MOHs Surgery: Targeting Skin Cancer with Surgical Precision
Studies show that Veterans have a higher rate of skin cancer due to sun exposure during their military services and lack of protection.
Along with poor protection, some Veterans are also exposed to radioactivity which can also contribute. For the Veterans who have since developed questionable spots, doctors suggest getting a skin exam. This can be done by the primary care doctor or within the dermatology clinic.
What is MOHs Surgery?
The precise surgical procedure to remove visible skin lesions to treat skin cancer was developed in 1938 by general surgeon, Fredric E. Mohs. The method allows surgeons to see where the tumor stops, which is not possible with other types of skin cancer treatment. Being able to see where the cancer stops means a higher cure rate, and the ability to preserve as much healthy skin as possible. Because how specialized of a procedure is, Mohs is not always offered in the community along with the extra training in plastic surgery that our Mohs surgeons have. Other staff in the Mohs clinic make sure to provide patients and their loved ones with as much pre-education before their procedure as possible.
What can I expect?
Upon your visit to the Mohs clinic, the surgeon examines the area being treated. Dr. Elizabeth Cusick says this is when she gets to learn the “story” of the patient's bumps which includes details like when it first appeared, and what type of treatment has been tried. The healthcare professionals at the Iowa City VA Healthcare System pride themselves on talking to their patients, rather than at them, to get a better understanding of the Veteran’s needs.
After the exam, the Mohs staff will use a marker to indicate where the skin cancer is. The surgeon uses these marks to remove the skin cancer, while the patient is awake but numbed. Once the initial removal is over, doctors will take the skin cancer and transfer it to the histology lab. It is in the clinic lab that tissue samples are put into slides and stained to highlight tissue features. During the doctor’s review, the patient remains in the waiting room in case until the doctor confirms they successfully removed all the cancer. “There’s a 50% chance of having to go back,” said Dr. Cusick. “If there is still skin cancer left in the margins, we bring the patient back to remove more bits little by little. We want to make sure we get all the cancer before the patient leaves so that we reduce the risk of the cancer coming back.”
Dr. Cusick suggests a yearly skin check for most people. Those with a history of cancer should be getting checked every 3 to 6 months. Her best advice to Veterans and their loved ones is “Be on the lookout for something that doesn’t seem right and ask questions.” For more information on Mohs Clinic, please talk to your Primary Care Provider or Dermatologist.
To get an inside look at our MOHs Clinic, please visit our YouTube