Surgery to Remove Skin Cancer

Mohs Micrographic surgery has withstood the test of time, remaining the best way to treat certain types of basal cell and squamous cell skin cancers.  Mohs—developed by general surgeon, Frederic E. Mohs—is microscopically controlled surgery used to treat common types of skin cancer. During Mohs surgery, the surgeon can see where the cancer stops.

This ability gives the Mohs surgeon two important advantages:

  • Mohs surgery has a high cure rate
  • Surgery allows you to keep as much healthy skin as possible because the surgeon only removes the skin with cancer cells

Surgery to Remove Skin Cancer

Basal cell and squamous cell skin cancers (referred to as nonmelanoma skin cancers) are incredibly common. With more than 3 million cases per year in the US alone!  Most of them can be treated with simple surgical techniques or even medication at times.

The best news is that it’s rare for nonmelanoma skin cancers to spread (metastasize). However, they can grow quite large and destroy surrounding tissues. Some types of nonmelanoma skin cancers can be particularly hard to remove. These include:

  • ones that have come back after previous treatments
  • areas that have higher rates of aggressive growth (like the head and neck)
  • others with especially aggressive microscopic features

For these particular basal and squamous cell skin cancers, Mohs surgery is often ideal because with its microscopically-driven stages of cancer removal the highest cure rates possible are achieved.

Standard Removal of Skin Cancer

A standard removal of a skin cancer is called an excision. With the excision technique, the removed piece of skin is processed overnight, and the margins are examined by what is called “breadloafing.”  In breadloafing, the margins on that piece of skin are microscopically analyzed at intervals along the original specimen. These are slices through the specimen, just like you’d slice a loaf of bread.   Though this treatment is sufficient for many skin cancers—for ones in higher risk circumstances noted above, we worry ABOUT THE SPACES BETWEEN THE SLICES.

Mohs Surgery to Remove Skin Cancer

This is where Mohs Surgery comes into importance. With Mohs, the microscope is king.  By using special rapid processing techniques, we can examine 100% of the edges of the specimen that very same day. In Mohs Micrographic surgery, the dermatological surgeon acts as both the surgeon and the pathologist by both removing the skin cancer and examining it microscopically.  In stages, the Mohs surgeon can identify areas which still contain cancer, map these out on a diagram, and remove more skin where necessary, repeating the process until a patient is free of cancer.

Advanced Dermatology of the Midlands Omaha & Council Bluffs

At Advanced Dermatology of the Midlands we perform Mohs surgery to remove skin cancer on a near daily basis. Monday through Friday.  We utilize our state of the art CLIA-certified laboratory to prepare and examine skin cancer specimens during the Mohs surgery procedure.  In addition to being board-certified dermatologists, both Dr. Mathew Davey and Dr. James Shehan are fellows of the American Society for Mohs Surgery.  Through the education and certification of this organization they are highly trained in the techniques of Mohs micrographic surgery.  Collectively they have more than 20 years total experience performing this procedure.

Patient Experience

Though their diligence in performing the surgery in a precise and meticulous way is extremely important to them, the overall patient experience is equally as important.  We recognize that two of the greatest challenges for patients can be:

  • discomfort from the procedure
  • the time it takes to wait as specimens are processed

Because of this, we have implemented several different techniques to reduce patient discomfort with local anesthesia which have been successful in our practice.  As far as the time in waiting goes, we have both cable television and Wi-Fi available in all our surgery rooms. These things help the time pass much more smoothly for all our patients while Mohs surgery specimens are processed.

If you have spots that are worrisome for skin cancer or questions about whether Mohs surgery is right for you, we would be happy to help at Advanced Dermatology of the Midlands.

For any information or to make an appointment please contact us today.