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Skin Cancer: Is Mohs Surgery the Right Choice?

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If you’ve been diagnosed with skin cancer, you’ll be facing some important decisions during a scary time. One of them may be whether to opt for Mohs surgery, also called Mohs Micrographic Surgery, or MMS.

It’s natural to have many questions. Let’s say you have to travel to work with a trained expert. Is it worth it? What if your cancerous growth is in a prominent place? Will Mohs surgery cause more scarring? Maybe you’re experiencing a recurrence of a previous skin cancer. Will MMS give you better odds this time?

Developed decades ago by Dr. Frederick E. Mohs, MMS is a procedure that requires the surgeon to go beyond simply removing the growth and sending it off to the lab. An MMS doctor is trained to be both the surgeon who removes the cancer, the pathologist who examines it and, often, the reconstructive surgeon.

In Mohs surgery, the doctor first removes the visible growth. Next, another layer of skin is taken so the physician can examine whether the “roots” of the cancer extend beyond what was visible on the surface. Very often they do (and that’s one reason that for so many people with skin cancer, recurrence is a real risk).

If the Mohs surgeon sees cancer cells at the fringes of the first skin section removed, he or she will mark where they are and remove another layer of skin confined to just that area, leaving the rest of the surgical site alone. The surgeon will repeat the process over and over, taking ever-smaller sections of skin until the growth and its roots have been completely removed.

According to the vast majority of skin cancer experts, Mohs surgery is the gold standard for treating basal cell and squamous cell carcinomas, both first time and recurring growths. It can also be used to treat melanoma. The American College of Mohs Surgery reports 99 percent five-year cure rates in new patients and 95 percent cure rates for recurring cancers. The ACMS says Mohs surgery is especially appropriate:

- Where healthy tissue must be saved for functional and cosmetic reasons
- Where the edges of the growth are ill-defined
- Where cancer has recurred
- Where scar tissue exists
- Where a growth is large
- Where the cancer is growing quickly or uncontrollably

Not only will you want to consider traveling to work with an expert Mohs surgeon if one is not available to you locally, you may want to choose a surgeon who has been trained at the American College of Mohs Surgery or in another one- to two-year fellowship level training program. These doctors participate in hundreds of procedures to learn how to remove growths and evaluate the pathology properly. They learn repair techniques suitable for most patients, and they know the value of calling in a plastic surgeon for challenging reconstructions. They will give you what you’re looking for in this difficult time: the best chance for a skin cancer cure with the least amount of physical trauma.

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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