Mohs Microscopic surgery is not indicated for all types of skin cancers. Mohs surgery does offer the highest cure rate, but is not used for every type of skin cancer. The treatment modality is based on several characteristics of the skin cancer, including, but not limited to location, size, aggressiveness and recurrence. Other treatment options for lower risk cancers are listed below. Most of these treatments have a cure rate of about 90% or lower.
Curettage & Electrodesiccation
A treatment in which the cancerous tumor and its extensions are removed by scraping (curettage) and burning (electrodesiccation). Only part of the diseased tissue is visible to the surgeon; the invisible cancerous tissue is identified by its softness on contrast to the firm, gritty texture of normal tissue. This treatment is most successful in the removal of the superficial tumors. Recurrence rates are higher when the tumor is in a scar tissue or extends into fat. With this destructive method, no tissue is available for pathological examination.
A method in which liquid nitrogen is applied on diseased tissue and the surrounding area. The nitrogen causes the temperature of the tumor and surrounding healthy tissue to drop to ‐ 30 degrees and ‐50 degrees centigrade. The intracellular ice crystals that form and this temperature kill the tumor cells. The dead tissue then sloughs off, allowing the wound to heal. As with curettage and electrodesiccation, tissue is not available for pathological examination. This technique is not used often for cancer treatment, but is better suited for pre-cancer treatment.
A treatment that is used to destroy the cancer and its microscopic extensions by using x‐rays to destroy cancer cells. This destructive treatment method, like the preceding ones, provides no specimen for pathological examination.
An excellent way to treat precancers (actinic keratoses), including visible keratoses and lesions that are currently invisible to the eye that may grow and harm you at a later time. Topical chemotherapy agents or anticancer agents in the form of a cream or lotion are applied to the affected areas. The topical creams kill the abnormal skin cells that make up actinic keratoses. After treatment, normal looking skin replaces the actinic keratoses. Some topical creams are FDA approved to treat superficial basal cell carcinomas on the trunk and extremities. Patients need to be compliant with the topical cream for them to be effective.
Blue Light Photodynamic Therapy Illuminator “PDT”
Is indicated for the treatment of precancers. This method of treatment involves the application of Levulan Kerastick directly to the area which is then absorbed by the pre-cancerous cells and converted to a chemical that is sensitive to light. When these cells are exposed to the blue light, the cells are destroyed.