The Ultimate Guide to CCPDMA and Mohs Surgery for Skin Cancer Treatment

Advanced Skin Cancer Removal Techniques

Skin cancer is the most common cancer in the United States, with over 5 million cases treated each year. When caught and treated early, most skin cancers have a high cure rate. However, if left untreated, they can be deadly. This makes choosing the right treatment approach critical.

Two of the most effective techniques for treating and removing skin cancers are CCPDMA and Mohs surgery. These advanced methods allow dermatologists to precisely target cancerous cells while preserving healthy tissue.

But what exactly are CCPDMA and Mohs? And how do you know which is the best option for you? In this comprehensive guide, we’ll explain everything you need to know about CCPDMA and Mohs surgery for skin cancer. 

Continue reading to understand these transformative skin cancer treatments so you can make the most informed decision.

What is CCPDMA?

CCPDMA stands for Complete Circumferential Peripheral and Deep Margin Assessment. It refers to a surgical technique used to remove certain skin cancers like basal cell carcinoma where the entire surrounding and deep margins of the excised tissue are examined. 

This helps ensure no remaining cancer cells are left and improves cure rates compared to standard excision.

How CCPDMA Removes Skin Cancer Cells

During CCPDMA, the tumor is excised with a margin of normal tissue. The entire circumferential peripheral and deep margin is then immediately examined by a pathologist, usually using frozen section histology.

This allows evaluation of the margins while the patient is still under anesthesia. If further tissue needs to be excised based on the pathologist's assessment, it can be done in the same setting until clear margins are obtained.

Benefits of CCPDMA for Skin Cancer Treatment

Some key benefits of CCPDMA include:

• High cure rates. CCPDMA allows for the removal of skin cancer with a very narrow surgical margin while achieving high cure rates.
• Assessment of deep margins. CCPDMA examines the deep margins of the surgically removed tissue to check for remaining cancer cells. This helps achieve clear margins.
• Narrow excision. By precisely mapping and examining removed tissue, CCPDMA minimizes the amount of healthy tissue removed while still thoroughly examining for cancer. This leads to better cosmetic outcomes.
• Early detection of underlying cancers. Examining removed tissue with CCPDMA can detect underlying skin cancers or pre-cancers that may otherwise have been missed.
• Monitoring of immunosuppressed patients. CCPDMA is recommended for thorough evaluation of skin cancers in patients with weakened immune systems.
• Adjuvant treatment planning. CCPDMA evaluation of removed tissue can help determine if patients may benefit from additional treatments like radiation therapy.

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What is Mohs Surgery?

Mohs surgery is a type of CCPDMA technique used to remove certain skin cancers. It is most commonly used to treat basal cell carcinoma and squamous cell carcinoma.

In Mohs surgery, thin layers of cancerous skin are progressively removed and examined under a microscope during the procedure to check if all cancer cells have been eliminated from the margins. This allows the surgeon to confirm complete removal of the cancer while preserving as much healthy tissue as possible.

Unlike other techniques, Mohs surgery involves complete, circumferential examination of 100% of the surgical margins, including peripheral and deep edges. This methodical removal and microscopic analysis of tissue layers continues until no residual cancer cells are seen at the margins, ensuring complete excision of the skin cancer with maximal preservation of healthy tissue. 

The CCPDMA nature of Mohs surgery allows precise removal of skin cancers while minimizing unnecessary excision of surrounding normal skin. Its layer-by-layer approach allows maximum preservation of healthy skin and involves stages such as:

Stage	Description
1	The surgeon removes the visible tumor plus a small margin of normal skin around it. This is examined under a microscope.
2	If cancer cells are seen at the edges after stage 1, the surgeon removes another thin layer of tissue from the areas where cancer cells were still present. This is examined.
Additional stages	The surgeon continues removing very thin layers of tissue and examining them under a microscope, stage by stage, until there are no more cancer cells seen at the edges.
Final stage	Typically no more than 5 stages are needed to fully remove the skin cancer. But difficult tumors may require more stages to clear the margins. After the cancer is fully removed, the surgeon repairs the wound.

Mohs surgery has a high cure rate for skin cancers as the removed tissue is thoroughly examined. It is often used for cancers in areas that would cause functional or cosmetic problems if removed in larger amounts of normal tissue.

The Unique Benefits of Mohs Surgery

Mohs surgery is a specialized surgical technique used to treat some forms of skin cancer. Some key benefits of Mohs surgery include:

• It has a high cure rate, ranging from 98-99%, for many types of skin cancer such as basal cell carcinoma and squamous cell carcinoma
• The surgeon is able to see exactly where the cancer extends down to the base of the skin, which allows for precise removal and minimizes amount of healthy tissue removed
• It allows for tissue to be examined microscopically layer by layer until no more cancer is seen, ensuring complete removal
• It provides same-day treatment and results since examination is done intraoperatively
• It aims to preserve healthy skin and minimize scarring compared to other surgical methods
• Patients are informed of their results immediately on the same day of the procedure
• The specialized tools and techniques allow for treatment of cancers in sensitive areas of the face where important functions or appearance need to be preserved
• It is considered the gold standard treatment for recurrent and high-risk non-melanoma skin cancers

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Mohs Surgery with Tubingen Torte Technique

The Tubingen torte technique is another form of micrographic surgery sometimes used after Mohs surgery. It was developed in Germany and is named after the city of Tubingen.

In this technique, the tissue removed during surgery is cut into small sections, embedded in paraffin, and processed using special stains. Thin slices are then taken from the entire circumferential and deep surgical margin. These slices are horizontally sectioned and microscopically examined to verify complete removal of the tumor.

The Tubingen torte approach allows thorough analysis of tissue in difficult to visualize areas like the deeper dermis and subcutis. It helps ensure no remaining cancer cells are present.

Benefits of the Tubingen torte technique include:

• Precise detection of any residual tumor cells in deep margins
• Low recurrence rates due to comprehensive margin analysis
• Can be used for large or high-risk tumors requiring extensive removal
• Useful for cancers in difficult locations on the head and neck

Combined with Mohs surgery, it provides maximum assurance of complete cancer elimination

The Tubingen torte technique offers a meticulous approach to verify full removal of complex skin cancers. It can provide added confidence after Mohs surgery in high-risk cases.

Enhance Your Confidence in Skin Cancer Elimination with Mohs Surgery Combined with Tubingen Torte Technique

Choose the Most Effective Skin Cancer Treatment for You

If you've been diagnosed with a skin cancer like basal cell carcinoma or squamous cell carcinoma, advanced removal techniques like CCPDMA, Mohs surgery, and the Tubingen Torte technique offer the highest cure rates while preserving healthy tissue.

To determine which is right for you, consult with a board-certified dermatologist such as Dr. Gary Mendese, who specializes in Mohs Surgery. He can evaluate your specific case and make a personalized recommendation.

At Dermatology and Skin Health, Dr. Mendese offers Mohs surgery. With multiple locations across New Hampshire and Massachusetts, schedule your consultation today to discuss these transformative skin cancer treatments.

Your skin health and beauty is our top priority. Together, we'll develop a customized treatment plan to effectively remove your skin cancer so you can get back to your healthy, radiant self.

FAQs

What is the main difference between CCPDMA and Mohs surgery?

The main difference between CCPDMA and Mohs surgery is that CCPDMA examines the entire circumferential margin while Mohs examines tissue layers progressively. However, Mohs is a type of CCPDMA technique.

How many stages are there in Mohs surgery?

Mohs surgery involves removing progressive thin layers of skin which are examined under a microscope. This continues in stages, typically no more than 5, until no cancer cells remain.

What makes Mohs surgery useful for cancers on the face?

Mohs surgery is useful for cancers on the face because it removes cancerous skin layer by layer, ensuring full removal while maximizing preservation of healthy tissue, which is ideal for sensitive facial areas.

What is the Tubingen torte technique?

The Tubingen torte technique is a variant of micrographic surgery that allows for comprehensive analysis of surgical margins after Mohs surgery by taking horizontal slices of tissue and examining them microscopically.

Why see a dermatologist for skin cancer treatment?

It is advisable to see a board-certified dermatologist specializing in Mohs surgery for skin cancer treatment like Dr. Gary Mendese, as they have extensive training to evaluate skin cancer cases and offer the most effective treatments.