Page 30 Healthy Cells Magazine Peoria June 2014

mohs surgery
What is Mohs Skin Cancer Surgery?
Developed by Frederic E. Mohs, MD, in the 1930s, the Mohs micrographic surgical procedure has
been refined and perfected. As the process evolved, surgeons refined the technique and now excise
the tumor, remove layers of tissue, and examine the fresh tissue immediately. The normal treatment
time has been reduced to one visit, allowing for immediate reconstruction of the wound. The color
coded mapping of excised specimens and their thorough microscopic examination remains the
definitive part of the surgery.
Mohs surgery is indicated when:
The cancer is large.
The cancer was treated previously and recurred.
Scar tissue exists in the area of the cancer.
The edges of the cancer cannot be clearly defined.
The cancer grows rapidly or uncontrollably.
The cancer is in a difficult area, where it is important to preserve healthy tissue for maximum
functional and cosmetic results such as eyes, nose, ears, and lips.
State-of-the-Art
Treatment for
Skin Cancer
By Jeffrey K. McKenna, MD, Soderstrom Skin Institute
STEP 1 The roots of a skin cancer may
extend beyond the visible porton of the
tumor. If these roots are not removed,
the cancer will recur.
STEP 2 The visible porton of the tumor
is surgically removed.
STEP 3 A layer of skin is then removed
and divided into sections. The Mohs
surgeon then color codes each of these
sectons with dyes and makes reference
marks on the skin to show the source of
these sectons. A map of the surgical site
is then drawn.
STEP 4 The undersurface and edges of
each section are then microscopically
examined for evidence of remaining cancer.
STEP 5 If cancer cells are found under
the microscope, the surgeon marks their
locaton onto the map and returns to
the patent to remove another layer of
skin - but only precisely where the cancer
cells remain.
STEP 6 The removal process stops when
there is no longer any evidence of cancer
remaining in the surgical site. Because
Mohs surgery removes only tissue
containing cancer, it ensures that the
healthy tissue is kept intact.
STEP 1 The roots of a skin cancer may
extend beyond the visible porton of the
tumor. If these roots are not removed,
the cancer will recur.
STEP 2 The visible porton of the tumor
is surgically removed.
STEP 3 A layer of skin is then removed
and divided into sections. The Mohs
surgeon then color codes each of these
sectons with dyes and makes reference
marks on the skin to show the source of
these sectons. A map of the surgical site
is then drawn.
STEP 4 The undersurface and edges of
each section are then microscopically
examined for evidence of remaining cancer.
STEP 5 If cancer cells are found under
the microscope, the surgeon marks their
locaton onto the map and returns to
the patent to remove another layer of
skin - but only precisely where the cancer
cells remain.
STEP 6 The removal process stops when
there is no longer any evidence of cancer
remaining in the surgical site. Because
Mohs surgery removes only tissue
containing cancer, it ensures that the
healthy tissue is kept intact.
STEP 1 The roots of a skin cancer may
extend beyond the visible porton of the
tumor. If these roots are not removed,
the cancer will recur.
STEP 2 The visible porton of the tumor
is surgically removed.
STEP 3 A layer of skin is then removed
and divided into sections. The Mohs
surgeon then color codes each of these
sectons with dyes and makes reference
marks on the skin to show the source of
these sectons. A map of the surgical site
is then drawn.
STEP 4 The undersurface and edges of
each section are then microscopically
examined for evidence of remaining cancer.
STEP 5 If cancer cells are found under
the microscope, the surgeon marks their
locaton onto the map and returns to
the patent to remove another layer of
skin - but only precisely where the cancer
cells remain.
STEP 6 The removal process stops when
there is no longer any evidence of cancer
remaining in the surgical site. Because
Mohs surgery removes only tissue
containing cancer, it ensures that the
healthy tissue is kept intact.
STEP 1 The roots of a skin cancer may
extend beyond the visible porton of the
tumor. If these roots are not removed,
the cancer will recur.
STEP 2 The visible porton of the tumor
is surgically removed.
STEP 3 A layer of skin is then removed
and divided into sections. The Mohs
surgeon then color codes each of these
sectons with dyes and makes reference
marks on the skin to show the source of
these sectons. A map of the surgical site
is then drawn.
STEP 4 The undersurface and edges of
each section are then microscopically
examined for evidence of remaining cancer.
STEP 5 If cancer cells are found under
the microscope, the surgeon marks their
locaton onto the map and returns to
the patent to remove another layer of
skin - but only precisely where the cancer
cells remain.
STEP 6 The removal process stops when
there is no longer any evidence of cancer
remaining in the surgical site. Because
Mohs surgery removes only tissue
containing cancer, it ensures that the
healthy tissue is kept intact.
STEP 1 The roots of a skin cancer may
extend beyond the visible porton of the
tumor. If these roots are not removed,
the cancer will recur.
STEP 2 The visible porton of the tumor
is surgically removed.
STEP 3 A layer of skin is then removed
and divided into sections. The Mohs
surgeon then color codes each of these
sectons with dyes and makes reference
marks on the skin to show the source of
these sectons. A map of the surgical site
is then drawn.
STEP 4 The undersurface and edges of
each section are then microscopically
examined for evidence of remaining cancer.
STEP 5 If cancer cells are found under
the microscope, the surgeon marks their
locaton onto the map and returns to
the patent to remove another layer of
skin - but only precisely where the cancer
cells remain.
STEP 6 The removal process stops when
there is no longer any evidence of cancer
remaining in the surgical site. Because
Mohs surgery removes only tissue
containing cancer, it ensures that the
healthy tissue is kept intact.
STEP 1 The roots of a skin cancer may
extend beyond the visible porton of the
tumor. If these roots are not removed,
the cancer will recur.
STEP 2 The visible porton of the tumor
is surgically removed.
STEP 3 A layer of skin is then removed
and divided into sections. The Mohs
surgeon then color codes each of these
sectons with dyes and makes reference
marks on the skin to show the source of
these sectons. A map of the surgical site
is then drawn.
STEP 4 The undersurface and edges of
each section are then microscopically
examined for evidence of remaining cancer.
STEP 5 If cancer cells are found under
the microscope, the surgeon marks their
locaton onto the map and returns to
the patent to remove another layer of
skin - but only precisely where the cancer
cells remain.
STEP 6 The removal process stops when
there is no longer any evidence of cancer
remaining in the surgical site. Because
Mohs surgery removes only tissue
containing cancer, it ensures that the
healthy tissue is kept intact.
STEP 1 The roots of a skin cancer may
extend beyond the visible porton of the
tumor. If these roots are not removed,
the cancer will recur.
STEP 2 The visible porton of the tumor
is surgically removed.
STEP 3 A layer of skin is then removed
and divided into sections. The Mohs
surgeon then color codes each of these
sectons with dyes and makes reference
marks on the skin to show the source of
these sectons. A map of the surgical site
is then drawn.
STEP 4 The undersurface and edges of
each section are then microscopically
examined for evidence of remaining cancer.
STEP 5 If cancer cells are found under
the microscope, the surgeon marks their
locaton onto the map and returns to
the patent to remove another layer of
skin - but only precisely where the cancer
cells remain.
STEP 6 The removal process stops when
there is no longer any evidence of cancer
remaining in the surgical site. Because
Mohs surgery removes only tissue
containing cancer, it ensures that the
healthy tissue is kept intact.
Jeffrey K. McKenna, MD
June 2014 Peoria Healthy Cells Magazine Page 31
mohs surgery
Highest Potential for Success
Mohs surgery, an advanced treatment for skin cancer, offers the
highest potential for success. As the most exact and precise method
of tumor removal, this procedure minimizes the chance of regrowth.
Mohs relies on the accuracy of a microscope to track and ensure
removal of skin cancer down to its roots. This enables the surgeon to
precisely identify and remove the entire tumor, leaving healthy tissue
intact and unharmed. Mohs surgery is most often used for treating
the two most common forms of skin cancer: basal cell carcinoma and
squamous cell carcinoma, as well as other rare forms of skin tumors.
Cost Effectiveness
In a study of costs of various types of skin cancer removal, the value
of the Mohs process was found to be comparable to the cost of other
procedures, such as electrodessication, curettage, and cryosurgery. It
is also less expensive than repeated surgical procedures, and radiation,
which can require 10 to 20 treatments in a series.
It is important to note that there is no modified Mohs procedure.
Effectiveness and cost effectiveness of the procedure is dependent
upon the fact that each step of the surgery is performed precisely.
Reconstruction
The best method of managing the wound resulting from surgery
is determined after the cancer is completely removed. When the final
defect is known, management is individualized to achieve the best
results and to preserve functional capabilities and maximize esthetics.
Some cancers are found in difficult areas like the ears, nose, or eyelids;
in such cases a board-certified plastic surgeon will assist with the pro-
cedure so the patient has the best final cosmetic result. A small wound
may be allowed to heal on its own, or the wound may be closed in a
straight line with stitches. Other surgical defects may be best repaired
using a skin graft or a flap of adjacent skin.
Soderstrom Skin Institute is proud to be celebrating 40 years in
Central Illinois! For additional information on their Mohs Surgery
program, contact them toll-free at 888-970-7546. To schedule a
consultation with Board-Certified Dermatologist and Mohs Surgeon
Jeffrey K. McKenna, please call 309-268-9980. Before and after
surgery photos are available at SoderstromSkinInstitute.com.
Procedure diagram reprinted with permission of The American Academy of Dermatology
Reference: American College of Mohs Surgery
Photo credit: Dean Bertoncelj/Thinkstock
Mohs surgery,
an advanced treatment
for skin cancer, offers
the highest potential
for success.
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