In Medical Dermatology, Skin Cancer

Skin cancer affects a wide range of people. With more than one million skin cancers diagnosed each year, it is the most common form of cancer in the United States. One in five Americans will develop skin cancer during their lifetime. More than 20 Americans die each day from skin cancer, predominantly from melanoma.

Patients whose cancer is detected early or before the tumor has penetrated the outermost layer of the skin often have a high survival rate. You can help prevent skin cancer by understanding proper sunscreen use and getting annual dermatology check-ups to safeguard your skin from this disease.

Should you develop skin cancer, there are options for treatment. The physicians at Columbia Skin Clinic treat patients by performing a type of skin cancer surgery called Mohs surgery, which has the highest cure rate of all removal methods.

What is Mohs surgery?

Mohs micrographic surgery was developed in the 1930s by Dr. Frederic Mohs and is considered the most effective technique for treating many squamous cell carcinomas and basal cell carcinomas, the two most common types of skin cancer.

The procedure is completed in stages, all in one office visit, while the patient waits. Our surgeon will start by removing a layer of tissue, then examining it under a microscope in an in-house lab. If he detects any cancer cells on the margins of the tissue, the surgeon will know exactly where the cells are located and can remove another layer of tissue from that precise location. The doctor then repeats the process until no cancer cells are detected in that part of the body.

Mohs surgery is the only type of treatment in which the doctor can see exactly where the cancer stops, sparing as much healthy tissue as possible. Saving healthy tissue is especially important when cancer develops in areas with a small amount of tissue beneath the skin, such as the eyelid, ear or hand.

Mohs surgery is used for people with skin cancer with a high risk of recurring and in areas around the eyes, ears, nose, mouth, hands and feet so that the surgeon can keep as much healthy tissue as possible.

What is it like to have Mohs surgery?

Columbia Skin Clinic can perform most Mohs procedures right in our medical office. The patient will be admitted to the hospital if extensive surgery is needed. Patients are given a local anesthetic that numbs the area where the tissue will be removed. Patients can stay awake and alert during Mohs surgery.

While the anesthetic takes effect, the surgeon will examine the affected area. Then the surgeon will start by cutting out the visible skin cancer and removing a thin layer of the surrounding skin. The patient is bandaged while the surgeon examines the removed skin under a microscope, looking for cancer cells. If cancer cells are found, the surgeon will remove another layer of skin.

The entire process can take several hours, depending on the severity of the cancerous cells. Once our Mohs surgeon no longer detects cancer cells, they will determine how to treat your wound. Some wounds will heal without stitches. Other areas may require stitches.

Some patients may require a skin graft or other type of surgery to minimize scarring and help the area heal.

What are the results?

A dermatological surgeon is concerned with not only removing the cancer but also minimizing scarring. Mohs offers the best cosmetic results of any skin cancer treatment because the least amount of skin is removed to treat squamous cell skin cancers and basal cell carcinomas. Preserving healthy tissues also leads to faster recovery times. Although Mohs surgery is not appropriate for treating all skin cancers, it is the most effective for recurring skin cancers or cancers with a high risk.

Where can I have Mohs surgery?

At Columbia Skin Clinic, our board-certified, fellowship-trained Mohs surgeon serves as both the pathologist and reconstructive surgeon. We understand that skin cancer can be a scary diagnosis. Our physicians and staff are here to walk you through the treatment process and treat your specific case.

For more information about what is Mohs surgery, schedule a skin cancer screening at at Columbia Skin Clinic. Make an appointment today at one of our four Midlands locations.

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