The increasingly common occurrence of skin cancer today is not surprising. Driving factors include overexposure to the sun’s rays, aging, and tanning bed use. The most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, or melanoma. Melanoma is the deadliest skin cancer, but it’s the non-melanomas that account for more than 90% of all skin malignancies.
According to the Skin Cancer Foundation, Mohs surgery, sometimes referred to as Mohs micrographic surgery, is considered the most effective technique for treating many basal cell carcinomas and squamous cell carcinomas. The procedure is done in different stages, including lab work, while the patient waits. This allows for the removal of all cancerous cells, giving the patient the highest cure rate while also sparing healthy tissue and leaving the most minimal scar possible . This is especially important given the typical location of basal cell carcinomas and squamous cell carcinomas: sun-exposed areas such as the face, ears, neck, lips, and backs of the hands.
During a typical, non-Mohs excision, the surgeon is using standard larger margins and guessing how much skin to cut, trying to ensure that they get it all and see clean margins. If they find cancer within those margins, the patient will have to come back again usually a week or more after the initial surgery for a larger and deeper excision. There is also the possibility that the pathologist may believe that the surgery achieved clean margins, when it didn’t. Non-Mohs excisions with traditional pathology examine less than 1/100th of the true margin of a tumor. This leads to a recurrence rate of 8-10% for non-Mohs excisions.
In contrast, with Mohs surgery, each layer of the removed tissue is frozen, cut tangentially into thin slices, and examined entirely under the microscope by the surgeon. Mohs surgery pathology examines 100% of the surgical margin. The cure rate for most common skin cancers with Mohs surgery is 98-99%. In essence Mohs surgery provides the highest cure rate while removing the least amount of normal tissue which simplifies final reconstruction.
Along with a high success rate, Mohs surgery is also an affordable option for patients. Because Mohs surgery combines the removal, pathology and reconstruction of a tumor into one procedure there are significant savings over other procedures which may involve several separate providers. Also, because Mohs surgery provides the highest cure rate it is more definitive than other procedures. Ensuring a cure from skin cancer with Mohs surgery reduces recurrences and repeat visits for patients. Given the cure rate and simplification of reconstruction that Mohs provides, Mohs surgery is a very cost-effective procedure.