Skin cancers respond well to micrographic surgery

Indiana University Health Special to the Courier

Although melanoma is the most deadly type of skin cancer, non-melanoma skin cancers - basal cell and squamous cell carcinomas - are the most common, affecting more than 3 million people in the United States each year.

According to a recent study, surgery for these non-melanoma cancers has increased substantially, mainly due to a specific procedure - Mohs micrographic surgery. From 2001 to 2006, the number of patients seeking Mohs surgery more than doubled.

"Mohs surgery allows us to examine the tissue during the procedure to ensure the removal of all cancerous cells, as opposed to an excision which later examines about 5 percent of the biopsied tissue," said Ally-Khan Somani, MD, director of Dermatologic Surgery and Cutaneous Oncology at Indiana University Health. "Because we end up having more healthy tissue to work with, we can reconstruct the area more effectively and minimize scarring."

In a traditional excision, the cancer is cut down the center like a loaf of bread, but with Mohs, the biopsy is flattened and cut on all edges.

"Think of it like cutting through the roots of trees," said Somani. "If you cut once, you might cut in between roots or cut only short roots and not see the entire cancer. But if you flatten the roots onto one level, you aren't going to miss anything."

With this procedure, skin cancer cure rates range from 95 to 99 percent, meaning fewer surgeries and fewer follow-ups for patients.

Because of its effectiveness and precise technique, Mohs is beneficial when:

• The cancer is in a highly visible area such as the head and neck.

• The cancer is in an area with little skin, such as the nose, eyelid, fingers, toes and genitals.

• The cancer was treated once and returned.

• There is existing scar tissue in the same area as the cancer

• The cancer grows rapidly or uncontrollably.