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When you hear Mohs, it sounds like one of those new procedures that just started in the new millennium, but that is not true, it has been here for as long as the 1930s. It is a surgical procedure that was developed and popularized by Frederic Edwards Mohs. The primary role of the surgery is to treat different forms of skin cancer, but the uniqueness of the plan is that it is done with the guidance of the microscopic. The beauty of the procedure is that it even gives additional information on whether there are more tissues that have been invaded by cancer. Mohs have been shown to successfully treat large numbers of the different types of skin cancer such as basal cell carcinoma, squamous cell carcinoma, and melanomas.

In the United States of America, the American College of Mohs Surgery, American Society for Mohs Surgery, American Society for Dermatologic Surgery Association, and American Academy of Dermatology Association have formed an alliance to set ethical ways of carrying out these procedures appropriately. These organizations have come together to create a guiding principle and standards to follow. These guidelines assist in deciding whether the job should be done at all in the first place.

How is the Mohs Surgery Performed?

One of the significant goals of this procedure is to avoid recurrence because Mohs will no longer be as effective at the point any longer. The foremost thing that the surgeon is burdened with is which tissue requires removal with regards to the tumor.

Step 1: The patient is given anesthesia, and the surgery commences.

Step 2: The visible part of the tumor is first removed by the surgeon utilizing adequate surgical

techniques.

Step 3: The surgeon goes further to extract a portion of the skin, separates them into distinct

portions, and mark them with unique colors, with the use of dyes, to know which source a skin section originated from particularly.

Step 4: That section of the skin already taken is then transferred to the laboratory, and it is placed

under the microscope, and evidence of cancer is examined.

Step 5: The Surgeon will use the color codes to identify any part of the skin that shows the

presence of cancer cells. When that occurs, a deeper layer of a source of that specific skin is taken. This is carried out for the purpose of causing as little scar as possible.

Step 6: The procedure continues until there is no other cancerous tissue present as observed

under the microscope.  It is at this stage the skin reconstruction plan comes into play, and then post-operative care comes in, as well.

The recovery process is encouraging as only local anesthetics are employed. Also, extreme care and accuracy are taken in choosing and using the surgical techniques that are used on the patient.

How Long Does it Take to do Mohs Surgery?

The procedure of removing completely every cancerous cell from the skin carefully and thoroughly takes a while. For some people who were diagnosed at a very early stage, it could take as little as an hour, but for others that had the diagnosis a bit later into its progression, may wait for up to three hours or more. The whole idea of the surgery is to eradicate cancerous tissue from the individual’s skin, and help prevent any form of relapse or recurrence. This is why patients are encouraged to bring along something to buy the time while waiting for the result from the laboratory. The surgeon will ask the patient to remain in the waiting room, while the skin extracted is being tested to see whether it is cancer-free. So novels, magazines, games, or even a friend to help pass the time will be great. The time spent in performing the surgery itself, I mean the removal of the skin, is very quick, what takes longer is the laboratory examination to rule out any cancer left. The procedure may take a while but, it is worthwhile.

How Effective is Mohs Surgery?

The dramatic rise to prominence of the Mohs surgery has been phenomenal. Most people are now using it, not just because of its fast recovery, but also for its efficacy in treating the notorious basal cell carcinoma, and other forms of skin cancer. Dermatologists have been more inclined to use the procedure as it helps them complete a surgery within a day, and making sure the entire cancer cells in the region being operated on, has been removed.

Even when the results of the thoroughness of clearing the cancer cells in cases of squamous cell carcinoma is compared to that of melanoma, as well as to the basal cell carcinoma, more than 70% success rate is found with all three,  making it super reliable. There may be controversy regarding the price of the surgical procedure. However, the surgeons who carry out these surgeries have spent a lot of time and resources in harnessing their skills. Dermatologists, who undergo additional four years after medical school as resident doctors, undertake one more year of fellowship to master the skills that will enable them become expert Mohs surgeons.

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Just before the movie released in the winter of 2017, “The Greatest Showman,” starring Hugh Jackman, something remarkable happened during the stage of getting funding for the project. Jackman, who is popular for his portrayal of the Marvel Universe action hero – Wolverine, was diagnosed with cancer up his nose, and it had to be removed. Unfortunately, the stitching came off during one of the performances for the prospective executive producers. However, nothing severe or dangerous resulted from that as the production got the green light, with the star putting on one of the phenomenal performance of his career receiving a golden globe nomination for the feat.

The story is to show that there is very little disturbance to one’s lifestyle after going through Mohs surgery, Surgeons are waiting to rescue you from such an avoidable cancer episode. Wolverine went back to sing just a day after his surgery, and he was not howling, his voice was superb and sonorous, delivered the rendition of the song from the motion picture “From now on” charismatically, and the money followed.

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References

American Surgery. (2017). The Mohs Step-by-Step Process | Mohs Surgery Patient Education. Retrieved from https://www.skincancermohssurgery.org/about-mohs-surgery/the-mohs-step-by-step-process

Mohs surgery – Mayo Clinic. (2017). Retrieved from https://www.mayoclinic.org/tests-procedures/mohs-surgery/about/pac-20385222

Mohs surgery AUC | American Academy of Dermatology. (2017). Retrieved from https://www.aad.org/practicecenter/quality/appropriate-use-criteria/mohs-surgery-auc

The Greatest Showman | “From Now On” with Hugh Jackman | 20th Century FOX. (2017). Retrieved from https://www.youtube.com/watch?v=PluaPvhkIMU&t=9s