Skin Cancer: Mohs Surgery vs. Traditional Excision

Originally developed in the 1930s, Mohs micrographic surgery has evolved into the most advanced, precise and effective treatment of skin cancers. With the Mohs technique, physicians can precisely identify and remove an entire tumor while leaving the surrounding healthy tissue intact and unharmed.

Mohs surgery is the most effective treatment for most types of skin cancer:

High-risk, nonmelanoma skin cancers
Skin cancers that are recurrent or have a high risk of recurrence
Skin cancers that are large or do not have a defined border
Skin cancers in areas where you want to preserve as much tissue as possible, such as around the eyes, ears, nose, mouth, hands, feet and genitals

Compared to traditional excision for skin cancers, Mohs surgery has many benefits, including a lower cost. Here’s an overview of what Mohs surgery is and how it compares to traditional excision.

What is Mohs Surgery?

Unlike traditional excision, the process of Mohs surgery involves a series of stages. During the first stage, your doctor will mark the area of tumor. S/he will then numb the area with a local anesthetic and uses a scalpel to remove a thin layer of the cancerous tissue. The tissue sample is then evaluated in an on-site lab. You will be bandaged and asked to sit in a waiting area until your tissue is analyzed.

If your doctor finds additional areas of cancerous tissue around the edges or base of the tissue sample, you will return to the operating room for the second stage of tissue removal. You will continue this process until all the cancerous tissue has been removed. Your doctor will then decide the best option for repair of the surgical defect. In some instances, the surgical site can heal on its own.

The entire process can take several hours, but the benefits of Mohs surgery outweighs the extra time spent at the doctor’s office.

Benefits of Mohs Surgery

Mohs surgery results in a smaller scar than traditional excision

Because your doctor only removes the thinnest layer of tissue possible at a time, it ensures that you do not have more tissue removed than is necessary. This preservation of healthy skin cells means you’ll have a smaller scar than you would have with a traditional excision in which a larger amount of tissue is taken at once.

Mohs surgery produces an extremely high cure rate

The process of evaluating skin tissue in stages allows 100 percent of the tissue to be examined, where in traditional excision, only 1 percent of the edges are examined under a microscope. This ensures that 100 percent of the skin cancer is removed during Mohs surgery, resulting in a cure rate above 98 percent.

Mohs surgery is cost effective

Because the cure rate is so high, most patients only need one procedure. Patients who undergo traditional excision surgery to remove skin cancer may need repeat procedures if the cancer is not fully removed or if it returns, which can result in increased medical costs. Additionally, patients may need more thorough reconstructive surgery following a traditional excision, which can be costly.

Of course, the best way to reduce healthcare spending related to the treatment of skin cancer is to practice prevention techniques such as:

Avoiding sunlight between the hours of 10 am and 4 pm
Wearing sunscreen
Wearing protective clothing
Avoiding both indoor and outdoor tanning
Examining your skin monthly to check for signs of cancer

If you do notice something abnormal about your skin, contact your doctor. If your doctor suspects cancer, he or she can determine the right method of treatment for you.