MOHS surgery in Cyprus (for skin cancer treatment)
Developed by Dr. Frederick Mohs in the 1930s, Mohs
micrographic surgery has come to be accepted as the single most effective
technique for removing Basal Cell Carcinomas and Squamous Cell Carcinomas (BCCs
and SCCs), the two most common skin cancers. It accomplishes the nifty trick of
sparing the greatest amount of healthy tissue while also most completely
expunging cancer cells; cure rates for BCC and SCC are an unparalleled 98
percent or higher with Mohs, significantly better than the rates for standard excision
or any other accepted method.
The reason for the technique's success is its simple
elegance. Mohs differs from other techniques in that microscopic examination of
all excised tissues occurs during rather than after the surgery, thereby
eliminating the need to "estimate" how far out or deep the roots of
the skin cancer go. This allows the Mohs surgeon to remove all of the cancer
cells while sparing as much normal tissue as possible.
In standard excisions, the visible skin cancer is removed
along with a 4-8 mm margin of healthy appearing tissue. The wound is then closed. The tissue is then send out for the margins
to be checked over the next few days.
When the pathologist looks at the tissue, they use a method called
“bread loafing” where the pathologies makes slices through the tissue and
examines those margins as a representative sample to determine that the margins
are clear.
In Mohs surgeries, the visible cancer is removed along with
a narrow rim of healthy tissue. The tissue is then processed while the patient
is waiting in the clinic. During the processing, the edges are laid down in
order to examine 100% of the margins. If the margins are cancer-free, the
surgery is ended. If not, more tissue is removed from the margin where the
cancer cells were found, and the procedure is repeated until all the margins of
the final tissue sample examined are clear of cancer. In this way, Mohs surgery
eliminates the guesswork in skin cancer removal, producing the best therapeutic
and cosmetic results.
Most common indications for MOHS surgery are:
1) Primary BCC or SCC
in an area which is important to preserve maximum healthy tissue for maximal
functional and cosmetic result.
(e.g. eyelids, Nose, ears, lips,
genitals, hands, feet).
2) Recurrent or
incompletely excised BCC or SCC.
3) Primary BCC or SCC
where the margins cannot be clearly defined.
4) Primary BCC or SCC
larger than 2 cm or rapidly growing.
5) Primary BCC or SCC
arising in scars or in sites of radiation therapy.
6) High risk or
aggressive types of SCC.
7) Patients with
multiple tumors in the same surgical area.
8) Young patients who
may expect to have further skin cancers on the face in the future.