The different skin cancer treatment options are:
- Mohs surgery – see description below.
- Radiation surgery involves going to the hospital on multiple visits to get radiation.
- Scraping or burning called electrodessication, curettage depending on the location of the skin cancer. This option has a tendency of producing a round whitish scar as opposed to a cosmetic line scar.
- Excision or removal of the skin cancer without Mohs surgery. With this option, there are wider margins, so there is a risk of leaving a larger scar and the potential risk of not getting it all out the first time and having to go back and repeat the procedure.
- In some cases, you can use topical immunotherapy with a medication called Imiquimod, or Aldara
As described in the list above, Mohs is just one of the many skin cancer treatment options. Dr. Mejia gives his patients all the other options available as in some cases Mohs may not be the best option. There may be instances when a combination treatment involving topical therapy.
Mohs skin cancer surgery was invented by Frederick Mohs. It is a procedure where the tumor is removed very carefully to ensure the highest cure rate and the lowest chance of recurrence. When you remove a tumor, you want to make sure you get it all out and leave minimal scarring. The technique involves the removal of the skin cancer and checking the margins in a circumference and in a deep plane all in the same day.
As part of the Mohs surgery, Dr. Mejia also does the reconstruction following the removal of the cancer. It is all done on the same day, same location. As a dermatological surgeon, he is trained in plastic surgery techniques. During his residency, he was trained by plastic surgeons in closures, flaps, grafts and other reconstructive treatment options.
As Dr. Mejia describes in the video, there are three types of skin cancers basal cell, squamous cell and melanoma. Typically, melanoma is not treated with Mohs.