As an ophthalmologist based in Saskatchewan, I’m acutely aware of the healthcare landscape in our region. It’s important to note that, currently, there are no Mohs surgeons in Saskatchewan. However, this blog aims to provide valuable information and references for those seeking this specialized treatment. Mohs surgery is a highly effective technique for treating skin cancer, and it’s crucial to understand its benefits, the role of a Mohs surgeon, and what to expect during and after the procedure. Although we lack a Mohs surgeon in our immediate vicinity, this post will guide you towards resources and professionals in neighbouring provinces.
Read on to discover why Mohs surgery is a top choice for skin cancer treatment and learn how this specialized technique can lead to better patient outcomes.
Key Takeaways
- Mohs surgeons are highly skilled specialists in treating skin cancer, with rigorous education and training to provide comprehensive care.
- Patients undergoing Mohs surgery benefit from high cure rates, minimal scarring, and personalized care tailored to their needs.
- Post-surgery care is essential for optimal healing and minimizing the risk of complications such as infection or recurrence.
The Role of a Mohs Surgeon
As skin cancer cases continue to rise, Mohs surgery has emerged as a leading treatment option, particularly for basal cell carcinoma and squamous cell carcinomas (SCCs). Mohs surgeons are at the forefront of this battle against skin cancer, performing surgery for skin cancer, such as Mohs micrographic surgery, and providing comprehensive patient care and follow-up.
Mohs surgeons, with their extensive education and rigorous training, are highly skilled specialists in treating skin cancer. Their precision and expertise make them a preferred choice for those seeking effective skin cancer treatments.
So, what exactly does it take to become a Mohs surgeon, and what kind of surgical expertise do they possess?
Education and Training
The journey to become a Mohs surgeon is challenging. The pathway includes a dermatology residency, followed by a one-year fellowship in Mohs surgery. It is during this fellowship that they develop expertise in treating various skin cancers, including squamous cell carcinoma.
Mohs surgeons are not only trained in the precise removal of cancerous skin tissue, but also in reconstructive techniques such as skin graft. This comprehensive training prepares them to provide outstanding care to patients battling skin cancer, ensuring optimal outcomes.
Surgical Expertise
Proficient in their craft, Mohs surgeons skillfully perform skin cancer removal using a specialized technique called Mohs micrographic surgery. This method involves removing skin cancer layer by layer, examining each layer microscopically, and performing necessary reconstruction. It allows for the precise removal of cancerous tissue while preserving healthy skin.
This tissue-sparing technique ensures that the surgical margins are examined thoroughly, guaranteeing the complete removal of cancerous cells. As a result, Mohs surgery boasts the highest success rates in treating skin cancer, making it the gold standard for patients seeking effective treatment.
Patient Care and Follow-Up
In addition to their surgical expertise, Mohs surgeons are committed to providing personalized care and diligent follow-up for their patients. They monitor patients for potential future skin cancers through regular examinations and advise on self-examinations at home.
Adhering to the physician’s directions for wound management, scar management, and post-operative check-ups is crucial to optimize the results of Mohs surgery. With a 40% chance of another basal skin cancer occurrence within the next five to ten years, regular monitoring and patient education are vital components of the care provided by Mohs surgeons.
The Mohs Surgery Procedure
The Mohs procedure, also known as Mohs surgery, is a step-by-step process that begins with preparing for surgery, followed by the surgical procedure itself, and finally post-surgery care. Each stage plays a crucial role in ensuring the best possible outcomes for patients battling skin cancer.
Let’s delve deeper into what each step entails and how Mohs surgeons ensure the highest standards of care throughout the process.
Preparing for Surgery
Before undergoing Mohs surgery, patients should discuss their medical history, current medications, and any concerns with their surgeon. While there are no dietary restrictions, certain medications such as herbal supplements, aspirin, and ibuprofen should be avoided as they can increase the risk of bleeding. It is recommended to consult with your Mohs surgeon for further instructions regarding any prescribed medications.
Being well-prepared for your Mohs surgery significantly contributes to a successful outcome. Your Mohs surgeon will guide you through the necessary steps to minimize the risks and optimize the results of your skin cancer treatment.
During Surgery
In a Mohs surgery, the surgeon strategically removes and examines skin layers under a microscope until the cancer cells are no longer visible. This process is performed under local anesthesia, meaning that patients remain conscious throughout the procedure. The entire procedure may last from one to five hours, depending on the number of stages involved.
Mohs surgery is a meticulous process that requires a high degree of precision. By examining each layer of skin microscopically, the surgeon can ensure complete removal of cancerous tissue while preserving as much healthy tissue as possible.
Post-Surgery Care
Following Mohs surgery, patients are provided with wound care instructions. They can then decide between allowing natural healing or opting for reconstructive surgery. Proper wound care is essential to minimize the risk of infection and ensure optimal healing.
Patients must adhere to their surgeon’s post-operative instructions and maintain proper wound care and hygiene practices to minimize the risk of complications and achieve the best possible outcome. The choice between natural healing or reconstructive surgery largely depends on the patient’s preferences and the extent of tissue loss.
Benefits of Choosing a Mohs Surgeon
Opting for a Mohs surgeon to treat skin cancer brings many benefits. These highly trained specialists offer high cure rates, minimal scarring, and personalized care tailored to each patient’s unique needs, preserving as much healthy skin as possible.
Let’s explore these benefits and why Mohs surgery is an excellent choice for skin cancer treatment.
The Landscape of Mohs Surgery in Saskatchewan and Neighboring Provinces
As of the time of writing this blog, it appears that no Mohs surgeons are practicing in Saskatchewan. Mohs surgery, a precise surgical technique used to treat skin cancer, is an important part of dermatological care. While Saskatchewan has many skilled dermatologists and surgeons, none currently specialize in Mohs surgery.
However, if you are a Saskatchewan resident needing Mohs surgery, don’t despair. Several highly qualified Mohs surgeons in the neighbouring provinces of Alberta and Manitoba can provide this specialized care. Here are a few:
In Alberta:
- Dr. Mariusz Sapijaszko, based in Edmonton (https://www.realself.com/find/Alberta/Edmonton/Mohs-Surgery)
- Dr. Muba Taher, also based in Edmonton (https://www.realself.com/find/Alberta/Edmonton/Mohs-Surgery)
In Manitoba:
- Dr. Tarek Afifi, based in Winnipeg (https://www.winnipegclinic.com/departments.php?id=3)
While it may be inconvenient to travel for this procedure, it’s important to remember that Mohs surgery is highly specialized and not all dermatologists are trained in this technique. These surgeons have the necessary training and experience to provide the best care possible.
We hope that in the future, Saskatchewan will have its own Mohs surgeons to provide local care for skin cancer patients. Until then, we are fortunate to have access to these skilled surgeons in our neighbouring provinces.
High Cure Rates
Mohs surgery, with its highest cure rate for basal and squamous cell skin cancers, is the most effective treatment option. The success rate of Mohs surgery for treating skin cancer, including squamous cell carcinoma, can reach up to 99%.
High cure rates make Mohs surgery a preferred choice for patients with high-risk skin cancer. The precision and expertise of Mohs surgeons contribute to these high success rates, ensuring patients receive the best possible care for their skin cancer treatment.
Minimizing Scarring
Scarring remains a primary concern for patients undergoing skin cancer treatment. Mohs surgery offers the advantage of minimal scarring compared to other skin cancer treatments due to its precision in preserving healthy skin and removing only affected areas.
Mohs surgeons employ various techniques to ensure minimal scarring during surgery, such as:
- Using silicone strips or gel to reduce the appearance of surgical scars
- Camouflaging the scar in natural skin folds or smile lines
- Keeping the surgical site moist by covering it with a bandage and utilizing certain ointments and emollients to promote healing and minimize scarring.
Personalized Care
At the core of Mohs surgery is personalized care, which ensures each patient receives the tailored attention they require. Mohs surgeons consider factors such as:
- The type and stage of skin cancer
- Its location on the body
- The patient’s overall health condition
- Any underlying medical conditions or medications that may impact the surgery
- The patient’s preferences and goals for treatment
This personalized approach to care results in increased patient satisfaction and better outcomes overall. From the initial consultation to post-operative follow-up, Mohs surgeons work closely with their patients to ensure their unique needs and concerns are addressed.
Reconstruction Options After Mohs Surgery
Post-Mohs surgery, reconstruction is frequently required to restore the look and function of the impacted area. Patients have several options for reconstruction, including immediate reconstruction, delayed reconstruction, or referral to a specialist.
Understanding these options will help patients make informed decisions regarding their post-surgical care.
Immediate Reconstruction
In many cases, Mohs surgeons can perform reconstructive surgery immediately after cancer removal, often in the same office visit. The extent of reconstruction can vary, ranging from small closures stitched into a wrinkle to larger flaps with multiple sutures in different face areas.
Mohs surgeons receive specialized training in reconstructive techniques, allowing them to provide the best possible cosmetic outcome for their patients following cancer removal. This immediate reconstruction offers the added convenience of addressing cancer removal and reconstruction in a single visit.
Delayed Reconstruction
Some patients may choose to wait for natural healing before undergoing reconstructive surgery. Delayed reconstruction has both advantages and disadvantages. Benefits include enhanced surgical preparation, decreased risk of complications, and optimal wound healing.
Disadvantages include an extended waiting period and potential psychological effects on patients. The choice between immediate and delayed reconstruction largely depends on the patient’s preferences, the location and extent of the Mohs defect, and the risk of postoperative complications such as infection.
Referral to a Specialist
During my fellowship in oculoplastic surgery at the University of Iowa Hospitals and Clinics, we often received referrals for patients who had undergone Mohs surgery and required eyelid reconstruction. This is not uncommon, as Mohs surgeons may refer patients to specialists, such as plastic surgeons or oculoplastic surgeons, for the reconstruction phase of treatment.
A variety of factors typically influences the decision to refer. These include the type and location of the skin cancer, the size and type of the defect left by the Mohs surgery, the patient’s history of prior skin cancer treatment, and their overall health. It’s crucial to ensure that the patient receives the best possible care and outcome, and sometimes, that means involving different specialists throughout the treatment process.
Risks and Potential Complications
Although Mohs surgery is widely regarded as safe and effective, patients should be cognizant of potential risks and complications. Understanding these risks can help patients make informed decisions about their skin cancer treatment and take necessary precautions to minimize potential complications.
Infection
Minimizing the risk of infection post Mohs surgery calls for appropriate wound care. The infection rate following Mohs surgery is generally low, ranging from 0.5% to 2.4%. However, it is crucial that patients follow their surgeon’s post-operative instructions and maintain proper wound care and hygiene practices to reduce the risk of infection.
In the event of an infection, it is important to reach out to your Mohs surgeon for further guidance and treatment. Early intervention can help prevent complications and ensure the best possible outcome for your skin cancer treatment.
Scarring
Despite the aim of Mohs surgery to reduce scarring, some extent of it is unavoidable. The potential for scarring after Mohs surgery is contingent upon the size and location of the wound, as well as the patient’s individual healing process.
Patients can take steps to minimize scarring by following proper wound care instructions and utilizing techniques such as massaging the area, which may help reduce the visibility of scarring. Additionally, Mohs surgeons are skilled in employing various techniques to ensure minimal scarring during surgery.
Recurrence
Despite Mohs surgery boasting the lowest recurrence rate among skin cancer treatments, patients should maintain regular skin cancer screenings to monitor potential recurrence. The recurrence rate after Mohs surgery is generally low, but it can be subject to variation depending on the type of skin cancer and the patient’s individual circumstances.
Continuing skin cancer screenings every six months post-Mohs surgery is essential for recurrence monitoring and early detection of any potential skin cancers. By staying vigilant and maintaining regular check-ups, patients can ensure the best possible long-term outcomes following Mohs surgery, as cancer cells remain a concern even after successful treatment.
Summary
Mohs surgery has emerged as a leading treatment option for skin cancer, offering patients high cure rates, minimal scarring, and personalized care. With the expertise of Mohs surgeons and the precision of the surgical technique, Mohs surgery provides an effective solution for those battling basal cell and squamous cell carcinoma. If you or a loved one is facing skin cancer, consider Mohs surgery as a viable and effective treatment option, and take the first step towards a cancer-free future.
Frequently Asked Questions
What is the Mohs procedure?
The Mohs procedure, or Mohs surgery, is a surgical technique used to treat skin cancer. It involves the removal of skin cancer layer by layer, with each layer being examined under a microscope immediately after removal.
What does Mohs surgeon stand for?
Mohs surgery, or Mohs Micrographic Surgery, is a specialized technique pioneered by Frederic E. Mohs to treat common types of skin cancer, such as basal cell carcinoma and squamous cell carcinoma, as well as melanoma and other less common skin cancers with a high risk of coming back or that have returned after previous treatment. This technique is highly effective, with a cure rate of up to 99%. It is also minimally invasive, with a low risk of scarring and other side effects. The procedure involves removing thin layers
What is the difference between a Mohs surgeon and a plastic surgeon?
A Mohs surgeon specializes in the removal of skin cancer through a precise procedure that ensures maximum preservation of healthy tissue, while a plastic surgeon focuses on reconstructing areas affected by surgery for optimal cosmetic results.
Who is Mohs surgery done by?
Mohs surgery is performed by doctors who are specially trained to fulfill three roles: as the surgeon, pathologist and reconstructive specialist.
How long does Mohs surgery usually take?
On average, Mohs surgery will take around 3-4 hours depending on the size, location, and type of skin cancer being removed, or potentially longer if required.
How serious is Mohs surgery?
Mohs surgery is a very common and effective treatment for skin cancer, as it has an up to 99% cure rate. It can also effectively treat skin cancer that has recurred after previous treatments with a 94% success rate. However, there are some risks associated with Mohs surgery such as bleeding from the site of surgery, hematoma formation, and pain or tenderness in the area where skin was removed.
What type of cancer is Mohs procedure for?
Mohs surgery is primarily used for treating basal and squamous cell skin cancers, although it can be used for other types of skin cancer as well. It is particularly effective for cancers that have a high risk of recurrence or have already recurred after previous treatment.
How long is recovery from Mohs surgery?
The recovery period from Mohs surgery varies based on the individual and the extent of the surgery. Generally, patients are able to return to their normal activities within a day or two. However, it may take a few weeks for the surgical wound to fully heal.
What is the difference between Mohs surgery and regular surgery?
The main difference between Mohs surgery and regular surgery is the method of removing the cancer and examining the tissue. In Mohs surgery, skin cancer is removed layer by layer, with each layer being examined under a microscope immediately after removal. This allows the surgeon to ensure all cancer cells have been removed at the time of surgery.
Is Mohs surgery a big deal?
Mohs surgery is a minimally invasive procedure, but it is a serious procedure as it involves the removal of skin cancer. It has a high success rate and is often the treatment of choice for many types of skin cancer, especially those that are aggressive or located in cosmetically sensitive areas.
How painful is Mohs surgery?
Most patients report minimal discomfort during Mohs surgery. The area being operated on is numbed with a local anesthetic, so patients typically feel pressure but not pain during the procedure.
What does Mohs skin cancer look like?
Mohs skin cancer isn’t a type of skin cancer, but rather a method of treating skin cancer. The appearance of skin cancer can vary greatly, but common signs include new growths, sores that don’t heal, or changes in existing moles.
What is the prognosis for a patient having a Mohs surgery?
The prognosis for a patient undergoing Mohs surgery is generally very good. Mohs has a high cure rate, often cited as up to 99% for new skin cancers and 95% for recurrent skin cancers.
How long does a Mohs procedure take to heal?
The healing process for a Mohs procedure varies depending on the extent of the surgery, but generally, it takes a few weeks for the wound to fully heal.
What type of cancer is Mohs surgery used for?
Mohs surgery is primarily used for treating basal and squamous cell skin cancers. It can also be used for other types of skin cancer in certain circumstances.
Is Mohs surgery always for cancer?
Yes, Mohs surgery is a procedure specifically designed for the removal of skin cancer.
Is Mohs surgery the best option for basal cell carcinoma?
Mohs surgery is often the treatment of choice for basal cell carcinoma, especially when it is located in a cosmetically sensitive area or has a high risk of recurrence.
How long is Mohs surgery for basal cell carcinoma?
The length of the procedure can vary depending on the size and location of the cancer, but most Mohs procedures can be completed in a few hours.
What to expect after Mohs surgery on the face?
After Mohs surgery on the face, patients can expect some swelling and discomfort, which can be managed with over-the-counter pain medication. It’s also important to protect the area from the sun and follow all post-operative care instructions.
What not to do after Mohs surgery?
After Mohs surgery, patients should avoid strenuous activity for a few days, keep the surgical area clean and dry, and avoid sun exposure. It’s also important to follow all post-operative care instructions provided by the healthcare team.
Why would a person need a Mohs procedure performed?
A person would need a Mohs procedure performed if they have a type of skin cancer that is aggressive, has a high risk of recurrence, or is located in a cosmetically sensitive area.
What kind of cancer is Mohs?
Mohs isn’t a type of cancer. It’s a surgical technique used to treat certain types of skin cancer, including basal cell carcinoma and squamous cell carcinoma.
How long does it take to heal from Mohs surgery on face?
Healing from Mohs surgery on the face typically takes a few weeks. However, patients are generally able to return to normal activities within a day or two.
How long is recovery after Mohs surgery?
Recovery after Mohs surgery typically takes a few weeks, but patients are generally able to return to normal activities within a day or two.
Is Mohs surgery serious?
Mohs surgery is a serious procedure as it involves the removal of skin cancer. However, it is minimally invasive and has a high success rate.
How long does Mohs surgery take to heal?
Healing from Mohs surgery typically takes a few weeks. However, patients can generally return to normal activities within a day or two.
How successful is Mohs surgery for skin cancer?
Mohs surgery has a high success rate for treating skin cancer, often cited as up to 99% for new skin cancers and 95% for recurrent skin cancers.
Is Mohs surgery worth it?
For many patients with certain types of skin cancer, Mohs surgery is worth it due to its high success rate and the ability to preserve as much healthy skin as possible.
References
- “Mohs Surgery” – American Academy of Dermatology Association [https://www.aad.org/public/diseases/skin-cancer/mohs-surgery]
- “Mohs Surgery Overview” – Mayo Clinic [https://www.mayoclinic.org/tests-procedures/mohs-surgery/about/pac-20385222]
- “What Is Mohs Surgery?” – American Cancer Society [https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/treating/mohs-surgery.html]
- “Mohs Micrographic Surgery” – Skin Cancer Foundation [https://www.skincancer.org/treatment-resources/mohs-surgery/]
- “What Is Mohs Surgery?” – Johns Hopkins Medicine [https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/mohs-surgery]
- “Mohs Surgery: A Treatment for Skin Cancer” – Cleveland Clinic [https://my.clevelandclinic.org/health/treatments/17145-mohs-surgery]
- “Mohs Surgery for Skin Cancer Treatment” – WebMD [https://www.webmd.com/melanoma-skin-cancer/mohs-surgery-for-skin-cancer]
- “What to Expect With Mohs Surgery for Skin Cancer” – Healthline [https://www.healthline.com/health/mohs-surgery]
Author
Dr. M. Ronan Conlon started his career in the field of ophthalmology at the same time as the development of refractive eye surgery in Canada. In 1996, he brought laser technology to Canada from Germany, which allowed him to perform laser eye surgery before it was available in the United States. With the establishment of the Conlon Eye Institute, Dr. Conlon has performed more than 40,000 refractive procedures and has advanced his expertise in LASIK and refractive cataract surgery.
The information on this page should not be used in place of information provided by a doctor or specialist. To learn more, read our Privacy Policy and Editorial Policy pages.
