Rescue Therapy Stems Tumor Recurrence.

• Position: Skin cancer removal - Brief Article

Mohs micrographic surgery is a specialized method of skin cancer removal considered to be the "rescue therapy" after other treatments fail. Experts in the procedure say patients should ask their dermatologist or family physician to consider it first instead of last in the treatment chain because, in addition to stopping the cycle of recurrent skin cancers, Mohs micrographic surgery offers a cure rate of up to 99% for certain types of first-time tumors, which is higher than other methods.

Removing skin cancer completely is a challenging process because a tumor that is visible to the naked eye usually is the "tip of the iceberg." Many cells may form roots of diseased tissue that can extend beyond the boundaries of the visible cancer. If these cancer cells are not removed completely, they can lead to regrowth and recurrence of the tumor.

With Mohs micrographic surgery, a precise "mapping" technique allows the surgeon to identify the exact location of remaining cancer tissue. Only the diseased tissue is removed, preserving as much of the surrounding normal tissue as possible.

John Skouge, vice president of the American College of Mohs Micrographic Surgery and Cutaneous Oncology, Schaumburg, Ill., urges patients to discuss treatment options with their physician. Other treatments--such as curettage (scraping away of diseased tissue), electrodesiccation (destroying diseased tissue by electric current), cryosurgery (freezing diseased tissue), radiation therapy, and standard surgical excision--are considered effective for some skin cancers. He maintains that Mohs micrographic surgery should be the treatment of choice when the cancer is large; its edges can not be defined clearly; the cancer is in an area of the body where it is important to preserve healthy tissue for the maximum functional and cosmetic result (eyelids, nose, ears, lips); the cancer is likely to recur if treated by other methods; and/or prior treatment has failed. "For skin cancers like these, common treatment methods are unsuccessful because they rely on the human eye to...