This procedure, now called Mohs Micrographic Surgery (MMS), is still the best method available for treating skin cancers that have a high risk of local recurrence. This includes cancers on the nose and the ears, as well as cancers around the lips, eyes, and ears. It also includes cancers that have recurred after the initial treatment.
In MMS, the area of the tumor is injected with local anesthetic, and a disk of tissue, which is thought to contain the entire cancer, is removed. A map is made indicating the position of the specimen on the patient, and identifying marks are placed on the tissue specimen to ensure its proper orientation.
The specimen is then prepared and examined under the microscope. Because of the preparation and orientation of the tissue, it is possible to examine the entire bottom and all the edges of the specimen. If there is no cancer at any of the edges, then one can be relatively confident that the entire tumor has been removed. If there is cancer at one or more of the edges, additional tissue is removed from these areas until the margins appear clear.
This technique is the most reliable approach for completely removing skin cancer. However, it is not foolproof and sometimes recurrences can occur.
Another advantage of MMS is that it is a tissue-sparing technique, allowing the removal of only a small amount of healthy skin. This results in a smaller defect and which may produce a better cosmetic outcome.
Because it is a labor intensive and time-consuming technique, MMS is not routinely performed in all skin cancers, but only in the more difficult ones.
Dr. Bock trained with Dr. Mohs during his residency, and Dr. Mohs' chief technician initially came to Stockton to supervise the organization of Dr. Bock's lab.
If you think you might be a candidate for MMS, you can schedule an office visit with Dr. Bock.
Dr. Frederic Mohs, a surgical professor of at the University of Wisconsin, developed a new and more precise method for removal of skin cancer in the 1940s. Initially, a chemical was applied to the skin and layers of tissue were removed and checked under the microscope for the presence of the cancer. The procedure took a number of days to complete. The technique has been improved and refined since that time. Today, it can be completed in a single appointment. Dr. Bock is proud to bring advanced Mohs surgery to Stockton and Lodi, CA.