An estimated 9,500 people in the United States get diagnosed with skin cancer each day. All in all, over three million individuals in the US live with non-melanoma skin cancer (NMSC) each year. Non-melanoma cancers include basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs).
Basal cell carcinomas are the most prevalent type of skin cancer in the US. Of the 5.4 million basal and squamous cell skin cancer diagnoses each year, 80% are of the basal type.
Fortunately, most skin cancers are highly treatable. For many patients, Mohs surgery is the most preferred skin cancer treatment choice.
So, what then is Mohs surgery, and what does it entail? Why do many surgeons view it as the best skin cancer treatment for non-melanoma skin cancer?
To that end, we came up with this guide listing the top reasons to consider this procedure. Read on to learn why it’s the gold standard treatment for many types of skin cancers.
Table of Contents
1. The Gold Standard for Both Basal and Squamous Cell Carcinomas
One of the first things you need to learn about Mohs surgery is that it’s the gold standard treatment for NMSCs.
In medicine, “gold standard” refers to a method most widely regarded as the “best” available. This can mean that a procedure has the highest cure or treatment rate and has the most accurate results. It can also mean that a technique suits most patients, despite their medical history.
Mohs surgery meets all these criteria, which is why it’s the gold standard treatment for BCCs and SCCs. It yields the highest treatment rate for both types of non-melanoma cancers. It’s also the most suitable procedure for patients with high-risk NMSC.
As such, most surgeons recommend Mohs micrographic surgery as the first-line NMSC treatment. They only choose other treatments if MMS is not available or suitable for the patient. Still, studies found Mohs to be appropriate in almost three out of four cases of NMSCs.
Note that some surgeons also use Mohs surgery in patients with early-stage melanoma. It’s much less common than NMSCs, but it grows at a much more rapid rate. However, if caught early, MMS can provide a 99% cure rate for melanoma.
2. Often Requires Only a Single Outpatient Surgery
One of the key differences between Mohs and excisional surgery is their timeline. With MMS, the surgeon typically performs the entire procedure in one visit. With excisional surgery, the patient has to wait for a few days prior to undergoing the procedure.
A Quick Overview of the Mohs Surgery Process
With MMS, the surgeon carries out all the steps in stages while the patient waits.
First, the surgeon examines the patient’s tissue sample using their on-site lab. This allows the doctor to determine the extent of the skin cancer and which areas it affects. The specialist can then begin the removal of the cancerous tissues right after the lab test.
The Mohs surgeon removes the cancerous tissues layer by layer, instead of “in one go.” This enables the specialist to spare as many healthy tissues as possible. The doctor then repeats the steps until only healthy tissues remain on the site.
Once no cancerous tissue remains, the doctor may either leave the wound open or stitch it up. This depends on how many layers the surgeon removed, as well as the surgery’s location.
What About Routine Excisional Surgery?
By contrast, excisional surgery requires the doctor to send a tissue sample to an off-site lab. The lab may take several days to complete the test, so patients need to wait. Once the surgeon gets the lab tests, only then can the procedure begin.
Mohs vs. Excisional Surgery
With that said, Mohs allows for the fastest treatment possible when it comes to most NMSCs. This is a vital consideration, as some types of skin cancer grow at a rapid pace. For example, experts say that SCCs metastasize in 5% to 8% of all patients.
So, the sooner you can get rid of cancerous skin tissues with MMS, the better the outcomes.
3. Precise Results
In cancerous tissues, “tumor margins” allow doctors to determine the exact areas affected. These margins are a small rim of healthy, normal tissues around the tumor. Their removal helps surgeons ensure that no cancerous tissues remain on the site.
This is an essential step in Mohs surgery, as doctors scrutinize 100% of tumor margins. This is why MMS enables them to spare as much healthy tissue as possible.
It’s also for this reason that Mohs micrographic surgery is extremely precise. Moreover, it lets doctors leave as little scarring as possible. The right skincare products post-OP can then help diminish scar appearance.
4. High Cure and Success Rate
Mohs surgery has a clearance rate of about 98% in patients with small primary BCCs. It also has a 97% clearance rate for small primary SCCs.
Other procedures for NMScs are also effective, but their cure rate isn’t as high as that of MMS. For example, the cure rate of curettage and electrosurgery is only about 90% for low-risk BCCs. What’s more, it delivers poor results for high-risk basal cell carcinomas.
5. No Contraindications
A contraindication is a specific situation that bars the use of a treatment. In skin cancers, this means that a surgeon must not use that contraindicated surgery. For example, doctors should not use curettage and electrosurgery for infected lesions.
MMS, on the other hand, has no “absolute” contraindications. So long as it’s suitable for the patient, then the patient can undergo it.
Consider Mohs Surgery for the Most Precise Results Possible
As you can see, there are plenty of reasons why you should opt for Mohs surgery. It yields the most precise results, and it also leaves the smallest scars. Best of all, it works on almost all non-melanoma cancers and even some melanoma cases.
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