More than 100,000 people in the United States will be diagnosed with melanoma in 2020, which accounts for only about 1% of all skin cancer diagnoses. Unfortunately, melanoma also leads to the most skin cancer deaths thanks to its aggressive behavior, which makes catching and exercising the cancer in its earliest stages critical. To underscore this point, the survival rate is 98% if the melanoma is detected and treated early — and one treatment method is Mohs surgery, though it’s not the best treatment avenue for melanomas across the board.
At Z-ROC Dermatology, our own Dr. Khongruk Wongkittiroch is a specially trained skin cancer and Mohs surgery specialist, and she’s helped scores of patients overcome skin cancer diagnoses.
If you’ve been diagnosed with melanoma, here’s a look at when Mohs surgery is beneficial.
Melanoma at a glance
Before we get into your treatment options when it comes to melanoma, it’s helpful to understand why they differ from other, more common, skin cancers, such as basal and squamous cell carcinomas.
Melanoma is a type of cancer that attacks your melanocytes, the cells responsible for producing the pigment in your tissue. Most melanomas — about 90% — are a result of exposure to ultraviolet rays, whether it’s from the sun or a tanning bed.
The problem with melanoma is its aggressive nature, quickly spreading to other parts of your body if undetected. Thankfully, most melanomas are detected in situ, which means it’s only affected a certain area of tissue and hasn’t spread throughout the body. (This is why we stress the importance of regular skin cancer screenings with us.)
If we’ve found that you have melanoma, our first step is to identify whether the cancer is in situ or whether it’s spread. If the melanoma is in situ, our next step is to excise the cancerous tissue. Traditionally, we approached the problem by excising the cancerous area, along with a fairly healthy margin, in a procedure known as a wide local excision. While effective, this type of surgery can cause collateral tissue damage and significant scarring.
With the more common type of skin cancers, we’ve been able to avoid the collateral damage and get rid of the cancer by employing an advanced technique known as Mohs surgery. With Mohs surgery, Dr. Wongkittiroch painstakingly removes the affected tissue layer by layer, checking each time for evidence of cancer cells. Once the biopsies are clear of cancer cells, she stops removing any more tissue. Ultimately, this tissue-sparing technique allows Dr. Wongkittiroch to successfully remove the cancer with the least amount of disruption to surrounding healthy tissues.
For this technique to work with melanoma, the cancer can only be local — if the cancer has spread, Mohs surgery is usually not the best course of action as the cancer has already gone beyond the primary site.
If your melanoma is still in situ, Dr. Wongkittiroch sits down with you to review your options. Rest assured, she makes every effort to use tissue-sparing techniques like Mohs surgery whenever possible, but some melanomas call for a wider approach.
If you’d like to learn more about whether your melanoma is a candidate for Mohs surgery, please contact our office in Fort Lauderdale, Florida, to set up a consultation.