Mohs Skin Cancer Surgery Offers Cure and ComfortLast updated: May 01, 2016
Thirty years ago, when Teresa Lee had her first skin cancer surgery the experience left a scar on both her shoulder and her memory. So earlier this year, when Ms. Lee found out that she had more skin cancer, the 50 year-old mother of three was understandably nervous. But thanks to a procedure known as Mohs micrographic surgery—a precise method that preserves as much healthy skin as possible—Ms. Lee described the process as easy and flawless.
“From the moment I walked into the room, it was all about my comfort. Everyone kept asking, ‘can I get you anything?’” describes Ms. Lee, who is a patient of Hari Nadiminti, MD, the Mohs micrographic surgeon at the Summit Medical Group. “I would never go to any other surgeon. He did a fabulous job, as I have basically no scarring on my face. It was a completely different experience than my first surgery at another facility.”
Mohs surgery is the most effective way to treat the one in five Americans who are diagnosed with skin cancer. During the procedure, cancerous tissue is removed one layer at a time and examined under a microscope in real time until only healthy skin remains. At Summit Medical Group’s Dermatology practice, Mohs surgeons partner with dermatologists and plastic surgeons to diagnose and treat a variety of skin conditions that affect patients across the lifespan, from acne to eczema and cancer.
“Skin cancer is truly an epidemic in the United States—it is more common than breast, prostate, and lung cancer combined,” says Dr. Nadiminti. “Our practice is unique because we provide comprehensive care. Patients can be screened, referred to a dermatological surgeon, and have reconstruction all in the same day.”
Mohs Surgery: Best Practice for Visible Skin Cancers
Dr. Nadiminti has performed over 5,000 Mohs surgeries at the Summit Medical Group. Today, he says, it is the standard of practice for treating patients with skin cancer lesions in certain areas, such as the face, neck, hands, and feet. Mohs surgeons receive specialized training in surgery and pathology—to learn how to surgically remove and examine tissue samples.
Most of Dr. Nadiminti’s cases are the two most common types of skin cancer—basal cell carcinoma and squamous cell carcinoma. However, Mohs surgery is also used in some cases to treat melanoma, a potential fatal form of skin cancer that can spread throughout the body very quickly.
“Since surgeons can operate so precisely, it minimizes the chance that the skin cancer will recur. Mohs surgery has the highest cure rate at 97 to 99 percent,” explains Dr. Nadiminti. “Furthermore, since the surgeon removes the least amount of normal skin, the scarring and recovery time is minimized. It is the best of both worlds.”
What Happens During Mohs Surgery
To understand the procedure, Dr. Nadiminti uses the analogy of a pie. When surgeons remove skin cancers it is essential that they identify and remove all the malignant cells. First, a local anesthetic is used to avoid feeling any pain. Then, Dr. Nadiminti begins to remove the obvious chunk of tumor—which he likens to pie filling—using an instrument known as a curette. Subsequently, a surgical blade is used to remove a rim around the remaining tissue—similar to the crust of a pie.
The final unique step is the way the tissue is processed. This occurs in a way that allows 100% of the margins to be examined. Once the tumor is removed, it is flattened, frozen, and stained with dye. All of this is done while the patient rests comfortably. Dr. Nadiminti then examines the sample under a microscope to determine if there are any cancerous cells that remain.
“By examining the tissue in this manner, we can precisely map out the skin cancer and ensure that healthy skin is not removed unnecessarily, causing less scarring and disfigurement,” explains Dr. Nadiminti. “If any cancer remains, we repeat the process and remap another thin layer of tissue until we have a clear margin.”
During this process, which usually takes about an hour, Ms. Lee rested in the procedure room and was able to read and watch TV. “I was concerned that one of the growths near my bangs would leave a scar,” explains Ms. Lee. “Dr. Nadiminti was so careful and removed such a small amount of skin each time. I was so grateful.”
Since many of these cancers are located in visible areas, such as the face, the goal of the surgery is to not only remove the cancer but also to provide the best aesthetic outcome. When needed, Dr. Nadiminti also works closely with plastic surgeons conveniently located in the same practice.
“When selecting a physician, comfort comes first and then convenience. I work full-time and have three kids, so having everyone in one central location makes life easier for me,” explains Ms. Lee. “I tell people Summit Medical Group is great because it has both.”
Call to Action: Mohs micrographic surgery has the highest cure rate for treating skin cancers and offers the best aesthetic outcome in visible areas, such as the face, neck, hands, and feet. For more information about the procedure, call Summit Medical Group’s Dermatology practice at 908-277-8668.
- Interview with Dr. Nadiminti
- American Academy of Dermatology https://www.aad.org/media/stats/conditions/skin-cancer