Mohs Surgery vs. Traditional Excision: Great Treatments with Key Differences and Benefits
When it comes to treating skin cancer, patients often wonder about the best surgical options available. Two common methods are Mohs surgery and traditional excision. Understanding the differences between these procedures, as well as thorough discussion with your surgeon, can help you make an informed decision about your treatment plan. Here, we'll explore the differences between the two options and the unique benefits of Mohs surgery.
What is Mohs Surgery? Mohs surgery is a highly specialized technique for removing skin cancer. It is particularly effective for treating the most common skin cancers including basal cell, squamous cell, melanoma, and some of the more rare carcinomas. This is especially true in areas where cosmetic and functional outcomes are crucial, such as the face, neck, scalp, ears, fingers, and toes. It is important to take into account several factors such as the size of the tumor, anatomic location and pathology when determining the best treatment option. It is also critical to understand that all skin cancers do not meet the appropriate use criteria for Mohs, so discussing this with your surgeon is imperative.
During Mohs, the surgeon removes the cancerous tissue layer by layer, examining each layer under a microscope until no cancer cells remain. This precision ensures that all cancer cells are removed while preserving as much healthy tissue as possible while the patient is in the office.
One of the unique aspects of Mohs surgery is that your Mohs surgeon is not just a surgeon but also functions as a pathologist. This means that during the procedure, the Mohs surgeon will microscopically examine the excised tissue to ensure all cancer cells have been removed. This dual role allows for immediate results and precise removal of cancerous cells, which is why Mohs surgery is considered the gold standard in skin cancer removal.
What is a Traditional Excision? Traditional excision is an effective mode of skin cancer treatment that involves removing the visible cancerous lesion with a margin of surrounding healthy tissue to ensure all cancer cells are excised. The removed tissue is then sent to a lab for testing, which typically takes several days to a week or so to process. If cancer cells are found in the margins, additional treatment may be required. However, when an excision is an appropriate choice and the procedure is performed with the appropriate margin and depth, Dr. Findley sees a low rate of positive margins.
Key Differences and Benefits
Precision and Tissue Preservation:
Mohs Surgery: This technique offers unparalleled precision. The surgeon acts as both the pathologist and the reconstructive surgeon, examining 100% of the tumor margins in real time. This approach minimizes the removal of healthy tissue, resulting in more optimal functional and cosmetic outcomes.
Traditional Excision: Traditional excision generally removes a larger margin of healthy tissue to ensure all cancer cells are excised. While this can lead to additional surgery or treatment if cancer cells are found in the margins, this rarely occurs if this procedure is properly selected and performed.
Effectiveness:
Mohs Surgery: Mohs surgery boasts up to a 99% cure rate for most skin cancers that have not been treated before, with a slightly less but still quite impressive cure rate for recurrent skin cancers. This high success rate is due to thoroughly examining tissue margins during the procedure under the microscope.
Traditional Excision: Traditional excision may have a lower cure rate than Mohs surgery if selected and performed on inappropriate skin cancers.
Immediate Results:
Mohs Surgery: The immediate microscopic examination during Mohs surgery provides instant results, ensuring that all cancer cells are removed in a single visit. This eliminates the waiting period for pathology results and the need for additional surgeries, importantly lowering the psychological burden for many patients of needing skin cancer treatment and waiting that can be so very tough.
Traditional Excision: This does inherently lead to a longer waiting time for results, however, as we have mentioned, Dr. Findley will recommend or select this treatment option in appropriate situations. Dr. Findley knows the pathologists that she utilizes very well and has partnered with them for years, ensuring optimal communication and the most effective collaborative care.
Specialized Training:
Mohs Surgery: Mohs surgeons undergo specialized training to perform three critical roles: the surgeon removing the cancerous tissue, the pathologist analyzing the lab specimens, and the reconstructive surgeon closing the wound. This comprehensive approach ensures the highest level of care and precision.
Traditional Excision: While traditional excision is often performed by skilled surgeons, it does not require the same level of specialized training. Dr. Findley is a double board-certified physician in both cutaneous oncology and Mohs surgery, as well as general dermatology.
While Mohs surgery does offer certain advantages over traditional excision, especially for skin cancers in cosmetically and functionally sensitive areas, it is not the only great treatment option available or appropriate. Mohs’ precision, effectiveness, and immediate results make it the preferred choice for many patients. Mohs surgery helps patients maintain their appearance and confidence by preserving healthy tissue and minimizing scarring.
If you are considering Mohs Surgery, call our office at 401-415-8586 to schedule a consultation with Dr. Findley.