Mohs Procedure Skin Cancer Edina

Knowing the intricacies of Mohs surgery can be life-changing; discover how this precise method treats skin cancer with up to 99% cure rates in Edina.

Mohs surgery is a precise method for treating skin cancer, particularly basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), with cure rates of up to 99% for new cases. Performed by specially trained surgeons in outpatient settings, the procedure involves removing the visible tumor and surrounding skin in layers, which are then examined under a microscope to ensure all cancerous cells are removed while preserving healthy tissue. 

You'll receive local anesthesia, and the process may take several hours, depending on the tumor's size and depth. Post-surgery, you'll need to follow specific wound care instructions and attend follow-up appointments.

What Is Mohs Surgery?

Mohs surgery, a precise and highly effective method for treating skin cancer, involves the layered removal and microscopic examination of skin tissue to ensure the complete elimination of cancerous cells while preserving healthy tissue. This procedure is performed by surgeons specifically trained in Mohs techniques, often in a doctor's office or outpatient surgical center.

During Mohs surgery, the visible tumor and a thin layer of surrounding skin are removed using a scalpel. The tissue is then examined under a microscope to check for cancer cells. If cancer is found at the edges of the removed tissue, the surgeon will remove another layer and repeat the process until no cancer cells are detected. This layer-by-layer approach allows for the removal of only the necessary tissue, minimizing damage to healthy skin and reducing the risk of scarring.

Mohs surgery is particularly beneficial for skin cancers in sensitive areas, such as the face, hands, or genitals, where preserving healthy tissue is crucial. It's also recommended for aggressive or large skin cancers, those with unclear edges, or cancers that have returned after previous treatments.

This method is a key component of skin cancer prevention and treatment, offering high cure rates and low recurrence rates for basal cell and squamous cell carcinomas.

Types of Skin Cancer Treated

Mohs surgery is predominantly used to treat the two most common types of skin cancer: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). These cancers are often found in areas exposed to the sun, such as the face, ears, and hands.

For BCC, Mohs surgery offers a cure rate of up to 99% for new cases and up to 94% for recurrent cases. For SCC, the cure rate is between 95% and 99% for new cases and around 90% for recurrent cases.

In addition to BCC and SCC, Mohs surgery can also treat certain types of melanoma, particularly early-stage melanomas that haven't spread deeply into the skin. This is often referred to as lentigo malignant melanoma or melanoma in situ.

However, the procedure for melanoma may involve a modified approach called slow Mohs, which requires a longer waiting period for the results.

Mohs surgery is also effective for treating rare skin cancers, including dermatofibrosarcoma protuberans, microcystic adnexal carcinoma, sebaceous carcinoma, and extramammary Paget's disease.

While actinic keratosis is a precursor to skin cancer and not typically treated with Mohs, the procedure's precision makes it invaluable for managing aggressive and high-risk skin cancers in sensitive areas where preserving healthy tissue is crucial.

The Mohs Procedure Steps

The Mohs procedure is a meticulous, layer-by-layer surgical process designed to precisely remove skin cancer while preserving as much healthy tissue as possible.

Here are the key steps involved in the Mohs procedure:

Steps of the Mohs Procedure

1. Anesthesia and Initial Excision

You will receive local anesthesia to numb the area, ensuring you remain awake and comfortable throughout the procedure.

The surgeon then removes the visible portion of the tumor using a scalpel.

2. Mapping and Color-Coding

The removed tissue is mapped, color-coded, and divided into sections to track its origin and orientation.

This mapping is crucial for precise removal of cancerous cells.

3. Microscopic Examination

The tissue sections are processed and examined under a microscope by the surgeon to check for any remaining cancer cells at the margins.

This process takes about 60 minutes, during which you'll be bandaged and can wait comfortably.

4. Additional Excisions and Reconstruction

If cancer cells are found at the margins, the surgeon returns to the specific area indicated by the map and removes another thin layer of tissue.

This process continues until all cancer cells are removed.

After the cancer is completely excised, the surgeon discusses reconstruction options to manage the wound, ensuring optimal procedure outcomes and minimizing patient experiences of discomfort.

This systematic approach ensures that all cancerous tissue is removed while sparing as much healthy skin as possible, leading to high cure rates and favorable patient experiences.

Preoperative Preparation

Before undergoing Mohs surgery, you'll need to prepare thoroughly to ensure the procedure goes smoothly and safely.

To start, you must inform your surgeon about all the medicines and supplements you're taking. This includes blood thinners like aspirin, Coumadin, Plavix, and non-steroidal anti-inflammatory medications (NSAIDs) such as ibuprofen. You may be advised to stop taking these medications for a specified period before the surgery, typically 2 weeks for aspirin and related products, and 3 days for NSAIDs.

Patient education is crucial; your healthcare provider will guide you on what to expect and how to manage any anxiety. Avoid alcohol for at least 24 to 48 hours before the procedure, as it can act as a blood thinner.

On the day of the surgery, shower and wash your hair, and eat a normal breakfast or a light meal. Wear comfortable, loose-fitting clothing and avoid wearing jewelry or makeup if the surgery is on your face.

Bringing reading material or other activities can help manage anxiety during the waiting periods. Ensure you have someone to drive you home after the surgery.

Following these preoperative instructions will help reduce complications and make your Mohs surgery experience more manageable.

Key Steps During Mohs Surgery

Step 1: Removal of Visible Tumor

The surgeon will use a scalpel to remove the visible portion of the tumor along with a thin layer of surrounding tissue.

This tissue is then prepared for microscopic examination.

Step 2: Mapping and Color Coding

The removed tissue is divided into sections, color-coded, and a detailed map of the surgical site is created.

This map helps the surgeon identify the exact location of any remaining cancer cells.

Step 3: Microscopic Examination

The tissue sections are frozen, sliced into thin sections, and examined under a microscope.

The surgeon checks all edges and sides of the tissue for any signs of cancer cells.

This process typically takes about an hour.

Step 4: Subsequent Removals

If cancer cells are found, you'll be called back to the surgical area for additional tissue removal, precisely targeted at the areas indicated by the map.

This process is repeated until no cancer cells are detected, ensuring the removal of all cancerous tissue while preserving as much healthy skin as possible.

This meticulous approach to surgical techniques enhances the patient experience by minimizing discomfort and ensuring the most effective removal of skin cancer.

Post-Surgery Care and Recovery

After the Mohs surgery is complete and all cancerous tissue has been removed, the focus shifts to post-surgery care and recovery. This period is crucial for ensuring the wound heals properly and minimizing the risk of complications.

Immediate Aftercare

Following the procedure, your surgeon will provide detailed instructions on how to care for the wound. Here are some key aspects of post-surgery care:

Aspect of Care	Instructions
Wound Care	Keep the wound clean and dry for 24 hours. Use 3% hydrogen peroxide or mild soap for cleansing. Apply petroleum jelly if advised, and cover the wound with a non-stick dressing
Pain Management	Manage pain with over-the-counter medications like acetaminophen. Avoid NSAIDs like ibuprofen or naproxen unless advised by your doctor
Activity	Refrain from strenuous activities for 1-2 weeks to avoid wound reopening and potential complications
Follow-Up	Attend scheduled follow-up appointments for suture removal and to monitor healing. Be vigilant for signs of infection such as redness, swelling, or oozing

Long-Term Recovery

During the recovery process, it is essential to keep the wound elevated to reduce swelling and discomfort. Cold compresses can be applied to alleviate swelling and pain. Follow your doctor's advice on scar treatments, such as silicone gel formulations, to minimize scarring.

Regular follow-up visits with your doctor are vital for monitoring the healing process and detecting any new skin cancer lesions. Adhering strictly to your post-surgical plan ensures a smooth and effective recovery from Mohs surgery.

Benefits of Mohs Surgery

Mohs surgery offers several significant benefits that make it a preferred method for treating skin cancer. Here are some of the key advantages:

High Cure Rate

Mohs surgery boasts an exceptionally high cure rate, often exceeding 99% for new cases of basal cell and squamous cell carcinomas, and up to 95% for recurrent cases.

Precision and Minimal Tissue Removal

The procedure involves removing thin layers of skin one at a time and examining them under a microscope, ensuring that only cancerous tissue is removed while preserving as much healthy skin as possible.

This precision minimizes scarring and reduces the risk of complications.

Immediate Results and Low Risk of Recurrence

During Mohs surgery, the tissue margins are checked immediately, which reduces the likelihood of cancer recurrence.

This immediate confirmation helps in ensuring that all cancerous cells are removed in a single session, minimizing the need for multiple surgeries.

Outpatient Procedure with Local Anesthesia

Mohs surgery is typically performed in a physician's office under local anesthesia, eliminating the need for hospital stays and the risks associated with general anesthesia.

This makes the procedure safer and more comfortable for patients.

These benefits, combined with patient testimonials and the latest surgical advancements, underscore why Mohs surgery is a highly effective and preferred treatment option for skin cancer.

Risks and Complications

When considering Mohs surgery, it's crucial to be aware of the potential risks and complications, although these are generally low.

Mohs surgery, despite its high success rate, comes with several potential risks and complications that you should be aware of. One of the most common issues is bleeding, which can occur if the surgical wound opens before it fully heals. Applying pressure with clean gauze is usually the first step to manage this, but you should seek immediate medical attention if the bleeding persists.

Infection is another risk, with signs including increasing pain, swelling, redness, and pus-like drainage from the wound. Infections are typically treated with oral or topical antibiotics.

Other patient concerns include pain and swelling, which can sometimes be accompanied by a skin rash due to allergic reactions to surgical tape or the local anesthetic Lidocaine. Scarring is inevitable, but Mohs surgery tends to minimize it by preserving healthy tissue. However, poor wound healing can lead to more noticeable scars.

More serious complications, though rare, can include nerve damage, wound dehiscence (the wound opening up after being closed), and osteonecrosis, especially in patients taking certain immunosuppressive medications.

Regular follow-ups are essential to catch any signs of recurrence or other complications early.

Reconstruction and Wound Closure

During the final stages of Mohs surgery, the focus shifts to reconstruction and wound closure, a critical step in the healing process. Once the Mohs surgeon is confident that all cancerous tissue has been removed, the attention turns to repairing the wound to achieve optimal wound healing and cosmetic outcomes.

The decision to perform immediate or delayed reconstruction depends on several factors, including the size and location of the wound, as well as your overall health. Here are some key considerations:

• Wound Size and Location: Larger or more complex wounds, especially those in delicate or high-tension areas like around the eyes or lips, may benefit from delayed reconstruction to allow for better surgical planning and to minimize complications.
• Granulation Tissue Formation: Delaying reconstruction allows time for the wound to form granulation tissue, which provides a more ideal surface for grafting and improves the integration of reconstructive flaps and grafts.
• Reduced Complications: Waiting for initial healing can minimize risks such as postoperative bleeding and infections, and may also lead to better cosmetic results by reducing scarring.
• Interim Wound Care: In cases where reconstruction is delayed, interim wound care, such as changing bandages, is essential to facilitate proper healing leading up to the reconstructive surgery.

Your Mohs surgeon will carefully evaluate your case and discuss the best timing and method for reconstruction to ensure the best functional and cosmetic outcomes.

Follow-Up and Aftercare

Once the reconstruction is complete, your focus shifts to the follow-up and aftercare process, which is vital for ensuring a smooth and successful healing journey.

You will need to attend several follow-up appointments to monitor your wound healing and remove any stitches. Typically, these appointments occur within two to four weeks after the surgery for suture removal and a follow-up evaluation of the surgical wound.

During these visits, your surgeon will examine the surgical site to ensure that the wound is healing properly and to check for any signs of infection or recurrence.

It's crucial to follow the detailed instructions provided by your surgeon regarding wound care, which includes cleaning the wound with mild soap and water, applying antibiotic ointment, and covering the wound with a sterile bandage.

Additionally, you may need to limit your activities for 1-2 weeks after the surgery to avoid strenuous tasks that could reopen the wound or lead to bleeding and infection.

Regular follow-up visits with your dermatologist are also essential for long-term skin cancer surveillance, as having had skin cancer increases your risk of developing new skin cancers.

Cure Rates and Success

Mohs surgery is renowned for its high cure rates and success in treating various types of skin cancer. This procedure, developed by Dr. Frederic Mohs, involves the precise removal of skin cancer layer-by-layer, with each layer examined under a microscope to ensure all cancerous cells are eliminated.

Here are some key points about the cure statistics and treatment outcomes of Mohs surgery:

• Primary Basal Cell Carcinoma (BCC): Mohs surgery has a cure rate of up to 99% for primary BCCs.
• Recurrent Basal Cell Carcinoma (BCC): The cure rate for recurrent BCCs is around 94-95%.
• Primary Squamous Cell Carcinoma (SCC): For primary SCCs, the cure rate is between 92-99%.
• Recurrent Squamous Cell Carcinoma (SCC): The cure rate for recurrent SCCs is approximately 90%.

These high cure rates are due to the meticulous nature of Mohs surgery, which allows surgeons to examine 100% of the surgical margin, ensuring that nearly all residual cancer cells are identified and removed.

This precision minimizes the risk of recurrence and preserves as much healthy tissue as possible, leading to superior treatment outcomes and minimal scarring.

Finding a Mohs Surgeon in Edina

To ensure the best outcomes for skin cancer treatment, it's imperative to find a highly qualified Mohs surgeon, especially if you're in the Edina area.

When searching for a Mohs surgeon, several key factors should be considered to ensure you receive the highest standard of care.

First, look for surgeon qualifications. The surgeon should be board-certified in dermatology and have completed a fellowship accredited by either the American College of Mohs Surgery (ACMS) or the American Society of Mohs Surgery (ASMS).

ACMS fellowship programs are particularly rigorous, requiring participation in at least 500-600 Mohs surgery cases, accurate interpretation of tissue samples, and performance of various reconstructions.

Experience and expertise are also crucial. Opt for a surgeon with extensive experience in Mohs surgery, as this often correlates with higher success rates and better cosmetic outcomes.

Patient testimonials can also provide valuable insights into the surgeon's skills, bedside manner, and overall patient experience.

Reading reviews and testimonials from previous patients can help you gauge the surgeon's proficiency and patient satisfaction.