It's normal to feel a lot of fear and anxiety when your doctor tells you that you have skin cancer. Especially if the cancer is in an area that is visible, like the face or neck, you may be worried about leaving a big scar after surgery. But don't worry. Today we're going to talk about a very precise and effective treatment method for removing skin cancer. This can minimize damage to healthy skin and completely remove the cancer. That's Mohs Surgery.
Simply put, what is Mohs Surgery?
Imagine you're removing a small, rotten part of a fruit. You want to scrape off only the rotten part and leave all the good parts. That's what happens in this Mohs surgery.
This is a very delicate operation. Here, the surgeon removes a very thin layer of tissue from the area where the cancer is. The removed tissue is then examined under a microscope in a laboratory. The surgeon looks closely at the edges of the tissue to see if there are still cancer cells.
If, somehow, cancer cells are still present, the doctor knows exactly where they are. The next step is to take another thin slice from that exact spot and examine it again. This process is repeated until the cancer cells are 100% removed.
The biggest advantage of this method is that it can target and remove only the cancer cells without harming healthy skin. Therefore, this is an ideal method for cancers in sensitive areas such as the face, ears, scalp, hands, and feet.
How is this different from a normal surgery?
To help you understand this difference more easily, let's compare these two methods.
| Feature | Mohs Surgery | Standard Excision |
|---|---|---|
| Amount of tissue removed | Just the cancer and a very small amount of healthy tissue around it. | The cancer and a large amount of healthy tissue around it are removed. |
| Edge inspection | 100% of the edges of the removed tissue are examined microscopically. | Less than 1% of the edges of the removed tissue are examined. |
| Healthy skin remains | The healthy skin is left as much as possible. The scar is small. | The scar may become larger because too much healthy skin is removed. |
| Recovery rate | Very high (up to 99%). Low chance of cancer recurrence. | High, but slightly lower than Mohs surgery. |
What types of skin cancers are treated with Mohs surgery?
This method 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, this method can sometimes be used for other types of skin cancer, such as certain types of melanoma and other rare cancers. Your doctor will decide if this treatment is appropriate for the type of cancer you have.
How will the surgery be? Will I have to stay all day?
This is a day surgery that can be done without a hospital stay. Before the surgery, your doctor will discuss your medical history, medications you are taking, and the pros and cons of the surgery.
Here's what happens on the day of surgery:
1. Numbness: First, the doctor will inject an injection to numb the area where the cancer is and the area around it. So you won't feel any pain. You will be fully conscious.
2. Removing the first part: Next, the visible part of the cancer and a thin layer of tissue underneath it are cut out and removed.
3. Sending for testing: The removed part is immediately tested in the laboratory. This can take about 60 minutes.
4. Your waiting time: During this time, you can relax in the operating room or waiting room. You can read a book, a newspaper, or use your phone.
5. Resection (if necessary): If the test shows that there are still cancer cells left, the doctor will take you back to the operating room and remove another small part from that specific area .
6. Until complete: This process is repeated until it is confirmed that the cancer cells have been completely removed. Depending on the size of the cancer, this may take several hours or even days.
What to do about the wound after surgery?
Once the cancer is completely removed, your doctor will explain to you the best way to heal the wound. There are several ways to do this:
- The wound will heal on its own.
- Closing the wound with stitches (`sutures`).
- Closing the wound by taking skin from near the wound (a `skin flap`) or skin from another part of the body (a `graft`).
Are there any risks to this surgery?
As with any surgery, there are some minor risks. However, Mohs surgery is a very safe procedure. The possible risks are:
- Scar formation.
- The wound is larger than expected.
- Delayed wound healing.
- Excessive bleeding.
- Infection.
- Nerve damage (this can be temporary or permanent).
- Very rarely, cancer recurs.
If you have any questions about this, talk to your doctor before the surgery and resolve them.
What should you pay attention to during recovery after surgery?
Your contribution is very important for the wound to heal well after surgery. Follow the doctor's instructions exactly.
- Pain: There may be mild pain for a few days. Your doctor may advise you to take a painkiller such as Paracetamol.
- Wound care: Do not remove the dressing for the first 24-48 hours. After that, clean the wound, apply petroleum jelly (such as Vaseline®), and apply a new bandage twice a day as directed by your doctor.
- Exercise: Avoid strenuous activities such as heavy lifting for about a week.
- Swelling: You can apply ice packs to reduce swelling and bruising. But do not put ice directly on the skin.
| If you have these symptoms, call your doctor immediately! | |
|---|---|
| Unstoppable bleeding | If the bleeding does not stop even after pressing the wound firmly. |
| Severe pain | Pain that cannot be controlled even with painkillers and that increases after a few days. |
| Signs of infection | Fever, yellow pus-like discharge from the wound, foul odor, redness, swelling, and warmth around the wound. |
Take-Home Message
- Mohs Surgery is a very precise and effective treatment for common skin cancers.
- This method minimizes damage to healthy skin, making it ideal for sensitive areas such as the face.
- Although the surgery can be completed in one day, it may take several hours depending on the nature of the cancer.
- Follow your doctor's instructions carefully about how to care for your wound after surgery.
- If you notice anything like bleeding, severe pain, or signs of infection, inform your doctor without delay.
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