Skin cancer is the most common cancer in the United States. It is estimated that 1 in 5 Americans will develop this disease in their lifetime, and 9,500 people are being diagnosed daily. Fortunately, when caught early and properly treated, the prognosis tends to be excellent. Regular skin exams with a dermatologist are just as important for maintaining one’s overall health as having routine exams in other medical specialties, ensuring appropriate monitoring and allowing for early diagnosis.

What is Skin Cancer?

Skin cancer is an abnormal growth of cancerous skin cells that can affect any skin type. Fortunately, the most common types of skin cancer, basal and squamous cell carcinomas and melanoma, are curable if detected early. Basal and squamous cell carcinoma infrequently spread (metastasize) to the lymph nodes and other parts of the body, but they can result in significant discomfort and local tissue destruction if left untreated. If skin cancer metastasizes, this can be life-threatening. Some of the known risk factors for skin cancer include a history of excess sun exposure, sunburns, tanning bed use and immunosuppression. According to the Skin Cancer Foundation, experiencing five sunburns over your lifetime more than doubles your chances of developing melanoma.

Treatment Options

Early diagnosis, prompt treatment and regular skin exams and surveillance are critical. The goals of treatment are to prevent progression and recurrence of the skin cancer.  The recommended treatment options and regimens will vary for patients depending on several factors, some of which include the type, anatomic location and prior treatments of the skin cancer. Potential treatments are topical chemotherapy, cryosurgery, surgical excision and Mohs surgery. Mohs surgery affords the highest cure rate for most skin cancers, and it should be utilized in the appropriate clinical scenarios. 

What types of skin cancer should be treated with Mohs surgery?

Many of the most commonly diagnosed skin cancers are most appropriately managed with Mohs surgery. The Mohs procedure allows the surgeon to optimize the functional and cosmetic outcome by minimizing the removal of normal healthy tissue, which is especially important for ill-defined or larger lesions. Furthermore, the Mohs procedure is safe, convenient and cost-effective.    

What is Mohs Surgery?

Mohs micrographic surgery is the gold standard in skin cancer treatment. It is the most effective and advanced treatment, offering up to a 99% success rate for many types of skin cancer. Because the surgeon is both operating and reading the pathology, this treatment allows for complete visualization of all tissue margins at the time of surgery. By minimizing the removal of the normal surrounding skin, it creates a smaller defect or wound, which often leads to a simpler reconstruction and easier recovery. Since this procedure is carried out under local anesthesia, the risk for the patient is quite small, even in those with a complicated medical history. Often performed on an outpatient basis, the surgeon can spare as much normal skin as possible to have the maximum amount of tissue for good healing and reconstruction. 

Mohs Surgeons Have Varying Training

All dermatologic surgeons may obtain their board certification in Micrographic Dermatologic Surgery from the American Board of Dermatology.  Far fewer Mohs surgeons, however, have completed a one-year rigorous surgical fellowship, providing specialized training to practice as the skin cancer surgeon, pathologist and reconstructive surgeon in a single visit.

If you are considering having Mohs Surgery, ask your doctor if he or she has completed fellowship training for this highly specialized treatment.

Dr. Alyssa Findley, MD, FAAD, FACMS is a Member of the American College of Mohs Surgery (ACMS) and is a Fellowship-Trained Mohs Surgeon. Dr. Findley additionally has over eight years of experience practicing Mohs for melanoma, a specialized procedure indicated for many types of melanoma. Treatment by an ACMS surgeon affords the highest success rate of all treatments for skin cancer (up to 99%). Visit her website at www.findleyderm.com for more information.