Mohs Therapy—Skin Cancer

Mohs micrographic surgery is a tissue-sparing, targeted procedure of skin-cancer removal named in honor of the surgeon who developed the therapy, Frederick Mohs (Prickett & Ramsey, 2023). It is renowned for its high cure rates across a variety of skin cancers, including basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) (Prickett & Ramsey, 2023). In the procedure, the surgeon performs piecemeal removal of thin layers of skin, one-by-one, and scrutinizes each layer under a microscope toward ascertaining if there are any remaining cancer cells. The surgeon repeats this procedure until only cancer-free tissue is left. Medication will be prescribed after the procedure to reduce infection risk. Laser therapies and diligent application of high-quality skin creams can be used to remove or alleviate scars, and restore skin at treatment sites (Ng, 2024). The primary advantage of Mohs surgery is that it provides precise microscopic control of the whole tumor region while optimizing conservation of healthy tissue (Prickett & Ramsey, 2023).

Disadvantages 
Mohs Therapy does have disadvantages. Bleeding at the site of surgery is possible (Cleveland Clinic, 2022; WebMD, 2024). Additionally, there can be bleeding into the wound, hematoma, from adjacent or surrounding tissue (Cleveland Clinic, 2022; WebMD, 2024). As a result, as was suggested previously, there is risk of infection (Cleveland Clinic, 2022; WebMD, 2024). Moreover, there can be a larger than expected wound, poor wound healing, regrowth of the tumor, protracted treatment (if a larger tumor cannot be removed in one day), and discomfort from multiple anesthetic injections (Cleveland Clinic, 2022).

Risks
Aside from potential bleeding into or directly from the treatment site, pain or tenderness, or infection, Mohs Therapy can result in temporary or permanent numbness in the treatment area; weakness at the treatment site due to cutting into a muscular nerve during excision of the tumor; itching sensation or shooting pain; and the development of a raised thick scar at the treatment site (which can be remedied through medical or skin-care procedures as mentioned). Please consult with your healthcare provider before undergoing the Mohs or any other skin-cancer treatment. (WebMD, 2024)

References



Prickett, K.A. & Ramsey, M.L. (2023). Mohs microscopic surgery. https://www.ncbi.nlm.nih.gov/books/NBK441833/

WebMD. (2024). What is Mohs surgery? https://www.webmd.com/melanoma-skin-cancer/mohs-surgery
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