JUDY K. CHIANG, MD
MEDICAL AND COSMETIC DERMATOLOGY
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MOHS MICROGRAPHIC SURGERY
A diagnosis of skin cancer is cause for concern—if left untreated, the disease can continue to progress. However, it needn’t be cause for panic. If treated early, skin cancer is not necessarily life threatening nor does the therapy have to be disfiguring.
Mohs Micrographic Surgery (Mohs) is a state-of-the-art treatment for skin cancer that offers the highest cure rate----up to 99%. Not all treatments for skin cancer are equal. Options range from common treatments offered by many physicians such as scraping and burning, freezing, radiation, and routine excisions to Mohs surgery, an advanced surgical technique performed by a highly trained specialist. When considering options, it is important to recognize that the tumor that is visible to you—even to your physician—may be just the “tip of the iceberg.” Not all cancer cells are apparent to the naked eye. Many “invisible” cells may form roots or “fingers” of diseased tissue that can extend beyond the boundaries of the visible cancer. If these cells are not completely removed, they can lead to regrowth and recurrence of the tumor. For these cancers, common treatments methods are often not successful because they rely on the human eye to determine the extent of the cancer. These methods can remove too little cancer, which could cause it to recur and require additional surgery, or too much healthy tissue, which could cause unnecessary scarring. Mohs surgery has proven effective in getting to the roots of skin cancer by combing the surgical removal of cancer with the immediate microscopic examination of the tumor. The physician serves as the surgeon and the pathologist. This process allows the dermatologist trained in Mohs surgery to see beyond the visible disease and precisely identify and remove the entire tumor…while sparing healthy skin.
Mohs surgery involves a complete systematic microscopic search for the “roots” of the skin cancer. Once the visible tumor is excised, the following processes occur:
a) The Mohs surgeon marks this tissue with colored dyes and a map is made.
This allows the Mohs surgeon to later pinpoint the exact location of any remaining tumor.
b) A technician processes the tissue. This takes 30-60 minutes.
c) The Mohs surgeon examines the tissue under a microscope.
d) If any tumor is seen during the microscopic examination, its location is established. The Mohs surgeon then returns to the specific area of the tumor site as indicated by the map and a thin layer of additional tissue is excised ONLY from the involved area. This process then repeats until the cancer is completely gone.
e) If no tumor remains, the Mohs surgeon then performs the reconstructive surgery necessary to repair the wound.
Mohs surgery is performed by specially trained dermatologists who are members of the American College of Mohs Surgery and have completed an approved one or two year fellowship program in addition to a three year residency. Dr. Judy Chiang is fellowship trained and belongs to the American College of Mohs surgery. For more information, you can call (847)330-9830 or go to www.mohscollege.org.
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