Surgery. Wish me luck!


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  • elayne001 profile image

    Elayne 6 years ago from Rocky Mountains

    Thank you Laura in Denver. Sorry to hear - actually here in Hawaii it is also prevalent amongst the whites (who are actually the minority) because of the year-round sun and trips to the beach.

  • Laura in Denver profile image

    Laura Deibel 6 years ago from Aurora

    Informative article. I live in NM and CO Rocky Mountain regions where skin cancer is prevalant.

  • elayne001 profile image

    Elayne 6 years ago from Rocky Mountains

    Thank you LianaK for your positive comments. I am glad to know Mohs surgery can help so many people. Aloha!

  • LianaK profile image

    LianaK 6 years ago

    Glad to hear that all is well. This information is very interesting and sounds like a great option to those who need it. Thank you for the wonderfully informative hub!

  • elayne001 profile image

    Elayne 6 years ago from Rocky Mountains

    Yes, thoughtforce, that is the worse part, and they called today to let me know the growth is not malignant. Great news! Thanks for your vote and comments.

  • thougtforce profile image

    Christina Lornemark 6 years ago from Sweden

    This is great information about a rapidly growing cancer form all around the world! It is so good to know there are modern and good treatments today. I wish you all the luck and hope it will turn out well! The worst part is when we have to wait for the diagnose,

    Voted up, useful


  • elayne001 profile image

    Elayne 6 years ago from Rocky Mountains

    I do hope it helps someone, donald1960. That Mohs guy is a very clever person to think of this method. I appreciate your comments.

  • Donald1960 profile image

    Donald 6 years ago from United States

    Hi elayne001,

    this Hub is really great. There are many people around the world who will find all benefits of Mohs surgery because of you. Nice work...helping people!

  • elayne001 profile image

    Elayne 6 years ago from Rocky Mountains

    Thank you to both Pamelas. I appreciate your interest and comments.

  • Pamela Kinnaird W profile image

    Pamela Kinnaird W 6 years ago from Maui and Arizona

    Hello. I hope all is well with you -- that the diagnosis you receive or have received is all clear. Thank you for explaining this kind of treatment.

  • Pamela99 profile image

    Pamela Oglesby 6 years ago from United States

    Skin cancer is such a common problem and I think your hub explained the problem and the treatments very well. I have had pre-cancerous growths removed twice but that has been about 3 years ago. The cure rate is impressive and I liked your video. Great hub.