Mohs micrographic surgery

One of the most effective ways of treating skin cancers is to surgically remove them. These include such as basal cell cancer, squamous cancer and melanoma.

This is often carried out under local anaesthetic using skin numbing injections so there is no need to be admitted to hospital.

Some skin cancers extend for an unknown distance under the skin before becoming visible on the surface. Because of this, the usual way to make sure all abnormal tissue is removed is to take a “safety margin” of normal looking tissue. This can vary from anything between 3mm to 6mm depending upon the type of skin cancer.

When the tissue has been removed it is sent to a laboratory to be examined. The results are usually available within a few days to a couple of weeks. Unfortunately with this method, there is no definite way to know how much safety margin is appropriate to take. We call this method ‘excision with standard surgical margins’.

As a day care patient for facial skin cancer I was treated first in the Dermatology theatre then moved into the Eye department ,ward 20 and then theatre for reconstruction. I cannot praise all the staff highly enough what a reassuring and caring experience by wonderful experts and their smiling teams.

Mohs micrographic surgery is different.

Performed in our dermatology surgical unit here at Newcastle’s Royal Victoria Infirmary, this innovative day case surgical treatment for skin cancer offers very high cure rates (close to 99%) whilst preserving as much normal skin as possible.

What to expect?

You should arrive at the Dermatology Surgical Unit for 8am on the day of your surgery and expect to be there for most of the day. This will differ for some people but is difficult to predict beforehand.

This is because the tissue is removed in small stages and examined in a special laboratory located behind the surgical theatre each time. We will apply a temporary dressing to your skin while you wait.

Using a special mapping technique alongside microscopic assessment, our specially trained consultant dermatologists can pinpoint where further tissue needs to be removed, and subsequently when the tumour is clear.

This process will be repeated until the dermatologist is happy that all of the cancerous cells have been removed.

We will then discuss with you how best to repair the wound with either stitches or dressings.

What are the advantages of Mohs surgery?

The main advantages of Mohs surgery is its high cure rate and the removal of tissue only where cancer cells are present. This means that the surrounding healthy tissue remains unharmed and reduces the risk of scarring or skin disfigurement. The treatment also minimizes the chance of regrowth.

This unique technique is particularly suited for areas where preserving as much normal tissue as possible is extremely important, such as tumours around the eyes, nose, lips and ears. This is particularly important for our younger patients.