What causes skin cancer?

The most important factor in the development of skin cancer is sun exposure.

Why should skin cancers be treated?

The two most common types of skin cancer are basal cell carcinoma and squamous cell carcinoma. Basal cell carcinomas grow slowly. Fortunately, they rarely spread throughout the body, but can be locally destructive if not entirely removed. Squamous cell carcinomas can potentially spread to lymph nodes and other parts of the body.

Why do I need Mohs surgery when it seems the biopsy removed all the cancer?

Cancers not only grow on top of the skin, but they also have roots that are deep within the skin. Sometimes what we see on the surface is only the tip of the iceberg. The biopsy samples only the top portion of the cancer. If the roots are not removed, the cancer will continue to grow.

What treatments are used for skin cancer?

Methods available include curettage (scraping the tissue), excision (cutting the tumor out), radiation therapy, topical cream, and Mohs micrographic surgery. The treatment modality is based on several characteristics of the skin cancer, including, but not limited to location, size, aggressiveness, and recurrence. Your physician is knowledgeable of the various treatment modalities and has recommended Mohs surgery.

What is Mohs surgery?

Mohs micrographic surgery is a safe and highly effective technique whereby skin cancers are removed under complete microscopic control. In Mohs surgery, a layer of skin is removed around the visible cancer. Detailed maps are then drawn of the area, and 100% of the tissue margin is examined under the microscope to be sure all of the cancer and its roots are gone. If any cancer remains, that exact area of involvement is sampled, and the entire process is repeated until the cancer is totally eradicated.

What are the advantages of Mohs surgery?

By using the mapping technique and complete microscopic control, the Mohs surgeon can pinpoint areas involved with cancer that are otherwise invisible to the naked eye. Therefore, even the smallest microscopic roots of cancer can be removed. Benefits include

1) the ability to save a maximal amount of healthy skin tissue
2) the highest possibility of curing the cancer

In contrast, standard surgery techniques look at <1% of the margins, providing only an estimate of whether the margins are clear. Also, with standard surgery, the slides are not examined the same day, allowing the chance of finding a positive margin at an outside pathology lab and having to perform surgery at a later time to clear the margin.

What are the chances for a cure?

Using Mohs surgery, the cure rate is more than 99% for most skin cancers and 95% when other previous forms of treatment have failed. Other methods of treatment offer cure rates that are significantly lower than Mohs micrographic surgery.