The Mohs procedure:
1) The tumor is excised with a narrow rim of normal tissue. The dermatologist then marks the specimen with special inks and diagrams the specimen on an anatomic map.

2) The specimen is then transported to the lab where it is immediately processed. This occurs while the patient waits in the waiting room.

3) Once the slides are prepared, the dermatologist reviews them and notes whether or not any cancer cells remain. The results are then diagrammed on the anatomic map.

4) If all cancer cells are gone, a closure of the wound is performed. If they are not, then only the areas where cancer remains are re-excised and the process is repeated. This allows the smallest amount of normal tissue to be removed, so that repairs are easier and more cosmetically pleasing.

Mohs surgery offers the highest cure rate for the treatment of basal cell and squamous cell skin cancers (~98%). It is particularly helpful for large tumors, recurrent tumors, tumors near important structures such as the eye or lip, and aggressive tumors (such as those occurring in young patients or those growing rapidly). Mohs allows viewing of 100% of the margin, whereas the standard permanent sectioning done only allows viewing of ~1% of the margin.

When scheduled for Mohs surgery, you should plan on being in the office all day. The procedure usually takes less than a day, but it is impossible to know in advance how many layers it will take to remove all the tumor. Because the procedure is performed under local anesthesia, you should eat and take your normal medications before coming to the office. If you normally take medicine during the day, please bring it with you so that you may take it at the appropriate time. You should have someone with you or make arrangements for someone to drive you home after the procedure.

For more information, please visit the following websites:

1) The American Society for Mohs Surgery — www.mohssurgery.org

2) The American Society for Dermatologic Surgery — www.asds-net.org