Mohs Surgery: Precise and Effective Skin Cancer Treatment in Singapore

What is Mohs Surgery?

Mohs surgery is a precise and effective surgical technique used to treat skin cancer. Developed by Dr. Frederick E. Mohs in 1983, this is named after him and can remove skin cancer lesions while preserving as much healthy skin as possible. Since its development, Mohs surgery has been refined into a preferred treatment for skin cancer because of its efficacy, as surgical margins are extensively evaluated.

During the surgery, the surgeon removes thin layers of skin one layer at a time and examines each layer under a microscope to determine if any cancer remains. This procedure continues until the tissue is cancer-free.

The goal of this treatment is to minimise the chance of the cancer growing back, preserve as much healthy skin as possible and maximise the functional and cosmetic outcome.

This surgery is a preferred alternative to standard surgery (local excision), which involves removing the visible cancer with standard clear margins of surrounding healthy tissue, all at once. In contrast, Mohs surgery allows the surgeon to verify that all cancer cells have been removed at the time of surgery. This increases the chance of a cure and reduces the need for additional treatments or surgery. For those who have been recently diagnosed with basal cell carcinoma in Singapore, this can be an effective treatment option. Speak to your doctor today to learn more about how you can prepare.

Why is Mohs Surgery Performed?

This surgery is especially useful for skin cancers that:

• Have a high risk of recurrence or that have recurred after previous treatment
• Are located in areas where you want to preserve as much healthy tissue as possible, such as around the eyes, ears, nose, mouth, hands, feet and genitals
• Have borders that are hard to define
• Are large or aggressive

How Is the Mohs Surgical Procedure Carried Out?

The Mohs surgical procedure typically takes place in the outpatient office setting, such as at a dermatology and surgery clinic and is performed under local anaesthesia. This means the patient is awake during the procedure so that it can be safely performed without the need for general anaesthesia.

The surgeon starts by first excising out the visible skin cancer together with a thin layer of surrounding skin. The wound is then dressed and bandaged. Patients can wait comfortably in a resting area. The excised tissue is then processed inhouse and examined under the microscope which will then be examined by the surgeon under the microscope. This will gauge the extent of the skin cancer and identify microscopic roots. If tumour cells remain at any of the margins, the map is used to remove an additional tissue layer precisely at the area where the cancer remains. This procedure continues until no visible cancer cells remains and preserves normal, healthy, surrounding tissue.

After the skin cancer has been removed repairing the site of the skin cancer can often be performed by the same surgeon or a reconstructive surgeon on the same day itself. The entire procedure usually lasts several hours.

Benefits of Mohs Surgery for Skin Cancer Treatment 

• High Cure Rate: This surgical procedure boasts a cure rate of 95-99% making it a reliable treatment for any type of skin cancer. Unlike traditional excision methods, which assess only a small portion of the removed tissue, this surgery examines complete surgical margins, ensuring that all cancerous cells are identified and removed. 
• Maximum Tissue Preservation: Unlike typical excision methods that remove a wider margin of healthy skin, this surgical technique targets only the affected skin. This approach is particularly beneficial for treating skin cancers in areas such as the face, ears, and hands. 
• Reduced Risk of Recurrence: By thoroughly analysing each layer of tissue during the procedure, Mohs surgery significantly lowers the risk of cancer returning. This is especially crucial for aggressive or previously treated skin cancers, ensuring long-term success.
• Minimal Downtime: Usually performed in a dermatology and surgery clinic under local anaesthesia, this surgery does not require hospitalisation or even general anaesthesia for the patient. Most patients can return home on the same day, with only a short recovery period and minimal discomfort.