Though Mohs micrographic surgery has long been used to remove basal cell and squamous cell skin cancers, surgeons were wary of using it to remove melanoma. It was feared the treatment wouldn’t remove all of the cancer. However, advances in surgical techniques has made Mohs surgery just as effective for melanomas as it is for other skin malignancies and saves much more healthy skin.
What to expect from Mohs surgery in Orange County
During Mohs surgery, a skin cancer dermatologist removes the suspected lesion along with layers of a small margin of healthy skin. The tissue is examined right away under a microscope, and the dermatologist keeps removing layers until no more abnormal cells are detected.
In the case of melanoma, doctors use an extra step to make sure that all of the cancer has been excised, especially cancer that can’t be seen with the naked eye. The melanocytes which give rise to the cancer are stained with an immunocytochemistry or immunohistochemistry stain, which allows the melanoma to be seen. This lets the doctor know if all of the cancer has been removed in the margins of the tissue or if there is more surgery to be performed. Because of this, the surgeon doesn’t have to guess how much cancer remains.
Before your cancer removal surgery
Before the surgery, the dermatologist uses a marking pen to outline the tumor along with a safety margin of skin that looks healthy. The patient is then given a local anesthetic, and the dermatologist cuts out the tissue according to the lines he or she has drawn. The amount of tissue that is taken depends on how extensive the lesion is. For example, if the melanoma is found in situ, or right on the top of the skin, the surgeon will remove about a half to one centimeter of marginal healthy looking skin. He or she will also remove the tissue down to the layer of fat. If the lesion is deeper, more marginal skin is taken, and the layers may be removed down to the fascia that covers the muscle. Still, this is less healthy tissue than was taken in older types of Mohs surgery.
The operation should take about a half an hour, depending on the size and extent of the tumor.