A very important part of my dermatology practice is the prevention, early detection and, of course, the cure of skin cancer. In the course of examinations, I sometimes find lesions that I think are skin cancers or sometimes even my patients bring to me and point out to me lesions which turn out to be skin cancers. And when the biopsy comes back, if it is a basal cell cancer or a squamous cell cancer, when I tell that to patients, from time to time, they’ll ask me if we can treat it with Moh’s surgery. It’s a little bit unusual for patients to suggest the treatment, but more and more people are reading about Moh’s surgery in magazines and newspapers because it’s been embraced by the public perhaps because it’s a catchy name or because it’s a particularly effective treatment for cancer. In Moh’s chemosurgery which, of course, is done under anesthesia, if this outline represents the skin cancer and, of course, we have a frowny face because nobody wants to have skin cancer, during Moh’s surgery, the bulk of the skin cancer is scraped out and, at the very edge of the skin cancer, then another little piece is taken, put under the microscope immediately to make sure that there is no cancer out here so that you know that you’ve gotten this part out completely, and that’s repeated as you go around the edge of the skin cancer. This is a very, very valuable technique if you don’t have a lot of extra tissue to remove because it’s at the edge of an eyelid, or the nose or even maybe on a genital, because to remove this with conventional surgery would require cutting out a piece this big on this side and this big on this side, and we just often don’t have that amount of extra tissue. But for most basal cell cancers and squamous cell cancers, there are other parts of the body like the chest, or the back or even arm, and I’ll give you an example. If this cut represents one of these skin cancers, look at all of the extra tissue that there is around this that we could easily cut out and sew this together with conventional skin surgery. Certainly, if you have a skin cancer and you are discussing it with your doctor, we want you to have a comfort level with all of your questions answered, but the next time your doctor does tells you that you have either a basal cell or squamous cell cancer to be removed, let me suggest that you let your doctor suggest the treatment of choice so that you don’t have to have a procedure which is more complicated, or more involved or more expensive. Let your doctor suggest the treatment for your skin cancer.
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