Mohs surgery is the state of the art treatment for basal cell and squamous cell skin cancer, and is increasingly becoming the treatment of choice for excision of melanoma skin cancers. Mohs surgery was introduced by Dr. Frederick Mohs in the 1930s but until the last couple of decades was not used as frequently as it is today.
Why is Mohs surgery so effective?
Mohs surgery is so effective because it expunges cancer cells in the skin and yet spares the greatest amount of healthy skin tissue. With Mohs surgery the cure rates for basal cell carcinoma and squamous cell carcinoma are now 98 percent or higher, better than any other accepted method.
Mohs surgery is different from other excision techniques in that during the surgery all excised tissue is examined under the microscope, one thin layer at a time. This allows the skin cancer dermatologist to accurately assess how deep and wide the skin cancer has spread, thereby allowing for removal of only the cancer cells while leaving as much healthy tissues as possible untouched. There is no guesswork about what tissue is cancerous and what is non-cancerous. This makes for a better outcome both medically and cosmetically.
Mohs was rarely used for melanoma surgery in the past because of the fear that some melanoma cells would be missed and later spread to other parts of the body. Now the surgeon is able to identify melanoma cells by the use of special stains that highlight the cells so that they are visible under the microscope. This has led to a revolution in melanoma surgery, and more Mohs surgeons are using Mohs micrographic surgery with certain melanomas. Since melanoma and other skin cancers are becoming increasingly common, the Mohs technique will play a larger role in treatment than ever before.