The best way to remove skin cancer: Let's learn everything about Mohs Surgery!

It's normal to feel a little scared and shocked when your doctor tells you that you have skin cancer. We all cringe when we hear the word "cancer." But don't worry. With today's advanced medical science, there are very effective and curable treatments, especially for skin cancer. Today, we are going to talk about one such, very precise, very effective treatment. That is 'Mohs Surgery.'

Simply put, what is Mohs Surgery?

Think of it like removing a rotten part of a large onion. We only remove the rotten part, slowly, without throwing away the whole onion, right? Mohs surgery is a very delicate procedure.

This involves your surgeon removing the cancer in layers. First, the visible cancer and a very thin strip of skin around it are cut out. Then, the underside of the removed piece of skin and the surrounding edges are examined under a microscope right there and then.

If this test shows that cancer cells are still present at those edges, the doctor knows exactly where the cancer remains. Then, another thin layer of skin is removed from exactly where the cancer cells were . It is again examined under a microscope. This process is repeated until it is 100% certain that there are no cancer cells at the edges of each piece of skin that is removed.

Why is this called 'Mohs'?

This surgical procedure was discovered and developed in the 1930s by a doctor named Frederic E. Mohs. So it is called 'Mohs surgery' in his honor. Although this procedure was a bit complicated and painful in the beginning, it has improved a lot over time and has become a very safe and successful procedure today.

How is this different from the usual excision of a cancerous tumor?

This is a question that many people have. You may wonder, "Why use this special method instead of the usual excision?" Let's look at the main differences between these two methods. Once you understand this, you will understand the value of Mohs surgery.

What types of cancers are most commonly removed by Mohs surgery?

This surgical procedure is most commonly used for two types of skin cancer that are common in our country.

• Basal Cell Carcinoma (BCC)
• Squamous Cell Carcinoma (SCC)

In addition to these, doctors may sometimes recommend this method for other serious skin cancers like melanoma and several other rare cancers.

What happens before the surgery?

Before you have Mohs surgery, your dermatologist will examine you. The two of you will discuss the following:

• Your complete medical history, medications, and vitamins you take.
• A report of a previous biopsy of your skin.
• They will clearly talk about your skin cancer, what treatment options are available, and the benefits and risks of having Mohs surgery.

Depending on your health condition and the location of the surgery, you may be asked to take antibiotics before the surgery.

Let's learn step by step how the surgery is performed.

You will be awake during this surgery, but you will not feel any pain. Let's see how this goes.

1. Numbness: First, the doctor will inject an anesthetic into the area where the cancer is and the surrounding area, completely numbing it. You will feel pressure and a sense of touch in that area, but you will not feel any pain.

2. Removing the first layer: Next, the visible cancer and a very thin layer of skin around it are cut out and removed.

3. Mapping: To ensure that the removed skin is not confused with the top, bottom, right, or left, the doctor will mark it in a special way and create a map of it. This is a very important step.

4. Microscopic examination: Next, the skin sample is immediately frozen in the laboratory, cut into very thin slices, stained, and examined under a microscope. This process can usually take about an hour.

5. Removing the remaining tissue: If, under the microscope, the doctor sees that there are still cancer cells along the edge of the area, according to the map, he will know exactly where to cut next. Then he will take you back to the operating room and remove another thin layer of tissue from exactly where the cancer cells were .

6. Re-examination: The newly removed piece is examined under a microscope as before. This process continues until it is confirmed that there are no cancer cells.

You will be able to stay in a rest room while these tests are being performed. You are free to read a book, listen to music, or use your phone during this time. This surgery can take a few hours, or it may take a whole day if the cancer is large or deep.

What to do with the wound that forms after removing the cancer?

Once the cancer is 100% removed, your doctor will talk to you about how to best heal your wound. There are several options for that.

• Spontaneous healing: If the wound is small, sometimes it will heal on its own.
• Sutures: This is usually done by bringing the edges of the wound together and stitching them together.
• Skin flap or graft: If the wound is large, a piece of healthy skin can be taken from nearby areas and used to close the wound. Or, a piece of skin can be taken from another part of the body (e.g., behind the ear) and grafted.
• Expert help: Sometimes, especially if the wound is large, especially around the eyes or in areas like the nose, you may need the help of a plastic surgeon.

Recovery time and care after surgery

How is the pain after the surgery?

Most people have mild to moderate pain . This will gradually subside over a few days. This pain can be well controlled with a simple painkiller such as Paracetamol.

How long does it take for the wound to heal?

It can take 12 to 18 months for the scar to fully heal and fade, so it's important to be patient.

How to care for a wound at home?

Your doctor will advise you on how to care for the wound after surgery.

• When you go home, you will have a dressing placed over the wound. Do not remove it for 24-48 hours.
• Then, clean the wound twice a day as directed by your doctor, using a mild soap or something your doctor recommends.
• After cleaning, apply petroleum jelly (such as Vaseline®) to the wound and cover it with a non-stick dressing. This will help keep the wound moist, speed healing, and reduce scarring.
• Avoid strenuous exercise and heavy lifting for at least a week after surgery.
• To reduce swelling and bruising, apply ice packs for the first few days. But don't apply the ice directly to the skin, wrap it in a cloth.
• Even after the wound has healed, be sure to apply a sunscreen with SPF 30 or higher when going outside on the scarred area.

When to talk to the doctor

It is very important to notify your doctor immediately if you experience any problems after surgery. Be sure to call your doctor if any of the following occur:

The word "cancer" is a scary thing to hear. But if your skin cancer is detected early, before it has spread to other areas, a precise procedure called Mohs Surgery can completely cure you in one day. So, if your doctor recommends this treatment, don't be afraid. It could be the best treatment you can get.