What is Mohs' surgery?
Mohs' surgery is a highly technical, micro-surgical technique used to treat skin cancers. Mohs' surgery is the most exact and precise method of tumour removal, which offers the highest potential for complete removal of the cancer while sparing the surrounding healthy tissue.
Mohs' surgery is now seen as the single most effective technique for removing Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC) - the two most common forms of skin cancer. Cure rates for BCC and SCC may be 99% with Mohs' surgery, which is higher than standard excision or any other accepted method. (1.) Mohs' surgery is also an effective treatment for other types of skin cancers; we recently introduced Mohs' surgery as a method for treating patients with melanomas in situ (Lentigo maligna) with the use of immunohistochemistry.
The technique is named after Dr Frederic Mohs, a professor in surgery in the USA during the 1930's.
The procedure allows gradual removal of the malignant tissue in layers, sparing as much normal tissue as possible.
During Mohs' surgery, our specially-trained Mohs' surgeon progressively removes microscopic horizontal layers of the patient's skin. That tissue sent to our Mohs Laboratory, then is immediately processed by using histocryotomy techniques and histochemical techniques by the specialised Mohs scientist. The slides are examined microscopically to determine whether the skin cancer has been completely removed. If not, the surgeon then removes minimal tissue with the cancer remaining, and the pathology process is repeated.
For more information about the procedure, download the brochure below.
Download the brochure
Mohs' surgery can only be carried out by accredited Mohs surgeons. There are several Mohs surgeons working at the Skin Health Institute.
They are specially trained dermatologists who have undertaken a minimum of an extra 1-2 years approved Mohs' surgery training. Approved Mohs surgeons are both Fellows of the Australasian College of Dermatologists (FACD) and accredited Mohs surgeons.
They are also required to undertake regular assurance programs in diagnostic dermatopathology, run by the Royal Australasian College of Pathology, and the rigorous standards applied by the Australasian College of Dermatologists.
A list of accredited Australian Mohs surgeons can be seen here.
Our Mohs surgeons
Associate Professor Greg Goodman
Dr Tim Rutherford
Dr Edward Upjohn
Associate Professor Phillip Bekhor
Dr Bonnie Swan
OUR MOHS SCIENTISTS
Ms Sonya Odhavji (Mohs Senior Scientist)
Mr Vaughan Hendersen
Why this technique?
The virtue of Mohs' surgery is that it removes the skin cancer very effectively, while minimising damage to surrounding healthy tissue.
Mohs' surgery is micrographically controlled, therefore provides extremely precise removal of cancerous tissue, while healthy tissue is spared. It is particularly advantageous in areas such as the eyelids, nose and lips.
With traditional surgical removal of skin cancers, only about 1-3% of the tumour margins are examined, which, when compared to Mohs' surgery, increases the chances that a small tumour cluster will be missed and left behind. Mohs' surgery allows for examination of 100% of the tumour thereby minimising the chance of tumour cells being left behind.
Am I a good candidate for Mohs?
Mohs' surgery is widely used for the surgical removal of the most common types of skin cancers (BCCs and SCCs). It is not currently used to remove non-cancerous growths. Mohs' surgery is especially useful for skin cancers that:
- have a high risk of recurrence or that have recurred after previous treatment
- are located in an area where you want to preserve as much healthy tissue as possible
- have borders that are hard to define
- are large or aggressive.
Even if Mohs surgery is the most appropriate treatment of skin cancer, some patients may not be good candidates for Mohs if they are unable to tolerate local anaesthesia, have extreme anxiety, have a surgical phobia, or are in very poor health.
Which areas are treatable using Mohs?
Mohs surgery is used primarily for treatment of head and neck basal and squamous cell cancers. It is particularly useful for skin cancers in difficult areas such as nose, eyelids, lips and ears. It is also used on hands and feet, where there is not a lot of extra tissue for large surgical removals. While it is more often used on the face, neck, hands and feet, any area of the body may be treated using Mohs' surgery.
What are the possible complications of Mohs?
While Mohs' surgery is overall a very safe and effective surgical treatment, like any surgery or procedure there are some possible uncommon complications. Most patients tolerate Mohs' surgery very well without any complications. After a few months, most patients will have only a very fine, barely visible scar.
As with all surgeries complication may arise. A list of these complications include:
- Incomplete removal of cancer
- Pain afterwards
Your surgeon will discuss associated risks and complications. Patients should speak to their doctor about any concerns or questions they may have.
for more information
Download the brochure