Prior to your procedure, please read SLUCare's pre-surgical instructions for Mohs surgery.
Mohs procedures are performed in an operating room or minor surgical procedure room. Prior to the surgery, a local anesthetic is used to numb the impacted area. You might feel a brief stinging or burning sensation. It takes about 20 minutes for the anesthesia to take full effect.
SLUCare Mohs specialists begin by cutting around the skin cancer with a scalpel. Only the area that appears to be abnormal is removed at first. The surgery itself takes only a few minutes.
After surgery, the area is bandaged and you will either remain in the surgical area or return to the patient lounge area while the sample is processed. Patients who have more than one skin cancer will require multiple visits, as each cancer is managed individually.
While you are waiting, SLUCare's certified histotechnician and our Mohs surgeons examine the tissue section under a microscope to see if there is any skin cancer on the outer edges. If we find cancer, we know that some skin cancer remains at the excision site.
This technique of preparing and examining the skin tissue immediately makes Mohs surgery unique and effective. Tissue processing usually takes about 20 to 30 minutes, but can take longer if the tissue section is larger.
If your SLUCare Mohs surgeon finds cancer remaining, we bring you back into surgery, re-numb the area, and repeat the Mohs procedure.
The procedure is repeated until the entire area has been cleared of skin cancer. Each Mohs surgery is referred to as a "stage." On the average, it takes two to three stages to remove all the skin cancer.
Our goal is to remove all of your skin cancer, while at the same time preserving the maximum amount of surrounding healthy tissue. Mohs surgery offers a high cure rate and minimizes the removal of healthy tissue. As a result, not only is all of the skin cancer removed, but the best overall cosmetic results are also possible.
However, not all surgical areas are small. Some skin cancer can be quite extensive. Choosing Mohs surgery as a procedure does not determine the size of the surgical area; it is determined by the size and nature of your skin cancer.
Even though Mohs surgery has the highest cure rate for several skin cancers, it is not 100 percent successful. The risk of recurrence is 1 to 5 percent for most cancers treated this way, depending upon the location and type, with recurrent cancers being more difficult to treat. Some cancers and certain situations may have a higher risk of recurrence.
In all cases, the area where your cancer was removed should be closely monitored by your referring physician. Once you have been diagnosed with skin cancer, you are at higher risk for developing a second skin cancer. Regular check-ups with your dermatologist are important so that any recurrence or new skin cancer can be treated early.
In some cases, no skin cancer is found on the first stage of the Mohs procedure. The skin cancer may have been entirely removed by a biopsy performed by your referring physician, or may be in an area adjacent to the sample that was removed. It is important to accurately identify your cancer biopsy site. We will confirm this with you at the time of your consult and surgery appointment to ensure that the proper site is excised.
It is also possible that your skin cancer was removed by the first Mohs stage and no other skin cancer remains. If the area appears normal, your SLUCare surgeon may decide to stop after the first stage and have the area followed by your referring physician. If the surgeon suspects residual skin cancer might remain, however, or there is extensive scar tissue, an additional surgical stage will be taken.