Malignant melanoma is the deadliest form of cancer, but now a skin sparing procedure used to treat other less aggressive forms of cancer is being performed on patients with early stage melanoma.
Mohs micro-graphic surgery is an outpatient procedure that allows the surgeon to perform up to eight procedures in a day going back and forth to evaluate the tissue for clean margins.
So who's a candidate?
"We say melanoma in situ, in the skin, a thin melanoma typically the location is face hands and sometimes feet," says Dr. Heidi Anderson, Board Certified Dermatologist.
But while Mohs surgery is being performed on some melanomas the tests results still need some work.
"Melanacytes which are the cells that transform into cancer are very difficult to read under frozen sections and when they're difficult to read, they are difficult to interpret under frozen sections and when they’re difficult to read they’re hard to interpret," says Dr. David Sax of University Park Dermatology.
With traditional skin cancer surgery standard sized borders are taken, but with Mohs there is a greater potential for closures. Patient Daniel Perkins was nervous prior to his surgery. "It came back as cancer, it was very easy to come in and get the procedure done, I didn’t realize what was involved."
Both Sax and Anderson agree although traditional surgery is still the standard for Melanoms that Mohs is gaining popularity as tests become more precise.
"Once you are able to let them know that there’s a treatment slow Mohs performed that we can hopefully reduce the amount of tissue that we have to take and hopefully increase recurrence rates their very happy," says Dr. Heidi Anderson.
One difference between Mohs procedures for basal and squamous cell cancers is that the tissue is evaluated on site, but with melanoma, specimens are sent out overnight to be thoroughly evaluated in a lab for best results.