A Closer Look: Mohs Surgery

This article originally appeared in Connections, a magazine published for physicians and the community by UMass Memorial Medical Center.

With its very high cure rate of 96 to 99 percent, Mohs surgery is the most effective treatment for common skin cancers, including basal and squamous cell carcinoma. It is frequently used for cancers in cosmetically sensitive areas such as the face, neck and scalp, and for aggressive tumors.

Mohs surgery is performed in stages. The tumor is removed initially with a thin rim of normal skin. Next, the specimen is processed in the lab and the edges are checked microscopically by the surgeon to ensure all cancerous cells are removed.

It takes about 20 to 40 minutes to process the tissue for each stage. "The average tumor requires two to four stages to remove. We take as little normal tissue and leave the smallest scar possible," said Mary Maloney, MD, chief of dermatology and director of dermatologic surgery at UMass Memorial Medical Center.

Mohs surgeons are also trained in facial reconstruction and discuss with patients repair options depending on wound size, shape and location. In most cases, the skin is repaired the day of the surgery using stitches. Some cases require a skin graft or flap to provide the best results.

"Patients are pleasantly surprised by their Mohs surgery experiences," said David Geist, MD, assistant professor of surgery. "They can sit up and take a break between stages. After leaving our clinic, patients do not lose sleep wondering what their test results and prognosis will be."

James Fallon, a longtime Mohs surgery patient, said, "The Mohs surgery team members take the time to get to know their patients. They are like a second family to me."

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