Nervous About Mohs Skin Cancer Treatment? Here’s What You Can Expect.
- Posted on: Nov 30 2018
Discovering that that strange-looking mole is actually a skin cancer can be an overwhelming experience in and of itself. Unfortunately, the fear surrounding skin cancer can prevent some people from obtaining the professional skin cancer screening that could greatly improve their prognosis should a cancerous lesion be found. Holding back on treatment can also be a temptation even when you understand the value of skin cancer removal.
In our Manhattan dermatology practice, we often treat skin cancer using the Mohs micrographic technique. We believe that knowing what to expect from this treatment is the best way to reduce unfounded fear and get the ball rolling sooner rather than later.
Mohs surgery is the technique that was developed more than fifty years ago and is now considered the gold standard in removing basal cell and squamous cell carcinomas. In some cases, Mohs may be appropriate for melanoma (in situ). The reason that more dermatologists are turning to Mohs is that this technique offers the best success rate, nearly 100%. At the same time, it is the most conservative in terms of tissue removal. Here is how the process works.
There are few steps to take to prepare for Mohs surgery. Patients with health conditions such as cardiovascular disease, diabetes, or artificial joints may be advised to speak with their primary care doctor to discuss the potential need for antibiotic treatment or medication changes coinciding with Mohs surgery.
Patients without preexisting conditions are advised to avoid medications and supplements that could thin the blood. These include vitamin E, ibuprofen and other nonsteroidal anti-inflammatory drugs, and aspirin. Alcohol consumption should also decrease or stop altogether in the week prior to Mohs treatment.
We can understand that patients may feel nervous about undergoing the Mohs procedure. We assure them that the process is more time consuming than it is painful. In fact, the use of local anesthetic makes Mohs virtually pain-free. The post-treatment response of most patients is “that was it?”
After numbing the dermis with an injection of local anesthetic, the surgeon removes a small section of skin. This will feel like pressure. This part of treatment takes only a few minutes; then, the waiting begins. The observation of tissue under a microscope can take one to two hours. During this time, the patient waits in the office. We recommend bringing a book or other entertainment to pass the time.
If the first tissue sample does not come back with clear margins, more anesthetic may be injected and a second layer of tissue will be removed. And, again, the waiting.
At the conclusion of the Mohs procedure, once a clear tissue sample has been confirmed, the wound may either be closed with sutures or covered with gauze to heal on its own.
Post-operative instructions are detailed and provided before the patient leaves the office. Directions for wound care will be precise and tailored to the location and size of the treatment area. In general, post-operative recovery may involve some bruising and swelling. The area may be tender or sore, but comfort can be managed with over-the-counter pain medication and cold compresses. Strenuous activity should be avoided for one to two days.