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Basal Cell Carcinoma Mohs Surgery

How Successful Is Basal Cell Carcinoma Treatment

Mohs Surgery of Basal Cell Carcinoma Recovery

Mohs micrographic surgery has the best cure rates with basal cell carcinoma, a 99 percent cure rate for carcinomas that are not returning growths. The cure rate when basal cell carcinomas are removed with wide excision can be as high as 98 percent. With curettage and electrodesiccation, the rate is from 91 to 97 percent.

Basal cell carcinoma is not considered life-threatening in almost all cases. It is simply disfiguring.

My Mohs Surgery Experience For Basal Cell Carcinoma

My Mohs Surgery experience for Basal Cell Carcinoma on my face. This post contains GRAPHIC before and after photos of Mohs Surgery for skin cancer.

When I was diagnosed with skin cancer, I thought it would be a quick in-office laser procedure by my dermatologist. However, my Basal Cell Carcinoma removal was not that simple. The most effective skin cancer treatment for Basal Cell Carcinoma is Mohs Surgery. The benefit of Mohs Surgery is the preservation of your healthy skin while removing all of the skin cancer cells.

The skin cancer on the side of my cheek grew deeply into my face. Thankfully the Basal Cell Carcinoma did not enter any bones or spread over a larger outer surface area. The lesion was the size of a quarter before the surgeon removed all of the cancerous cells. The cancer free area after surgery was three times the size as the original spot.

Can Mohs Treat Melanoma

Yes, dermatologists occasionally recommend Mohs for treating melanoma, the most serious type of skin cancer. Mohs is only used to treat an early melanoma, and it must be a type of melanoma called lentigo malignant melanoma. This type of melanoma stays close to the surface of the skin for a while.

When treating melanoma, the surgeon uses a modified type of Mohs surgery called slow Mohs. Its called slow because the patient must wait longer for the results. Its not possible for the surgeon to look at the removed skin and know right away whether it contains cancer cells. More time is needed.

If you have slow Mohs, the surgeon will remove the visible skin cancer and a bit of normal-looking skin around it. Youll then be bandaged and sent home.

Most patients return the next day. Its then that the patient learns whether more skin must be removed or the wound can be closed. Again, some wounds are left to heal on their own.

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What Is It Like To Have Mohs Surgery

If you have Mohs surgery, youll see a doctor who is a trained Mohs surgeon. Most Mohs surgeons are dermatologists who have completed extensive training in Mohs surgery.

During Mohs surgery, most patients remain awake and alert. This means Mohs can safely be performed in a medical office or surgical suite. Only if extensive surgery is necessary would you be admitted to a hospital.

On the day of the surgery, your surgeon will first examine the area to be treated. Youll then be prepped for surgery. This includes giving you an injection of anesthetic. This injection only numbs the area that will be operated on, so youll be awake during the surgery.

Once the anesthetic takes effect, the surgery can begin. The surgeon starts by first cutting out the visible skin cancer. Next, the surgeon removes a thin layer of surrounding skin. Youre then bandaged so that you can wait comfortably.

While you wait, the Mohs surgeon looks at the removed skin under a microscope. The surgeon is looking for cancer cells. If cancer cells are found, youll need another layer of skin removed.

This process of removing a thin layer of skin and looking at it under a microscope continues until the surgeon no longer sees cancer cells.

Once cancer cells are no longer seen, your surgeon will decide whether to treat your wound. Some wounds heal nicely without stitches. Others need stitches. To minimize the scar and help the area heal, some patients require a skin graft or other type of surgery.

How Is Mohs Surgery Performed

Mohs Micrographic Surgery

The Mohs procedure involves a layer-by-layer removal of skin that contains cancer cells. Here are the typical steps in the procedure:

  • Your surgeon numbs the skin around the cancer cells with an injected anesthetic.
  • They remove any visible, raised area of the tumor.
  • They also remove a thin layer of tissue from the site. Your surgeon will try to preserve as much healthy, normal skin as possible.
  • They mark the tissue so they can identify the right, left, top and bottom, and create a map of the site.
  • They immediately freeze, cut and stain the tissue the doctor’s office. This process takes approximately one hour, but this time varies from case to case.
  • Your surgeon examines the entire bottom and outer edges of the removed tissue layer under a microscope.
  • If there are any cancer cells in the sample, your surgeon identifies their precise location , and removes an additional thin layer of tissue from the area where cancer cells remain.
  • The process of microscopic examination and removal of additional layers of tissue continues until there are no more cancer cells. Will I need reconstruction of the resulting wound?

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What Happens Before Mohs Surgery

Before you have a Mohs surgery for skin cancer, youll see your dermatologist for a physical exam of the site and surrounding tissue. Together, you and your dermatologist will review:

  • Your medical history and any medications or supplements you take.
  • The results from your biopsy.
  • Your diagnosis of skin cancer, including your treatment options and the risks and benefits of Mohs surgery.

Depending on your general health and the location of the surgical site, you may need to take preoperative antibiotics.

Basal Cell Carcinoma Surgery At Moffitt Cancer Center

At Moffitt, patients work with not just one doctor, but an entire multispecialty team focused on the treatment of basal cell carcinoma. This team collaborates to create an individualized treatment plan for each patient, ensuring everyone receives the most appropriate therapy for their unique circumstances and experiences the best possible outcome and quality of life.

To learn more about basal cell carcinoma surgery, or to consult with an oncologist specializing in this form of skin cancer, call or submit a new patient registration form online.

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How Is Basal Cell Carcinoma Diagnosed

Your provider at the office of Ali Hendi, MD, examines the growth or growths, noting the color, size, shape, and texture of the suspicious area. They look at whether it’s oozing, bleeding, or crusting. They also may ask to look at other parts of your body for spots that could be related to basal cell carcinoma.

If your provider suspects your growth is cancerous, they recommend a skin biopsy. A biopsy involves numbing the area and taking a small tissue sample to examine under a microscope.

Your provider can perform a skin biopsy with various methods. Your provider recommends an appropriate method based on the suspected type of carcinoma, the size, location, and other factors.

The types of biopsies include a punch biopsy, which uses a slim, cookie-cutter like tool to remove a sample, or a shave biopsy, where your provider removes a sliver of the growth with a scalpel.

Reconstruction After Mohs Surgery

Basal Cell Carcinoma – Mohs Surgery Afterthoughts

Some Mohs procedures may not require reconstructive surgery at all, but for those that do, the reconstruction can most often be performed by your Mohs surgeon immediately after the skin cancer has been removed.

If a Mohs surgery leaves a large defect in a visible or sensitive place such as the nose or the areas around the eyes or ears, you may need a skin graft or local flap to cover the defect and restore the function and appearance of the face.

Advanced cases that require more extensive reconstruction are performed in the operating room under sedation or general anesthesia. In these cases, your Mohs surgeon may coordinate your reconstructive work with a plastic, facial plastic or oculoplastic surgeon. A consultation with your Mohs surgeon will help determine what type of reconstructive surgery you will need.

Reconstruction After Mohs Surgery | Amber’s Story

Mohs surgery for the removal of squamous cell carcinoma left Amber with a large wound on her face. Willing to travel anywhere for the best facial plastic and reconstruction surgeon, Amber found Lisa Ishii, M.D., at Johns Hopkins to repair her cheek and is delighted with the outcome.

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How Do You Prepare For Mohs Surgery

As with any surgery, discuss your allergies, medications, and supplements with your doctor. If you drink one or more alcoholic beverages daily, ask if you should stop your intake prior to surgery. Also let your doctor know if you smoke cigarettes or use any other tobacco or nicotine product.

Come clothed for the procedure in comfortable, loose-fitting clothing.

If youre having the surgery done near your eye and wear contact lenses, ask your doctor if you should remove them for the day. If you wear dentures and need surgery near your mouth, you may need to remove your dentures during the procedure.

Youll be awake for the entire surgery. Its hard to predict how long Mohs surgery will last. Three or four hours or longer is common. The procedure may comprise several waiting periods while the layers of removed tissue are analyzed. Youll be able to sit up and relax during these wait times. You may wish to bring something to occupy yourself, such as a book, crossword puzzles, or knitting.

Even though the time frame for Mohs surgery is hard to predict, make plans ahead of time to have someone waiting who can take you home once the surgery ends. Dont schedule anything else for the day other than rest.

Since you will not be under general anesthesia, its usually recommended that you eat breakfast before arriving.

What Are The Risks

Mohs surgery is generally considered very safe, but there are some risks:

  • Bleeding from the site of surgery
  • Bleeding into the wound from surrounding tissue
  • Pain or tenderness in the area where skin was removed

Although these are less likely to happen, there are other potential problems:

  • You could have temporary or permanent numbness in the area where the skin was removed.
  • If your tumor was large and your surgeon cut a muscle nerve while removing it, you might feel some weakness in that part of your body.
  • You might feel itching or shooting pain.
  • You could develop a thick, raised scar.

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What Can I Do To Prevent Future Skin Cancers

Minimize your exposure to the sun by applying a sunscreen with a minimum sun protection factor of 30. It should be applied 20 minutes before you go outdoors. Sunscreen is under-utilized by the majority of individuals. Be sure to use it liberally and often.

Wear a hat with a broad brim , and avoid direct exposure to the sun between 10 am and 4 pm

Be sure to visit your dermatologist for yearly checkups especially if you have had a skin cancer in the past or have numerous moles, since these conditions increase your risk of skin cancer. If you notice any suspicious areas on your skin between visits, ask your physician if a biopsy might be needed.

What Is Basal Cell Carcinoma Of The Nose

Mohs Reconstruction in San Diego after Skin Cancer  SKY Facial Plastic ...

Basal cell carcinoma is a type of skin cancer. About 80% of all skin cancer in people is basal carcinoma. Basal cancers start in the basal cell layer, or surface layer, of your skin.

Basal cell carcinoma grows slowly. Typically, basal carcinoma of the nose can be surgically removed before it spreads to other areas. But if its left untreated, its possible for the cancer to spread to your bones and nearby tissues.

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Will I Need Reconstruction Of The Resulting Wound

After complete removal of the skin cancer, your surgeon will discuss the best method of managing your wound. The choices include:

  • Letting your wound heal on its own .
  • Closing your wound with stitches .
  • Closing your wound with a skin flap or a graft .
  • A combination of the approaches listed above.
  • Involving another surgical specialist like an oculoplastic or facial plastic surgeon .

How Are Postoperative Wounds Managed

Once the entire cancer is removed, your Mohs surgeon or other reconstructive surgeon as decided upon at the time of consultation will discuss wound-management options that will achieve the best results in preserving functional capabilities and maximizing aesthetics.

Mohs surgeons are trained in reconstructive procedures and often will repair the wound with stitches, a skin graft or skin flap. In some cases, the wound is allowed to heal by itself a process that requires daily bandage changes for two to six weeks.

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Targeted Therapy Or Immunotherapy For Advanced Basal Cell Cancers

In rare cases where basal cell cancer spreads to other parts of the body or cant be cured with surgery or radiation therapy, a targeted drug such as vismodegib or sonidegib can often shrink or slow its growth.

If these drugs are no longer working , the immunotherapy drug cemiplimab can sometimes be helpful.

Basal Cell Carcinoma Surgery

Basal and Squamous Cell Skin Cancers: Treatment including Mohs Surgery Video – Brigham and Womens

One of the most commonly used treatments for basal cell carcinoma is surgery. There are several factors such as how large the cancer is and where it is located that influence whether surgery would be appropriate and, if so, what type of procedure would be used. Some patients might not want to or be able to undergo surgery, in which case other treatments may be recommended.

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How Dangerous Is A Basal Cell Carcinoma

While melanoma rightly deserves the attention it receives as the most dangerous form of skin cancer, basal cell carcinoma isnt something to brush off as harmless. Yes, this most common form of skin cancer rarely causes fatalities, but it can become quite disfiguring.

While basal cell carcinoma lesions rarely spread beyond the original tumor site, they should not be allowed to grow freely. These lesions can grow widely, penetrating deeply into the skin destroying skin, tissue, and bone. Plus, the longer you leave a basal cell carcinoma untreated, the more likely it is to come back. And because it will usually return in the same area, this can create problems removing the lesions without overly disfiguring the patient.

Skin Cancer Specialists & Mohs Surgeons Located In Chevy Chase Md

Sores that dont heal or raised reddish growths are common signs of basal cell carcinoma. If you suspect you have this form of skin cancer, rely on the skin cancer specialists at the office of Ali Hendi, MD, in Chevy Chase, Maryland. Dr. Hendi provides effective outpatient procedures onsite, such as Mohs surgery, which has a 99% cure rate for basal cell carcinomas while minimizing scarring. We proudly serve the Washington, DC/DMV and the surrounding areas including: Bethesda, Silver Spring, Rockville, Potomac, PG County, Baltimore County, Arlington, Mclean, Tysons Corner, Vienna, Chantilly, Alexandria, and Fairfax. For expert care, call our practice today.

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What Are The Advantages Of Having Mohs Surgery

The most important advantages of Mohs surgery are the complete microscopic examination, which allows for complete removal of the cancer and high cure rates, and the ability to spare as much normal skin as possible.

Additional advantages of Mohs surgery for skin cancer include:

  • Its done in a single outpatient visit.
  • Youll receive local anesthesia to numb the area, so youll recover faster compared to general anesthesia or sedation.

Who This Works For

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Mohs micrographic surgery might make sense for MCC patients that have local disease presenting on the face, who have already had a sentinel lymph nodelymph nodeA rounded mass of lymphatic tissue that is usually surrounded by connective tissue and about the size of a green pea. Lymph nodes filter lymphatic fluid, also know as lymph, which is fluid that drains from the tissues of the body and contains immune cells. Cancer cells often travel through lymph vessels and lodge and grow in lymph nodes, sometimes causing the nodes to markedly increase in size.biopsybiopsyThe removal of cells or tissue in order to determine the presence, characteristics, or extent of a disease by a pathologist usually using microscopic analysis..

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Basal Cell Carcinoma Before And After Pictures

To start, they marked and measured me. The red area in the circle is the basal cell carcinoma. Not that big of an area, or so I thought. Remember the front office gal I mentioned?

Well, she was like the best hostess ever. She brought me coffee. And teased me with treats she would be bringing around later. It was nice to spend some time with my husband. It was all very relaxed and enjoyable.

My husband and I, still in good spirits, took joke pictures to send to his mom. He doesnt do well in medical situations so we thought this photo, of him pretending to have passed out, seemed appropriate.

The dermatologist did round one. They laid me back, numbed me up and made an incision. It took just a few minutes. It wasnt awesome, but it was manageable. They removed some cells and took them to their onsite lab to evaluate.

Just a little bit of cotton and tape were put over the incision while we waited to see what would happen next. We were told results would take about an hour so we just had to relax and wait.

Sweet, sweet lady. First my husband and I were brought warm cinnamon swirl bread from the front office gal. Then an hour later she came by with these abelskivers from Trader Joes! I loved this place! They really did their best to make you comfortable.

But I wouldnt be there that long. At this point I just needed to be stitched up. So while the original red mark appeared to be very small, the cancer was actually much larger below the surface.

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