Knowing Options for Skin Cancer Surgery

Mohs micrographic surgery can preserve skin

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) For most skin cancers, a simple excision is enough. But in some cases, doctors might decide to have the cancer examined under microscope to make sure it was removed completely.

A study examining Medicare records for skin cancer treatment from 2001-2006 found that there were significant differences in current surgical practices.

Of the two methods currently used - simple excision, and Mohs Micrographic Surgery - Mohs is ideal because the process involves looking at the cancer under a microscope during the surgery.

"Ask your oncologist about new diagnostic tests."

The study sampled five percent of all Medicare skin cancer surgical patients from 2001-2006. Out of the 26,931 patient records examined, 36 percent were treated with Mohs surgery and 64 percent had simple excision.

The study found that the city of Atlanta had the highest rate of Mohs surgery performed out of all areas at 45 percent, whereas Louisiana had the lowest rate at 11 percent.

There is some debate over public policy as to whether Medicare should cover Mohs surgery as a matter of cost efficiency. However, ensuring that no trace of cancer remains to recur or metastasize appears to justify the cost.

Perhaps for that reason, researchers found that the younger a patient was at the time of the surgery, the more likely the surgeon was to use Mohs surgery.

Current practices also recommend the use of Mohs surgery on cancers found on the head, especially the face, as they are both higher risk cancers and more likely to recur.

The study authors concluded their findings with the recommendation that larger prospective studies be performed in order to find out the absolute difference in treatment outcomes between the two surgical procedures so as to establish future treatment guidelines.

The study was published in the April, 2012 edition of Archives of Dermatology.

No financial disclosures were made by the study authors.

Reviewed by: 
Review Date: 
April 17, 2012
Last Updated:
April 17, 2012