The Mohs Surgery Solution

              

This article on Mohs surgery by Dr. Patel appeared in the January 2013 issue of DeSoto Magazine. It addresses skin cancer and the most effective surgery available to treat it. If you have questions about the procedure, call Advanced Dermatology & Skin Cancer Associates at 901-759-2322 or leave a comment on this post. 

Skin cancer is the most common form of cancer in the United States, with more than 3.5 million cases diagnosed and treated each year. On average, one in five Americans will develop some form of skin cancer in their lifetimes – despite the fact that many types of skin cancer are preventable!

Although not the most common, melanoma is the most dangerous form of skin cancer, accounting for fewer than 5 percent of skin cancer cases but the vast majority of deaths. The incidence of melanoma increased by 800 percent for women and 400 percent for men from 1970 to 2009. This makes it the only cancer of the seven most common with an increasing incidence.

Luckily, like other skin cancers, melanoma is treatable and preventable. About 86 percent of melanomas can be attributed to exposure to ultraviolet radiation, and a person’s risk for the cancer doubles after he or she suffers five sunburns at any age. The best way to avoid skin cancer and, specifically melanoma, is to wear sunscreen with at least 30 SPF every day – even in the winter! It’s also important to consider long sleeves, hats or other protective clothing.

If you are at risk or if you have developed melanoma or another skin cancer already, it can be treated quite effectively. Unlike other cancers, skin cancer does not often require multiple rounds of chemotherapy or radiation. In fact, it can often be removed if caught early through a simple outpatient procedure known as Mohs surgery.

Developed by Dr. Frederic Mohs, Mohs micrographic surgery is the most advanced and effective treatment procedure for skin cancer available today. The procedure is performed by specially trained surgeons. Mohs surgeons complete at least one additional year of fellowship training with a Mohs College member in addition to a three-year dermatology residency and a one-year medicine residency. With the Mohs technique, surgeons are able to see beyond the visible disease to precisely identify and remove entire tumors layer by layer, leaving surrounding healthy tissue intact and unharmed. As the most exact and precise method of tumor removal, it minimizes the chance of re-growth and lessens the potential for scarring or disfigurement.

Because Mohs surgeons are specially trained in surgery, pathology and reconstruction, Mohs surgery has the highest success rate of all treatments for skin cancer − up to 99 percent. The Mohs technique is also the treatment of choice for cancers of the face and other sensitive areas, as it relies on the accuracy of a microscopic surgical procedure to trace the edges of the cancer and ensure complete removal of all tumors down to the roots.

“The increase in skin cancers is alarming,” said Dr. Purvisha Patel, physician and owner of Advanced Dermatology & Skin Cancer Associates. “But our advances in treating these cancers are promising. Mohs surgery is constantly evolving and improving, and we are able to treat a variety of skin cancers very effectively.”

The ABCDE of Melanoma

Photo by Texas Institute of Dermatology

Everyone has heard of melanoma. It’s not as common as other types of skin cancer, but it is much more dangerous, accounting for about 75 percent of skin cancer-related deaths each year.

Melanoma is most often caused by genetic predisposition and/or prolonged exposure to the sun or sun-like UV light, such as a tanning bed. Even if you wear sunscreen daily, it’s important to regularly examine any suspicious spots on your skin, and to see a dermatologist if you are concerned. The good news is that if it’s caught early, melanoma can be treated. At Advanced Dermatology & Skin Cancer Associates, we perform a procedure called Mohs surgery, which offers a 99 percent cure rate for skin cancers and leaves little or no scarring.

The trick is to catch these cancers early. When examining a spot, keep an eye out for these common signs of melanoma. Dermatologists refer to this as the “ABCDE of Melanoma,” and if all signs are present, you should visit a doctor as soon as possible.

A – Asymmetry

Unlike benign moles, melanoma almost always has an asymmetrical, or irregular, shape. You should look for uneven edges or a spot that has two distinctly different sides.

B – Borders

Benign moles or freckles usually have smooth, even borders and present as a circle. Melanoma, on the other hand, will typically have irregular borders that don’t look like a regular shape.

C – Color

A benign mole or freckle is usually a single shade of brown. If you have a spot that shows multiple colors, it could be a melanoma. Colors that often present in melanoma spots include blue, black, brown and tan.

D – Diameter

Melanoma will often present as a larger spot than a benign mole. A melanoma lesion is usually 6 millimeters or larger in diameter, or at least the size of a pencil eraser.

E – Evolving

Keep an eye on your moles or other spots. Even if you don’t have melanoma, knowing how these types of spots evolve on your skin under normal circumstances may help you spot a problem later. If a mole changes color and size, visit a dermatologist as soon as possible.