Mohs Surgery

Mohs Surgery
By Hanna Sutton

     “You get to keep all your skin today!” remarks certified nurse practitioner Kristen Wozniak (who works in Derick Dermatology’s Barrington and Elgin locations) after a successfully clear skin exam of a patient. After all, that is the best case scenario when a patient comes in for an annual checkup with his or her dermatologist. However, not all patients are so lucky. Patients whose skin has been exposed too much to the sun or who simply have unlucky genes often end up losing skin to the shave biopsy Dermablade, or a high-pressure canister of liquid nitrogen, or even a scalpel in the case of skin cancer removal. Due to advancements in dermatological surgery, the good news is that there is an advanced technique that allows patients diagnosed with non-melanoma skin cancer to keep much more of their skin. The advanced technique is Mohs Surgery.

     In 1936, Dr. Frederic Mohs treated the first patient with his revolutionary technique that involves excising thin layers of tissue from an affected area. The tissue is then frozen and stacked on slides in preparation for on-site pathological examination, all of which takes place while the patient waits in the office. Since the pathology results are quickly available, the surgeon can decide whether or not to excise deeper tissue in stages, all in the same office visit. Subsequent layers of skin are excised until the pathology results are cancer-free. This technique was coined Mohs Surgery in 1953 and then was refined and popularized in the 1980s by Dr. Perry Robins, the founder of the Skin Cancer Foundation.

     The advantages of Mohs surgery are clear. It is the crown jewel of skin cancer procedures for effectiveness. Mohs surgery boasts a much higher cure rate than more traditional skin cancer excision surgery, as well as a lower rate of recurrence. Since Mohs surgery is done in stages, little tissue is excised beyond what is absolutely necessary. Consequently, Mohs surgery leaves patients with more cosmetically pleasing results. Less skin excised from the area makes for a speedy recovery as well leaving a much less noticeable scar. Since the skin is the largest organ of the body, and also the most visible, cosmetic integrity is always a concern in dermatological procedures.

     According to the American Cancer Society, basal cell carcinomas and squamous cell carcinomas (more commonly known as non-melanoma skin cancers) are most commonly found on the face, neck and shoulders. These areas are not only the most exposed to the sun but also of most cosmetic concern. Non-melanoma skin cancers of the face and neck are considered to be intermediate-to-high-risk skin cancers and therefore often recommended to be treated with Mohs surgery. Not only will Mohs surgery likely remove all of the skin cancer, but it will also leave minimal scarring in cosmetically sensitive areas. Mohs is also recommended to patients with skin cancers that demonstrate challenging margins as well as particularly large cancers that are in otherwise low-risk areas such as the arms and legs.

      As with every form of skin treatment, Mohs surgery has some downsides, notably time. Because pathology is performed on-site, the office visit is time-intensive for both the surgeon and the patient. The reward is that the skin cancer is gone when a patient leaves the office—a wonderful outcome given that one in five adults in America will be diagnosed with a non-melanoma skin cancer at some point in their life.

     Employing two of the six Mohs surgeons to receive the Top Skin Cancer Doctor 2017 award in Chicago, Derick Dermatology has embraced the advancements that Mohs surgery has made in fighting skin cancer. Dr. Jessica Sheehan and Dr. Tracy Campbell are both board-certified Mohs surgeons and successfully perform this procedure on a regular basis in Derick Dermatology’s Elgin and Arlington Heights offices. If you have recently been diagnosed with non-melanoma skin cancer and want to learn more about Mohs surgery, please call Derick Dermatology at 847-381-8899 for a consultation.