precision of the surgeon reading the pathology slides gives Mohs surgery the highest cure rate. Each removal and processing of tissue called a “stage” takes approximately 1 hour. If cancer is visualized under the microscope, the surgeon marks that precise area on the map. The patient is brought back into the procedure room and additional tissue is precisely removed from the positive region only and submitted to the Mohs lab for processing. This process is repeated until the margins are clear of cancer. On the average, it takes one to three
“stages” to clear the cancer. Benefits of Mohs Surgery
Mohs surgery offers the absolute highest chance for cure of most skin cancers compared to all other therapies. The cure rates for other common techniques used to treat skin cancer can be as low as 50-70% for previously unsuccessfully treated skin cancers. Using Mohs techniques with the surgeon as the pathologist, precisely locating tumor roots and excavating those roots leads to cure rates as high as 97-99%, even when other forms of treatment have been unsuccessful. Besides the highest cure rate, the precision of tissue evaluation allows the smallest margin possible to be taken, which results in smaller surgery scars, because an unnecessary margin of healthy tissue is not taken. Those who prefer to know definitively that the cancer is completely removed before the tissue is repaired (no guessing), prefer Mohs because when tissue is sent to a pathology lab it generally takes 5-7 days after surgery to find out if the estimated margins were indeed adequate. Prepare for the Day of Mohs Surgery Please be aware that you may need someone to drive you home after your Mohs surgery depending on the location of the surgery (near the eye) or if you receive anti-anxiety medications to help your day go smoother. Most patients are scheduled directly for surgery without a preoperative visit. Your provider will have reviewed your pertinent medical history including pathology reports before your surgery and a consultation will be done on the day of the procedure. It is important that you read all the information that we have provided and fill out the Health Questionnaire before your appointment. If you would like to see your provider in consultation prior to the surgery date, we will gladly schedule you an appointment. Please plan accordingly as you will be subject to activity restriction following your surgery. It is recommended you do not participate in athletic activities for 7-10 days following surgery. Mohs surgery is performed under local anesthesia using injections; you will not be put to sleep. We suggest that you eat your normal breakfast or lunch unless otherwise specified. Take all of your normal medications on the day of surgery, unless instructed to do otherwise. Please bathe or shower and wash your hair to minimize your risk of a surgical site infection. If needed, we will provide you with an anti-anxiety medicine once you have signed the consent form. You will need someone to accompany you to give you a ride home. This is a requirement if you receive anti-anxiety medicine. Many of our patients are on blood thinners that are prescribed by their physician. We do not recommend stopping them without explicit permission from the prescribing physician. If your prescribing physician has given you guidelines for stopping blood thinning medicines for a few days prior to minor procedures (surgery or dental procedures), check with your physician and follow those guidelines. For those on Coumadin/Warfarin , please make sure that your INR is in the therapeutic range and please have your most recent INR available for your provider. We request that you stop taking any prophylactic aspirin or ibuprofen compounds (like Anacin, Bufferin, Advil or Motrin), alcohol, vitamin E, ginko biloba and garlic pills at least 10 days before your surgery. They can increase your risk of bleeding during surgery. If your physician has instructed you to take aspirin for any reason other than routine prevention, please do not discontinue without their permission. Finally, get a good night’s sleep the night before surgery. On the Day of Mohs Surgery When you arrive and first see your provider on the day of Mohs surgery, you will need to positively identify the biopsy site on which surgery will be performed. The surgical assistant will review your history and prepare the lesion for Mohs surgery. This is a great time to ask the surgical assistant any questions you might have. Your provider will review your case and come in to mark the surgery site in surgical ink. You will be asked to sign consent that you understand the possible risks of surgery (bleeding, pain, infection, recurrence, numbness, scar) and not doing surgery (cancer grows/spreads). The surgical assistant will numb the area with a local anesthetic and prep the area for surgery, which includes getting you comfortable, cleansing the surgical area with antiseptic
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