Nathan J Cleaver D.O. completed a fellowship at Northeast Regional Medical Center specializing in this technique. Without question, this technique has given the medical field an advantage in treating non-melanoma skin cancers of the head and neck. Initially developed by Dr. Frederick Mohs in the 1930s, Mohs micrographic surgery has become the gold standard in treating these types of cancer in the 2000s.
Today, Mohs surgery has come to be accepted as the single most effective technique for removing Basal Cell Carcinomas and Squamous Cell Carcinomas (BCCs and SCCs), the two most common skin cancers. It spares the greatest amount of healthy tissue while also ensures the highest clearance of cancer cells; cure rates for BCC and SCC are an unparalleled 99 percent or higher with Mohs, significantly better than the rates for standard excision or any other accepted method.
The reason for the technique’s success is its simple elegance. Mohs differs from other techniques in that microscopic examination of all excised tissues occurs during rather than after the surgery. The standard surgical margin for excisions on the arms, trunk and legs is at least 4 mm on each side of the tumor. However, in this technique, the margin is determined clinically, and by microscopically examining the margins of the skin cancer that is removed, the Mohs surgeon is able to remove all of the cancer cells while sparing as much normal tissue as possible. The procedure entails removing one thin layer of tissue at a time; as each layer is removed, its margins are studied under a microscope for the presence of cancer cells. If the margins are cancer-free, the surgery is ended. If not, additional tissue is removed at the margin where the cancer is still present, and the procedure is repeated until all the margins of the final tissue sample examined are clear of cancer. In this way, Mohs surgery microscopically assists in skin cancer removal, producing the best therapeutic and cosmetic results.