Russell Akin, MD | Board-Certified Dermatologist | Fellowship-Trained Mohs Surgeon | Midland, Texas
A skin cancer diagnosis can be a scary and uncertain time for many people. Mohs surgery, a skin cancer removal procedure, may be the best skin cancer treatment option for you or your loved one. In today’s post, I am going to share information about Mohs surgery and what Mohs surgery means for patients with skin cancer.
What is Mohs Surgery?
Mohs surgery is a surgical technique for skin cancer removal that relies on a complete margin evaluation of the tissue to allow for higher cure rates. Essentially, Mohs surgery removes thin layers of cancer-infected skin until cancer-free skin remains.
Mohs surgery can be used to remove skin cancers in various areas, such as the face, ears, nose, hands, feet, fingers and genitalia, where tissue preservation and removal of only the cancer-infected skin leads to improved cosmetic appearance.
The goal of Mohs surgery is to evaluate 100 percent of the tissue margin, standard breadloafing of skin specimens reportedly evaluates less than 1 percent of the margin.
What is the History of Mohs Surgery?
Mohs surgery was developed in the 1950’s by Fredrick Mohs, MD, who was seeking a solution to incomplete margin evaluation of tissue examination. In the 1980’s, frozen section processing was incorporated into the process to allow for preparation of the tissue for evaluation in less than 30 minutes. As a result, Mohs surgery allows the tumor to be removed in a timely and efficient manner with complete margin evaluation.
During the last 10 years, immunohistochemistry stains have been added to Mohs surgery to remove superficial melanoma skin cancer with this margin technique to allow evaluation of the margin in a more efficient way, compared to permanent sections that can take 2-4 days for the patient to receive results.
In turn, ill-defined melanomas can be removed with confirmation of negative margins in a timely manner, which allows for immediate reconstruction. Increased adaptation by ACMS fellowship-trained Mohs surgeons has allowed for more widespread availability of this technique.
Mohs Surgery Education & Training
Fellowship training in Mohs surgery was developed by American College of Mohs Surgery and was transferred to the Accreditation Council for Graduate Medical Education before 2010. The fellowship program is a one-year intensive-training program involving Mohs surgery and reconstruction after tumor removal. Fellowship training is the standard of training in Mohs surgery. Board certification will soon be available for Mohs surgery and Cutaneous Oncology fellowships, but not all board-certified Mohs surgeons will be fellowship trained initially, and this is an important distinction for patients to understand.
Initially, any physician performing Mohs surgery will be able to sit for the exam for five years after, and only fellowship-trained physicians will be allowed to sit for the examination. In the future, it will be important for patients to know that their surgeon is fellowship-trained and board-certified, and seek out physicians for care that are experienced and well-trained.
Is Mohs Surgery Right for Me?
Not all skin cancers should or need to be treated with Mohs surgery. Mohs surgery is primarily for invasive skin cancers on the head and neck, recurrent skin cancers, larger skin cancers on the trunk and extremities, or more aggressive subtypes of skin cancers. Other superficial skin cancers and small or less aggressive skin cancers can be treated with excision, curettage, superficial radiation or topical chemotherapy medications.
If you’re interested in learning more about what skin cancer removal procedure is right for you, schedule an appointment with board-certified dermatologist and fellowship-trained Mohs surgeon, Dr. Russell Akin at Midland Dermatology in Midland, Texas. For more information or to schedule an appointment, call our clinic at 432-689-2512.