Mohs Surgery For Skin Cancer New York
Q: I am thirty-two years young and was just diagnosed with a skin cancer on the nose. It is not a melanoma fortunately but a squamous cell carcinoma. I don’t want a scar. Someone told me that they had an uncle who had radiation treatment for a skin cancer on their face. Should I consider radiation instead of Mohs surgery?
A: You are very young for a skin cancer, but in my practice of specializing in skin cancer, I certainly see quite a large number per year of younger and younger patients with skin cancer. Squamous cell carcinoma if untreated, can progress into a deeply invasive form which will travel through the system to other organs. Once metastatic, the chance of succumbing to this illness is extremely high. It is a shame to give a chance for a fatal outcome for a disease that is curable! Mohs micrographic surgery has the highest cure rate compared with any treatment while conserving tissue and keeping the wound the smallest possible. This is done by examining, not a sampling of the tissue removed, but looking under the microscope at 100% of the surgical margin.
A narrow margin of normal-looking skin can be removed and then the three dimensional margin is examined microscopically in a two dimensional model. If any tumor is seen persisting at the margin, its location is mapped out and that area is re-excised with a tissue-sparing margin of 1 mm. in thickness. This is repeated, stage by stage, until the entire tumor is removed. When Mohs surgery is done, you obtain the highest chance of cure compared with freezing, burning, scraping, radiation and excision without the Mohs analysis. You also have the highest chance of cure while obtaining the greatest tissue conservation. If you give the skin cancer a greater chance of recurring then you are allowing it to live longer and grow to a larger size which would compromise the aesthetic outcome. Don’t yield to a less effective treatment because you’re concerned of the cosmetic outcome.
Choose Mohs surgery, especially because it’s on the nose, and have good reconstruction and frequent follow-up so that cosmetic treatment may be rendered if necessary. Massage exercise is important and should start around six weeks after surgery. Fraxel laser resurfacing helps scars look better many times but without any treatment, surgical scars improve over a year or more. Dermabrasion, Fraxel Restore and Fraxel Repair laser resurfacing, massage, silastic gel dressings, V-beam laser, Portrait plasma resurfacing, and moisturizers help make the scar improve, as does time alone.