Mohs Surgery

Dr Smith specialises in this technique which is standard practice in America and Australia.

What is Mohs Surgery?

In the early 1940's, Dr Frederick Mohs. Professor of Surgery at the University of Wisconsin, developed this treatment for skin cancer. The technique has since come to be known as "Mohs Surgery".

Mohs Surgery is a highly specialised treatment for the total removal of skin cancers, in which the microscope is used to determine the extent of the tumour and its location.

The major advantage of Mohs' Surgery over other surgery are:

	The tumour is completely removed with minimal loss of normal skin
	Using this method, the rate of cure is approximately 98%, which is substantially higher than any other mode of treatment

Surgical Procedure

The area to be treated is first numbed with local anaesthetic, and the suspicious area is removed. A dressing is applied to the patient's wound while the removed tissue is prepared and examined.

The doctor marks the edges of the tissue with coloured dyes and a map made of the tissue. The tissue is frozen and cut by the lab technician, mounted onto microscope slides and then stained using highly specialised chemicals to identify the different cell types.

The doctor then examines the tissue under the microscope and determines whether the tumour is completely removed.

If the tumour is shown to be completely removed the patient's wound is repaired and the patient discharged home.

If there is residual tumour, the wound is re-anaesthetised, further tissue removed and microscopically checked. This process continues until the doctor is satisfied that no cancerous cells remain.

The wound is then repaired and the patient returns at a later date (usually one week) for removal of stitches.

Occasionally, the wound may be repaired by another specialist if the tumour site is in an area requiring a different expertise. For example, if certain structures around the eyes are involved, an occulo-plastic surgeon may be asked to repair the defect.

When is Mohs surgery recommended?

Mohs surgery is ideal in the following situations:

	A skin cancer has recurred after previous treatment
	It is in a difficult site eg on the face, but especially around the nose, eyes, lips and ears

What are the benefits?

This process ensures that all cancerous cells are removed, and as much healthy skin as possible is preserved.

Why is it important that it is all removed?

If cancer cells are left behind at the time of initial surgery, then there is a very high chance that the cancer will recur. Frequently when this happens it grows for a substantial period of time underneath the scar and may not be visible on the skin for many years. This makes subsequent treatment much more extensive and difficult.

Mohs surgery offers the highest chance of cure with the initial treatment.