Overview of Mohs Micrographic Surgery
Originally developed in the 1930s, Mohs micrographic surgery has been refined into the most advanced, precise, and effective treatment for an increasing variety of skin cancer types. With the Mohs technique, physicians can precisely identify and remove an entire tumor while leaving the surrounding healthy tissue intact and unharmed.
Why Choose a Fellowship Trained MOHS SURGEON
You want your skin cancer treatment to be performed with the highest standards of quality and competency. The American College of Mohs Surgery is the only organization that requires its members to have successfully completed an extensive fellowship that requires at least one full year of training and hands-on experience provided by highly qualified instructors after completing their years of residency training. Learn More
Mohs surgery is the most effective treatment for most types of skin cancer. To learn more about your options, find a fellowship trained Mohs surgeon in your area.
Success Rate of Mohs Surgery
The Mohs procedure involves surgically removing skin cancer layer by layer and examining the tissue under a microscope until healthy, cancer-free tissue around the tumor is reached (called clear margins). Because the Mohs College surgeon is specially trained as a cancer surgeon, pathologist, and reconstructive surgeon, Mohs surgery has the highest success rate of all treatments for skin cancer – up to 99%.
Advantages of Mohs Surgery
Mohs surgery is unique and so effective because of the way the removed tissue is microscopically examined, evaluating 100% of the surgical margins. The pathologic interpretation of the tissue margins is done on site by the Mohs surgeon, who is specially trained in the reading of these slides and is best able to correlate any microscopic findings with the surgical site on the patient. Advantages of Mohs surgery include:
- Ensuring complete cancer removal during surgery, virtually eliminating the chance of the cancer growing back
- Minimizing the amount of healthy tissue lost
- Maximizing the functional and cosmetic outcome resulting from surgery
- Repairing the site of the cancer the same day the cancer is removed, in most cases
- Curing skin cancer when other methods have failed
Other skin cancer treatment methods blindly estimate the amount of tissue to treat, which can result in the unnecessary removal of healthy skin tissue and tumor re-growth if any cancer is missed.
Cost-Effectiveness of Mohs Surgery
When assessing the cost-effectiveness of Mohs surgery there are several factors to consider. Because of the number of personnel involved as well as the advanced technology required, the initial procedure is often more costly than other treatment methods. However, because of the procedure's high success rate, most patients require only a single surgery. This surgery usually includes the repair of the wound as well. While other methods might initially be less expensive than Mohs surgery, additional surgeries and pathology readings are required to repair the wound and to treat the cancer if it is not completely removed. Each of these additional surgeries and pathology readings will require separate fees, while a single Mohs surgery procedure includes all of these into one fee.
There are also human costs to be considered. Because Mohs surgery minimizes the amount of healthy tissue removed, it also reduces the impact to the surrounding area. The aesthetic outcome of the surgery is optimized. Furthermore, the psychological impact of being subjected to multiple procedures when cancer recurs can be significant. Patients usually find it reassuring to know that their cancer has been treated with a single procedure that gives them the highest possible chance of complete cure.
Various studies have been conducted to calculate and compare Mohs surgery costs with those of traditional surgical methods (see examples cited below). Studies cited in Journal Watch Dermatology and the Journal of the American Academy of Dermatology show that Mohs surgery is no more costly than standard excision and less expensive than radiation therapy or excision in an ambulatory surgery center. Because the process of Mohs surgery minimizes the risk of recurrence, it reduces and frequently eliminates the costs of larger, more serious surgeries for recurrent skin cancers.
References
1. Hruza, George J., MD, "The Cost of Mohs Surgery vs. Excision," Journal Watch Dermatology, March 28, 2006. Covering: Essers, BA, et al., Archives of Dermatology, 2006 Feb; 142: 187-94.
2. Hruza, George J., MD, "Mohs Surgery and Excision: Comparing the Costs," Journal Watch Dermatology, June 30, 2004. Covering: Bialy, TL, et al., Archives of Dermatology, 2004 Jun; 140: 736-42.
3. Coldiron, Brett M., MD and Rogers, Howard W., PhD, "A Relative Value Unit-Based Cost Comparison of Treatment Modalities for Non-melanoma Skin Cancer: Effect of the Loss of the Mohs Multiple Surgery Reduction Exemption," Journal of the American Academy of Dermatology, 2009 July, Volume 61, Issue 1, pages 96-103.
4. Cook, Joel, MD and Zitelli, John A., MD, "Mohs micrographic surgery: a cost analysis," Journal of the American Academy of Dermatology, 1998 November, Volume 39, Issue 5, pages 698-703.