The Gold Standard in Skin Cancer Treatment: Mohs Micrographic Surgery

When it comes to any cancer treatment, you want to know you’re in good hands. For skin cancer, something that affects 1 in 5 Americans, early detection and treatment are crucial for preventing fatality.

And while preventing skin cancer by protecting your skin and maintaining beneficial habits is your first line of defense, you can’t always predict when skin cancer will strike, no matter how well you’ve cared for your skin.

Even if you do everything right, a single skin check can unearth a scary reality 20% of Americans face each year. When those times arise, knowing there is hope in the form of a treatment with the highest rate of recovery can help ease concerns. 

Mohs micrographic surgery is often the best solution for safe and effective removal of skin cancer. 

Skin Cancer Treatment Reinvented with Mohs Micrographic Surgery

While this procedure may sound complicated, the process is actually quite simple, and with experts like Dr. Jorge Garcia-Zuazaga and Dr. Patrick Killian who have performed over 50,000 procedures between the two, it’s safe and effective.

Here are the steps for Mohs Micrographic Surgery and what you can expect:

Step #1 – Outlining the procedure area

First, your doctor will outline the procedure area by drawing it with a marker used for surgery. This ensures they know exactly what area to treat when they begin to perform surgery.

Step #2 – The affected skin is excised

Local anesthesia is administered prior to removal, where your surgeon will then begin the process of excising the cancerous skin tissue and cells.

Step #3 – A deeper layer of affected tissue is removed

After the initial cancer growth is removed, the surgeon will return to the area and remove a deeper layer of tissue that still contains cancerous cells.

Step #4 – Tissue is divided and marked

During this step, the doctor will color code tissue removed from a certain section of the skin in order to trace where each portion of tissue originated. 

Step #5 – The tissue is examined

This phase is responsible for reviewing the removed tissue to examine the edges and underside for cancerous cells and growth, to ensure the entirety of the affected skin is fully removed.

Step #6 – More affected tissue is removed

Should the examination find skin cancer cells still present, the surgeon will perform another round of excising the affected tissue in order to remove all cancerous growth.

Step #7 – The tissue removal and review process is repeated

Each of the steps involved in removal and reviewing of the excised tissue continues until there are no traces of cancerous cells present in the sample. This ensures all traces of cancer are removed from the area to reduce rates of return growth.

Step # 8 – Wound is cleaned, dressed, and stitched

Once it’s confirmed there are no more cancerous cells present, the surgeon will clean, dress, and stitch the wound.

With Mohs surgery, the process is made to ensure that only cancerous cells are removed from the area, allowing the maximum amount of healthy skin cells and tissue to remain. This cuts down on healing time and wound size, so patients may experience the least amount of both down time and potential scarring.

Mohs Micrographic Surgery Efficacy

Mohs surgery has the highest rate of curing skin cancer, surpassing even radiation, topical chemotherapy, and standard excision. 

In a study performed of the differences in return rates for Basal Cell Carcinoma treated with Mohs and standard surgical excision, only 2.4% (2) patients experienced a recurrence in cancer growth with Mohs micrographic surgery, whereas 12.1% (10) patients experienced a recurrence of cancer growth with standard surgical excision practices.

This staggering study shows that Mohs surgery is much more effective at removing cancer and reducing return-rates.

Also to note, the quality of life experience by recipients of Mohs surgery increases significantly after this procedure, according to a study. This study of 772 patients reveals that after the healing of the surgery site (3 months after), their perceived quality of life increased.

What this means is that while skin cancer certainly impacts your physical health, your emotional and mental health can also be severely altered due to the stresses and anxieties of skin cancer, the treatment, and worry over its return.

Mohs surgery, having the top recovery rate for most skin cancers, puts these emotional stressors to ease, and allows patients to return to a higher quality of life both physically and mentally. 

Skin Cancers Best Treated by Mohs Micrographic Surgery

Not all skin cancers can be removed and cured by this surgery. However, outside of melanoma cancers, many of the most common types can be.

Among the types of skin cancer best suited for cure via Mohs surgery are basal cell carcinoma, squamous cell carcinoma, and other rare tumors like atypical fibroxanthoma, sebaceous carcinoma, microcystic adnexal carcinoma, malignant fibrous histiocytoma, Dermatofibrosarcoma Protuberans, and other malignancies.

Ultimately, your doctor will be able to assess if your particular skin growth can be treated with this surgery, along with the best course of action for recovery. 

Meet the Doctors With a Combined Over 50,000 Mohs Surgeries Under Their Belts

Dr. Jorge Garcia-Zuazaga is one of the leading surgeons for Mohs surgery. Along with Dr. Patrick Killian, the two specialists have performed over 50,000 procedures.

Following residency, Dr. Garcia-Zuazaga was offered a position as a Fellow for Mohs Micrographic Surgery and Aesthetic Dermatology at Harvard Medical School and the Lahey Clinic. During this year he performed over one thousand cases of Mohs surgery and facial reconstruction.

In 2008, Dr. Garcia-Zuazaga was privileged to return to Northeast Ohio to serve as Director of Mohs Surgery and Aesthetic Dermatology at University Hospitals. 

Upon completion of his residency, Dr. Patrick Killian trained under Dr. Brett Coldiron, former president of the American Academy of Dermatology and the American College of Mohs Surgery, at the Skin Cancer Center in Cincinnati, Ohio. After completing his Mohs fellowship, he joined Central Ohio Skin and Cancer in the Columbus area. 

After working with them for 2 years he decided to return home to Northeast Ohio and began working in Medina, Ohio at Trillium Creek Dermatology & Surgery Center where he performed over 20,000 Mohs surgeries and reconstructions. He is happy to now join Dr. Garcia-Zuazaga at Apex Dermatology and offer Mohs skin cancer expertise to even more Ohians.