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Skin Cancer Mohs Surgery

Sarah Cannon at SMC

Mohs Micrographic Surgery, Denver, Colorado

Mohs Micrographic Surgery – or Mohs – is an advanced treatment procedure for skin cancer, which offers the highest potential for recovery. It is a state-of-the-art procedure in which the physician serves as surgeon, pathologist and reconstructive surgeon who relies on the accuracy of a microscope to trace and ensure the complete removal of cancerous tissue down to its roots.

This procedure allows dermatologists who are specially trained in Mohs Surgery to see beyond the visible disease and to precisely identify and remove the entire tumor, leaving healthy tissue unharmed. Mohs Surgeon Dr. Joel Cohen, of About Skin Dermatology, recommends that patients make sure their Mohs surgeon has completed a full year of fellowship and has performed more than 500 Mohs surgeries. He adds that, "these qualifications ensure that you are under the care of a doctor that is well trained and experienced in performing this specialized surgery."

Mohs is most often used in treating two of the most common forms of skin cancer: basal cell carcinoma and squamous cell carcinoma. The cure rate is the highest of all treatments for skin cancer-up to 99 percent even if other forms of treatment have failed. This procedure, the most exact and precise method of tumor removal, minimizes the chance of regrowth and lessens the potential for scarring or disfigurement.

The Mohs Procedure

Mohs Surgery

The Mohs process includes a specific sequence of surgery and pathological investigation. Mohs surgeons examine the removed tissue for evidence of extended cancer roots. Once the visible tumor is removed, Mohs surgeons trace the paths of the tumor using two key tools: a map of the surgical site and a microscope. See the visual image of the Mohs process at the bottom of this page.

Once the obvious tumor is removed, the Mohs surgeon:

  • removes an additional thin layer of tissue from the tumor site
  • creates a "map" or drawing of the removed tissue to be used as a guide to the precise location of any remaining cancer cells
  • microscopically examines the removed tissue thoroughly to check for evidence of remaining cancer cells

If any of the sections contain cancer cells, the Mohs surgeon:

  • returns to the specific area of the tumor site as indicated by the map
  • removes another thin layer of tissue only from the specific area within each section where cancer cells were detected
  • microscopically examines the newly removed tissue for additional cancer cells

If microscopic analysis still shows evidence of disease, the process continues layer by layer until the cancer is completely gone.

This selective removal of only diseased tissue allows preservation of much of the surrounding normal tissue. Because this systematic microscopic search reveals the roots of the skin cancer, Mohs Surgery offers the highest chance for complete removal of the cancer while sparing the normal tissue. Cure rates exceed 99 percent for new cancers, and 95 percent for recurrent cancers.