Excision is recommended for melanomas, many non-melanoma skin cancers (basal cell and squamous cell cancers), dysplastic nevi, cysts, lipomas and some unwanted benign growths. These procedures are performed in the office under local anesthesia. The surgeon determines the appropriate margin of normal skin to remove around the growth and excises the area in an elliptical shape that will allow the final scar to lie flat. The area is then sutured. Tissue is later reviewed pathologically to ensure all margins are clear.
Mohs Micrographic Surgery is recommended for most nonmelanoma skin cancers (basal and squamous cell carcinomas) on the head, neck, hands, and feet as well as large, recurrent, or aggressive tumors or those arising on areas where tissue sparing is as important as complete cure. It enables the physician to take the narrowest possible margin of healthy tissue, with confirmation of cure by examination of 100% of the peripheral and deep margin before performing the most ideal repair for the location.
Mohs Micrographic Surgery was developed by Frederic E. Mohs, M.D. in the 1930s. It is a highly precise, highly effective method that excises not only the visible tumor but also any “roots” that may have extended beneath the skin surface. Five-year cure rates have been demonstrated up to 99 percent for first-treatment cancers and 95 percent for recurring cancers.
Mohs surgery involves the systematic removal and microscopic analysis of thin layers of tissue at the tumor site until the last traces of the cancer have been eliminated. The immediate and complete microscopic examination and evaluation of excised tissue is what differentiates Mohs surgery from other cancer removal procedures. Only cancerous tissue is removed, minimizing both post-operative wound size and the chance of recurrence.
Dr. Kamell, Dr. Bodnar, and Dr. Mitchell are each highly trained to function as surgeon, pathologist and reconstructive surgeon during the cancer removal process. All three underwent rigorous training, passed comprehensive written and practical examinations, and demonstrated extensive in-office experience to become recognized as fellows of the American Society for Mohs Surgery. Our office is equipped with state of the art surgical and laboratory facilities and we are supported by Mohs-trained nursing and technical staff.
Patient Information Brochure from ASMS
Other Treatment Options
Electrodessication and curettage – the site is numbed with local anesthesia; cancer cells are then removal by scraping or “curetting”; the base is burned or “cauterized” with an electric needle. This is used for superficial basal cell carcinomas on the trunk, arms, and legs.
Topical Therapy – medications such as Imiquimod and 5-Fluorouracil applied to the skin usually for a 10-12 week period; may be selected to treat superficial basal cell carcinoma or squamous cell carcinoma in situ.
Radiation– in some instances radiation is the preferred treatment, often for tumors that are inoperable or for patients unable to tolerate surgery. Multiple treatments are generally needed. For very aggressive tumors, additional treatment with radiation may be recommended to prevent recurrence after a surgical site has healed.