Skin Cancer Surgery
Skin cancer is one of the most common cancers, but if detected early, it’s quite treatable. Mohs surgery was named after Dr. Frederic Mohs, who initially developed the technique in the 1930s. It is a precise surgical treatment for skin cancer that is very effective. This procedure is particularly useful for treating skin cancers that occur in areas like the face, neck, and hands, where preserving healthy tissue is essential. In this article, we’ll delve into Mohs surgery, its benefits, procedure, risks, recovery, and costs, along with the best hospitals in India for this treatment.
What is Mohs surgery?
Mohs micrographic surgery (shortly known as Mohs surgery) is an intricate surgical treatment to remove skin cancer. In this technique, a surgeon removes an exceptionally thin layer of the cancerous tissue, and a pathologist examines each layer immediately under a microscope to ensure that all cancerous cells are removed. The team continues the process until they find no cancerous cells, so Mohs surgery serves as a highly accurate way of treating skin cancers and results in saving the greatest possible amount of healthy tissue.
Doctors often use this technique in basal cell carcinoma and squamous cell carcinoma, two of the most common skin cancer types. Tumors that doctors place at sensitive and observable locations like ears, faces, and noses do particularly well since the cosmetic outcome is one of the more essential requirements in their treatment.
Why is Mohs Surgery Performed?
The main reasons for conducting Mohs surgery are as follows:
- To remove skin cancer effectively: This surgery is for the removal of skin cancer very precisely, eliminating all cancerous cells while losing as little normal tissue as possible.
- To use in cancers located in cosmetic-sensitive areas: The procedure best suits cancers occurring in areas with cosmetic outcomes considered paramount, such as the face, ears, or neck.
- Doctors use it to treat aggressive or recurrent cancers. Physicians always recommend Mohs surgery for patients who develop recurring cases of skin cancer or have aggressive growths of a tumor that has invaded tissue alongside its former position.
- To reduce the recurrence rate: The Mohs surgery significantly reduces the rate of cancer occurrence because it removes all cancerous cells in a single procedure.
Types of Skin Cancer Treated using Mohs Surgery
Mohs surgery is mainly used to treat the following types of skin cancer:
- Basal Cell Carcinoma (BCC): BCC is the most common type of skin cancer and tends to be slow-growing and localized. However, when it occurs in critical or cosmetic areas, Mohs surgery is the ideal treatment.
- Squamous Cell Carcinoma (SCC): SCC is the second most common skin cancer. It may appear as a scaly patch or a sore that doesn’t heal. Doctors often recommend Mohs surgery for SCCs that have grown larger, spread, or are located in delicate areas.
- Melanoma: Doctors do not generally use Mohs surgery for melanoma, but they may use it in certain situations, such as when a sensitive or cosmetic area contains melanoma.
Procedure Steps for Mohs Surgery
Mohs surgery is usually an outpatient procedure and is performed under local anesthesia. Here are the general steps involved in the procedure:
- Anesthesia: The surgeon applies a local anesthetic to the region around the tumor to ensure that the patient is comfortable throughout the procedure.
- Initial Tumor Removal: The surgeon removes a thin layer of tissue that contains the tumor.
- Microscopic Examination: The tissue removed is taken to a lab immediately and examined under a microscope. If doctors find cancerous cells, they remove additional layers of tissue from the affected region.
- Repeat layers: the procedure goes on, where the surgical team takes out and inspects the tissue layers for cancerous cells till they find none, and then they remove only the cancerous tissue exactly.
- Closing: when the surgeons have completely removed the cancerous tissue, they close the wound by either stitches or simply leave it to heal naturally; they could undertake reconstructive surgery if possible to obtain the best cosmetic results.
Benefits of Mohs Surgery
Mohs surgery offers numerous advantages for patients with skin cancer:
- Precision: Mohs surgery allows for the removal of cancerous tissue with great precision, minimizing the removal of healthy tissue. This is especially important in areas where preserving healthy tissue is critical, such as the face.
- It has a high cure rate, particularly in basal and squamous cell carcinomas. It can easily be more than 99% successful for the cancer that hasn’t spread.
- Minimum scarring: Since Mohs surgery involves only removing cancerous cells, the procedure aims to avoid scarring as much as possible, yielding excellent cosmetic outcomes.
- Immediate results: Since the surgeon examines tissue during the procedure, they can ensure that they remove all cancer cells before closing the wound, thereby reducing the need for additional surgeries.
- Treatment for recurrent cancer: Mohs surgery is particularly useful for treating skin cancers that have recurred after previous treatments, as it ensures complete removal of the cancerous cells.
Cost of Mohs Surgery
Here’s the cost of Mohs surgery in different countries:
- United States: $3,000 to $10,000
- United Kingdom: $2,000 to $6,000
- India: $1,500 to $3,500.
Top Hospitals in India for Mohs Surgery
India has several reputed hospitals throughout the country to perform Mohs surgery with satisfactory success rates. Some of these top hospitals include:
- Metro Hospital Faridabad
- Medanta—The Medicity—Gurgaon
- Max Super Speciality Hospital, Delhi NCR
- Fortis Memorial Research Institute – Gurgaon
Risk and Complication
Mohs surgery is almost safe, and like every other surgical procedure, it has some risks, such as:
- Infection: As with all types of surgeries, surgeons face an inherent risk at the site from which they excised the lesion, particularly with poor aftercare.
- Bleeding: Although there will normally be some postoperative or intraoperative bleeding that the medical team can easily control.
- Scar: Scars are avoided since the Mohs technique is specifically focused on sparing and minimizing scar sizes, and can be worse where the lesion or tumor is particularly large. However, residual or recurrent cancer
- This might eventually occur due to recurrence.
- Nerve damage: This depends on how close to the nerves the tumor is. This can lead to localized numbness and other sources of weakness in that region.
Recovery
Recovery time after Mohs surgery is usually very short, especially for smaller tumors. Here’s what you can expect:
- Post-operative care immediately after surgery: You will dress the wound, and you may need to apply certain ointments or take pain medication in other cases to reduce discomfort.
- Follow-up visits: The healthcare provider schedules a follow-up appointment to monitor healing and check for signs of infection or other complications.
- Wound care: Healthcare providers usually advise patients to keep the wound clean and avoid activities that could strain the area for a few weeks.
- Return to normal activities: Most patients can return to their normal activities within a few days, although they may need to avoid physical exertion until healing is complete.
- Cosmetic reconstruction: Depending on the area and size of the tumor, a surgeon can perform reconstructive surgery to achieve cosmetic reconstruction.
