Mohs Surgery (cont.)
Nili N. Alai, MD, FAAD
Dr. Alai is an actively practicing medical and surgical dermatologist in south Orange County, California. She has been a professor of dermatology and family medicine at the University of California, Irvine since 2000. She is U.S. board-certified in dermatology, a 10-year-certified fellow of the American Academy of Dermatology, and Fellow of the American Society of Mohs Surgery.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is Mohs micrographic surgery (MMS)? Why is the procedure called Mohs?
- Where can I have Mohs Surgery, and how long does the surgery take?
- What kind of physician can perform Mohs surgery? Where can I find a doctor board-certified in Mohs?
- Is Mohs only for skin cancer?
- Am I a good candidate for Mohs surgery?
- What if I have artificial joints or other health issues?
- What areas are treatable by Mohs surgery?
- What are possible complications of Mohs?
- What is reconstruction? Will I have a scar?
- What are alternatives for Mohs surgery?
- What about insurance coverage and costs?
- How do I prepare for my surgery?
- How is recovery? Is it painful?
- How do I take care of my surgical area after Mohs surgery?
- What is the chance that my cancer will recur?
- How many "levels" of Mohs will I need?
- How are skin cancers treated?
- Find a local Dermatologist in your town
What is the chance that my cancer will recur?
There is a very low chance that your skin cancer will recur after Mohs surgery. Mohs cure rates have been reported as high as 96%-99%.
It is important to understand that no cancer treatment or surgery has a 100% cure rate. A skin cancer may recur or a new cancer may arise in the same or adjacent area even after Mohs or other surgery. Some skin cancers are more aggressive than others and need additional treatment and closer follow-up. Skin cancers frequently need additional follow-up and possible further treatment. Although Mohs surgery tends to have the highest cure rate compared to other treatments, Mohs may not be necessarily curative in advanced skin cancer (rare) and may need one or more procedures, such as radiation or further surgery, to fully treat the lesion. Follow-up appointments with your physician are very important, especially in the first few years after Mohs surgery. Many patients are seen every four to six months after their diagnosis of a skin cancer. Self skin examinations monthly are good practice for patients with a history of skin cancer. Any changing or new growth should be promptly checked by your physician. More regular follow-up appointments may be needed for those with more aggressive tumors or tumors in high-risk areas. Your physician will recommend the proper follow-up for your specific condition.
How many "levels" of Mohs will I need?
On average, most patients may only need one or two levels before clearing the tumor. Depending on the skin cancer type and location, a patient may need anywhere from one to 10 or more levels of Mohs to clear a tumor.
There is no way to predict ahead of time how many levels your cancer will require for cure. The number of Mohs levels needed to completely remove the skin cancer depends on how big your cancer is. Mohs surgeons always try to remove your cancer in as few levels as possible.
There is very little way to predict beforehand how large a skin cancer is because often there are invisible portions that can be seen only with the help of a microscope. Sometimes, more than one surgical procedure may be required to remove very large or invasive tumors, cancers in small areas or difficult areas, or to obtain the best medical and cosmetic result.
How are skin cancers treated?
There are many effective ways to treat skin cancers. Options include local radiation (X-ray) treatments, curettage and desiccation "C&D" (scrape and burn), cryosurgery (specialized deep freezing), photodynamic therapy using Levulan and laser and or blue light, regular surgical excision, laser removal and surgery, Mohs surgery, and several prescription creams including Aldara (imiquimod) and Efudex (flurouracil).
Medically reviewed by Norman Levine, MD; American Board of Dermatology
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