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Mohs Surgery an Innovative Approach to Skin Cancer

In recent years, we have been encouraged to learn more about protecting ourselves from skin cancer. The various forms of this condition pose a serious threat to health and wellness. However, innovative treatment options have emerged, one of them touted for its high success rate at removing basal cell and squamous cell carcinomas. We are pleased to provide our patients the option of Mohs Micrographic Surgery for skin cancer removal.

A Delicate Approach

Historically, skin cancer lesions have been removed through cauterization, scraping, freezing, or surgical excision. Each of these methods is based on the same basic methodology of physical examination and removal. The success of these techniques depends on the accurate identification of the extent of abnormality. With Mohs, guesswork disappears.

Mohs Micrographic surgery is a step-by-step process of removal. It does not excise a growth in one fell swoop, but in stages. During surgery, one layer of tissue is removed at a time. After a single layer of cells is removed, it is immediately examined microscopically. The meticulous removal and examination of cells continues until no abnormal cells are seen under magnification. Mohs Surgery can take several hours, but patients know when they leave our facility that the margins of their growth are clear.

When to Consider Mohs Surgery

MOHSThere are two specific situations in which Mohs is an ideal procedure:

  • Visible skin cancers. Cancerous growths on the face or other area that cannot be hidden beneath clothing require careful consideration. Physical assessment of a growth does not typically return the most accurate data. For this reason, a small amount healthy tissue around a growth is also removed. The removal may lead to permanent scarring, which you do not want on your face or other obvious area.
  • Aggressive cancers. Some carcinomas are rapid growers, presenting a challenge to accurate assessment in terms of size and depth. Other difficult growths include those that have recurred after an initial removal procedure. The outcome of such cases improves with the precision and immediate verification of Mohs surgery.

The founder and director of Pacific Dermatology & Cosmetic Center, Dr. Reichel is a fellowship trained Mohs surgeon. The accredited ambulatory surgery center in which she performs  is staffed by nurses who have also completed specific training in this procedure.

We don’t leave your skin to chance. Call Pacific Dermatology & Cosmetic Center for your skin cancer screening and treatment.


Skin Cancer Treatment with Mohs Surgery

Mohs surgery is one of the most effective procedures proven to treat skin cancer. Performed by specially-trained dermatologists around the world, this surgical technique is microscopically controlled to treat different forms of skin cancer. Mohs surgery is a treatment procedure developed by a general surgeon Frederic E. Mohs in 1938 and is known to have a cure rate of around 98% for the most common type of skin cancer, basal cell carcinoma. Also known as chemosurgery, Mohs surgery is one of the most effective treatments available to patients with cancers in difficult areas like the ear, nose and lips.

What Exactly is Mohs Surgery?

  • The procedure: Mohs surgery is a precise surgical procedure, which is controlled microscopically to eliminate the cancer containing skin cells. The procedure involves the removal of one or more layers of skin containing cancerous cells. The procedure ends once the dermatologist finds skin tissue without any cancerous cells. This procedure is precise in that can remove the cancerous skin layers without affecting the healthy tissue surrounding it. One advantage of Mohs surgery over the standard procedures it enables surgeons to verify that all the cancerous cells are removed.
  • Recovery: Mohs Surgery is usually an outpatient procedure, performed with local anesthesia. The recovery period may be anywhere between 2 weeks and 4 weeks, depending on the extent of the surgery and the stage of cancer being treated. After the surgery, your dermatologist may either stitch up the wound or leave it to heal naturally. Sometimes, healthy skin tissue from other parts of the body is used to reconstruct the part of the body where a lot of skin has been removed.

Interested in Learning More About Mohs Surgery? Contact Pacific Derm Center.

For more information about Mohs Surgery, contact our team of doctors today. We are located at two convenient locations in Seattle and Renton, Washington and can be reached directly at 206.859.5777. We look forward to hearing from you soon.


Types of Skin Cancer: What You Need to Know

Skin cancer involves the uncontrolled growth of cancer cells in the skin. Left untreated, these cells can spread to other tissues and organs, including the lymph nodes and bone. Read on for more information about the three main types of skin cancer and their treatments.

     

  • Basal Cell Carcinoma. Basal cells make up the lowest layer of the skin. Cancer of these cells is known as basal cell carcinoma. Basal cell carcinoma is most common on the head or neck and looks like raised, waxy pink bumps. This type of cancer is extremely common, but is slow growing and hardly ever spreads beyond the tumor site.
  • Squamous Cell Carcinoma. Squamous cells reside in the middle layer of the skin. Cancer of these cells, called squamous cell carcinoma, appears as red, scaly, and rough lesions on the hands, head, neck, lips, or ears. It is typically more aggressive than basal cell carcinoma.
  • Melanoma. Melanoma occurs in the skin cells that create pigment. It is far more dangerous than the other two types of skin cancer, but is less common. This type of cancer creates abnormal moles or lesions. Dermatologists look for the ABCDE signs of melanoma, which include asymmetrical shape, border irregularities, color, diameter and evolution of the mole.

Treatments for Skin Cancer

The treatments for skin cancer that PD&CC offer vary based on the type of cancer and its severity.

  • Mohs Microscopic Surgery. According to the Skin Cancer Foundation, Mohs surgery is the most effective method for treating basal cell carcinoma and squamous cell carcinomas. It is also used for certain types of melanoma. A Mohs surgeon uses a scalpel or curette to remove the tumor with a very thin layer of tissue around it. This layer is then immediately checked under a microscope. If the cancer is still present in the surrounding tissue, the procedure is repeated until the last layer viewed under the microscope is free of cancer.
  • Excisional Surgery. A dermatologist uses a scalpel to remove the entire growth and a surrounding border. The tissue is then sent to a laboratory to verify that all cancer cells have been removed.
  • Curette and Electrodissection. The tumor is scraped off with a curette and a needle sends electrical currents into the skin to destroy any remaining tumor.

Contact the Pacific Dermatology & Cosmetic Center for More Information about Skin Cancer

If you suspect you have skin cancer, contact the Pacific Dermatology & Cosmetic Center immediately. Our offices are located in Seattle, and we can be reached at (206)859-5777.


Skin check for Melanoma

I just found out that my first cousin was diagnosed with Melanoma.  I’m scared that I might get it too, what should I do?

Thank you, S

 

Dear S,

It is understandable to be a little scared when you learn of someone close to you being diagnosed with cancer.  Malignant Melanoma, is unfortunately, occurring in greater numbers, with the incidence doubling every 10 years.  Therefore, there are more & more of us that are directly or indirectly affected.  Although Melanoma rates are on the rise, most are nowadays detected in the earlier stages, requiring only surgical excision locally.  Ways to minimize your risks include protecting yourself from the harmful effects of the sun, and getting regular full body skin exams with a dermatology clinician.  You can make this appointment at our Renton office.   At your office visit, we usually review good sun protective habits, and what to look for when doing self-skin checks at home.  If there are any moles of concern, we can usually do a simple procedure that day called a skin biopsy. Most areas are well healed within 1-2 weeks, and the results are in within 1 week.  I hope this answers your question, Sara, but please come in to see me for skin exam and I would be more than happy to answer any additional questions you may have!

Suzi Miner, PA-C

Physician Assistant

Pacific Dermatology & Cosmetic Center - Renton, WA
425.970.4155


A quote from our MOHS patient today:

My first Mohs patient of the morning told me about this amazing  book he had just read; “The Craftsman” by Richard Sennett.   Upon removing his first layer of tissue and waiting for it to process, I took the opportunity to google this auther and further found this review; (The New York Times Book Review said:  “An inquiring, intelligent look at how the work of the hand informs the work of the mind.”    I went back to my patient to finish his procedure and tell him about this review I had just seen.  He further quoted from the book on what he had experienced today:

" The state makes neuronal sense of the experience of curiosity, an experience that suspends resolution and decision, in order to probe.  The work process can thus be imagined as following a certain time rhythm, in which action leads to suspension while results are questioned, after which action resumes in a new form.  We have seen this rhythm of action-rest/question-action to mark the development of complex hand skills; merely mechanical activity, which does not develop technique, is simply movement."

I thanked him for his recommendation as well as being an excellent patient, went into my office and ordered the book!


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