When it comes to treating non-melanoma skin cancers, everything old is new again. Mohs Micrographic surgery—developed in the 1930s and refined in the 1970s—is the current gold standard treatment for high-risk nonmelanoma skin cancers. Blount Memorial board-certified dermatologist and fellowship-trained Mohs surgeon Dr. Ryan Skinner explains.
“Mohs surgery has the highest success rate (up to 99 percent) of all skin cancer treatments,” says Skinner, who sees patients at Blount Memorial’s Center for Dermatology and Plastic Surgery in Alcoa. “It’s most commonly used to remove basal and squamous cell carcinomas, the two most-common types of skin cancer, and offers the added benefit of smaller scars than traditional excision procedures.”
In addition, since Mohs fellowship-trained surgeons are trained in reconstructive procedures, the approach makes it possible to reduce or even eliminate the appearance of scars using skin flaps, skin grafts, collagen injections and other techniques. Any cosmetic procedures may be performed at the same time as the Mohs surgery or at a later date.
Named for its inventor, general surgeon Dr. Frederic Mohs, the Mohs technique involves surgically removing and immediately examining (under a microscope) skin cancer layer by layer. The process continues until healthy, cancer-free tissue around the tumor is reached (called clear margins). Since the technique involves multiple steps, Mohs surgeons need to be highly skilled in cancer surgery, pathology and reconstructive surgery.
Although Mohs surgery has been around since the 1930s, longer lifespans, increased awareness of skin cancer and proven results (such as the lowest recurrence rates, highest cure rates and best cosmetic results) have helped spark a boom in the procedure. Between 1995 and 2009, the use of Mohs as a skin cancer treatment increased by 400 percent, according to the American College of Mohs Surgery.
Skinner emphasizes that Mohs isn’t appropriate for all skin cancers. In general, the technique may be recommended to treat skin cancers which:
- Develop on the nose, eyelids, lips, hairline, hands, feet and other areas where preserving cosmetic appearance and function are important
- Have recurred after previous treatment or are likely to recur
- Are located in scar tissue
- Are large
- Have edges that are ill-defined
- Grow rapidly
“I’m excited about the opportunity to bring the Mohs technique to Blount County,” says Skinner, Blount County’s first fellowship-trained Mohs surgeon. “Of course, I would prefer to identify cancers early—before the Mohs technique is needed. When we can find skin cancers early, then the surgeries don’t have to be that extensive. That’s why It’s important to check your skin regularly and to schedule an annual visit with a dermatologist.”
To make an appointment with a Blount Memorial dermatologist, call Dr. Ryan Skinner or Dr. Kemunto Mokaya at 865-238-6400.