• When is Mohs needed?


• How Successful is the Treatment of Skin Cancer?


• What is skin cancer?


• Will I Develop More Skin Cancers?

Mohs

Mohs Micrographic Surgery
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The Laser & Skin Surgery Center offers a comprehensive approach to your skin cancer care, providing state of the art diagnosis, treatment and preventative procedures in a comfortable outpatient setting that maximizes cure rates, cosmetic outcomes and patient recovery.
Mohs micrographic surgery is a unique process of treating skin cancers that offers highest cure rates and the best cosmetic outcomes for patients diagnosed with skin cancer. Mohs surgery is named after Dr. Fredrick Mohs who developed the technique in the 1940s, which has since been refined to become the gold standard for surgical treatment of skin cancer.
During Mohs surgery the skin cancer is removed in a unique way that allows for orientation, mapping, and processing of the tissue so that 100 percent of the tumor margin is evaluated, which ensures the highest cure rates while sparing normal surrounding tissue. Once the cancer is completely removed, reconstructive surgery is performed by the Mohs surgeon with optimal cosmetic results.
Mohs defects are generally much smaller than wounds from traditional excision, as Mohs surgery spares as much healthy tissue as possible. Smaller wounds usually result in smaller scars and faster healing for the patient.
Dr. Willey is a Fellowship Trained Mohs and Reconstructive surgeon who specializes in performing complex closures, flaps, grafts and scar revision to achieve the best functional and cosmetic results.

Mohs surgery and reconstruction are usually performed in one outpatient visit under local anesthesia. This allows for rapid patient recovery and avoids the risks associated with general anesthesia. This outpatient treatment may especially benefit elderly patients, who are most susceptible to skin cancer.

Patients with one or more skin cancers may be at an increased risk for developing additional skin cancers. Because of this, Dr. Willey focuses on risk reduction and prevention measures for each patient.
Risk-reduction treatments may include topical chemotherapy, topical immunomodulators, photodynamic therapy. In addition, the adjunctive laser treatments including, ablative and non-ablative skin resurfacing and scar revision procedures can be performed if needed.

Q. When is Mohs needed?

When a tumor is in an area of the body where it is not effectively curable with other methods.
When a tumor is located on a structure that is so important that one wishes to spare as much as the normal skin as possible, such as on the face including the nose, eyelids, lips, or ears.
When the extent of the tumor cannot be easily defined by visual inspection.
When the cancer has recurred after a previous treatment.

Q. How Successful is the Treatment of Skin Cancer?

Initial surgical treatment of skin cancer has a success rate of greater than 90 percent. Methods that are commonly used to treat skin cancer include excision, curettage and electrodessication (scraping and burning with an electric needle), cryosurgery, and radiation therapy. The method chosen depends on several factors, including the microscopic subtype of tumor, the location and size of the tumor, and previous therapy. You may have had one or more of these treatments before coming for Mohs surgery.
If a skin cancer that has been previously treated by one of the above techniques recurs, re-treatment with one of these methods has a success rate of less than 75 percent. The success rate of Mohs micrographic surgery is 97-98 percent.
Unlike other methods of treatment, Mohs surgery does not rely on surface inspection of the skin to judge the extent of cancer growth. If the tumor is not well defined, blending into the normal skin with unclear margins, or if it is growing within a scar from a previous surgery, too little tissue may be removed leaving tumor behind, or too much may be removed. This could lead to tumor recurrence or unacceptable scarring. Mohs surgery allows the surgeon to trace out the margin of the tumor with the use of a microscope so that only the diseased tissue is removed, which results in higher cure rates, smaller defects, better cosmetic outcomes.

Most Mohs surgeries are complete in two to three stages. You will be re-anesthetized for each stage. Once the cancer has been completely removed, we will discuss the options and recommendations for your reconstruction. Most reconstructions are completed on the same day and patients are asked to return in one week for surgical follow up.

Q. What is skin cancer?

Cancer is the abnormal growth of cells at an uncontrolled and unpredictable rate. The cancer tissue usually grows at the expense of surrounding normal tissue. In the skin, the most common types of cancer are basal cell carcinoma and squamous cell carcinoma. The names reflect the cell within the skin from which the particular type of cancer originates. Malignant melanoma is a form of skin cancer that arises from the pigment cells in the skin and often looks like a brown spot or an unusual mole.

Q. Will I Develop More Skin Cancers?

After having skin cancer, statistics say that you have a higher chance of developing a second skin cancer. The damage your skin has already received from the sun cannot be reversed. However, precautions can be taken to prevent further damage that may contribute to additional skin cancers. Protective measure include, avoiding direct sunlight and excessive exposures, especially during peak hours of 10am to 2pm, applying sunscreen at least 10 minutes before exposure and every two hour while in the sun, wearing a wide brimmed hat and protective clothing is recommended. Sunscreens that have an SPF of 30 or greater and both UVA and UVB coverage are most protective. The use of sunscreens with one of the following active ingredients is recommended: titanium dioxide, zinc oxide, and avobenzone. You should perform self skin exams regularly and have your skin examined by your dermatologist every six months.

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