Mohs surgery can also be used to treating melanoma. However, moh’s surgery has a higher cure rate if treating melanoma in situ. It has been used in the removal of melanoma-in-situ (cure rate 77% to 98% depending on surgeon), and certain types of melanoma (cure rate 52%). Another study of melanoma-in-situ revealed Mohs cure rate of 95% for frozen section Mohs, and 98 to 99% for fixed tissue Mohs method. In situ is a condition that a cancer is still not become cancer yet.

However, mohs surgery is appropriate when:

• The skin cancer is in an area where it is important to preserve healthy tissue for maximum functional and cosmetic result, such as: eyelids, nose, ears, lips, fingers, toes, genitals.
• The skin cancer was treated previously and recurred.
• Scar tissue exists in the area of the cancer.
• The skin cancer is large.
• The edges of the cancer cannot be clearly defined.
• The skin cancer is growing rapidly or uncontrollably.

Main article – Mohs Surgery

basal cell carcinoma skin cancer

The base and edges are microscopically examined to verify sufficient margins before the surgical repair of the site. If the margins are insufficient, more is removed from the patient until the margins are sufficient.

basal cell carcinoma

However, mohs surgery procedure usually performed by specially trained surgeons who have completed at least one additional year of fellowship training (in addition to the physician’s three-year dermatology residency) under the tutelage of a Mohs College member.

skin cancer treatment

With the Mohs technique, physicians are able to see beyond the visible disease, to precisely identify and remove the entire tumor layer by layer while leaving the surrounding healthy tissue intact and unharmed. As the most exact and precise method of tumor removal, it minimizes the chance of re-growth and lessens the potential for scarring or disfigurement.

basal cell carcinoma treatment

Because the physician is specially trained in surgery, pathology, and reconstruction, Mohs surgery has the highest success rate of all treatments for skin cancer – up to 99 percent. The Mohs technique is also the treatment of choice for cancers of the face and other sensitive areas as it relies on the accuracy of a microscopic surgical procedure to trace the edges of the cancer and ensure complete removal of all tumors down to the roots during the initial surgery. Mohs surgery also used for squamous cell carcinoma; however, the cure rate is not as high as Mohs surgery for basal cell carcinoma.

mohs surgery

Main article – Standard Surgical Excision

• Frozen section histology, or
• Parafin embedded fixed tissue pathology

Standard Surgical Excision is a preferred removal method of basal cell carcinoma (BCC) and/or for this skin cancer treatment. The cure rate for this method, whether done by a plastic surgeon, family doctor, or dermatologist is totally dependent on the surgical margin. When standard surgical margin is applied (usually 4 mm or more) a high cure rate can be achieved with standard excision. The narrower the free surgical margin (skin removed that is free of visible tumor) the higher the recurrence rate.

Basal Cell Skin Cancer

This skin cancer treatment has a weakness that is a high recurrence rate of basal cell cancers of the face, especially around eyelids, nose, and facial structures. On the face, or on recurrent basal cell cancer after previous surgery, special surgical margin controlled processing (Mohs surgery is one of the methods) is required. With surgical margin controlled frozen section histology, a surgeon can achieve a high cure rate and low recurrence rate on the same day of the excision.

Skin Cancer Treatment

However, most standard surgical excisions done in a plastic surgeon or dermatologist’s office are sent to an outside laboratory for standard bread loafing method of processing. This method has a high “false negative” rate due to the random sampling of the tumour. For cosmetic reasons, many doctors take only very small surgical margins 1-2 mm, especially when facial tumour is being removed. A pathology report from such a case indicating “margins free of residual tumour”, often is inaccurate, and a high recurrence rate of up to 38% might occur.

Standard Surgical Excision

When in doubt, a patient should demand that either Mohs surgery or frozen section histology with either margin control or thin serial bread-loafing is utilized when dealing with a tumour on the face. The pathologist processing the frozen section specimen should cut multiple sections through the block to minimize the false negative error rate. Or one should simply process the tissue utilizing a method approximating the Mohs method during frozen section processing.

Skin Cancer Treatment

However, this method is difficult when applied to frozen sections; and is very tedious to process. When not utilizing frozen section, the patient might have to wait a week or more, before informing the patient if more tumors are left, or if the surgical margin is too narrow. And a second surgery must be performed to remove the residual or potential residual tumour once the surgeon inform the patient of the positive or narrow surgical margin on the surgical pathology report.

Skincancer-Fact.com

Main Article – Basal Cell Carcinoma Treatment Option

• The most common type of skin cancer
• Basal cell carcinoma (BCC) is the most common form of skin cancer; an estimated 2.8 million BCCs are diagnosed annually in the US.
• BCCs are rarely fatal or metastasis, but can be highly disfiguring if allowed to grow.
• Can cause massive disfigurement, but rarely metastasis and fatal.
• More common in Caucasian
• Only two-thirds of basal cell carcinomas skin cancer occur on sun-exposed areas of the body, one-third occur on areas of the body that are not exposed to sunlight.
• It is often difficult to distinguish basal cell cancer from acne scar, actinic elastosis, and recent cryodestruction inflammation, skin biopsy often needed.
• Unlike Melanoma, basal cell carcinoma caused by DNA damage.
• It is much more common in fair-skinned individuals with a family history of basal cell cancer and increases in incidence closer to the equator or at higher altitude.

Main Article - Basal Cell Carcinoma Skin Cancer

Basal cell carcinoma skin cancer usually treats with the following skin cancer treatment:

1. Moh’s Surgery
2. Chemotherapy
3. Standard Surgical Excision
4. Immunotherapy
5. Radiation

Moh’s Surgery

Some people claimed that Moh’s Surgery has a very high cure rate as skin cancer treatment, up to 98%.  Moh’s surgery works by surgically excising the tumor and then immediately examined under a microscope. The base and edges are microscopically examined to verify sufficient margins before the surgical repair of the site. If the margins are insufficient, more is removed from the patient until the margins are sufficient. Moh’s surgery is also used for squamous cell carcinoma, however, the cure rate is not as high as Moh’s surgery for basal cell carcinoma.

Basal Cell Carcinoma Treatment

Chemotherapy

Chemotherapy as skin cancer treatment usually uses 5-fluorouracil. Skin cancer topical treatment with 5% Imiquimod cream, with five applications per week for six weeks has a reported 70-90% success rate at reducing, even removing, the basal cell carcinoma skin cancer. Chemotherapy often used after Moh’s surgery to eliminate the residual superficial basal cell carcinoma after the invasive portion is removed.

Skin Cancer Treatment

Standard surgical excision

Standard surgical excision is the most preferred method in treating basal cell carcinoma, even among all basal cell carcinoma skin cancer treatment. The cure rate of this skin cancer treatment depends on surgical margin, and when standard surgical margin is applied (usually 4 mm or more), a high cure rate can be achieved with standard excision.

Treatment of Skin Cancer

Immunotherapy

Immunotherapy research suggests that treatment using Euphorbia peplus, a common garden weed, may be effective. Australian biopharmaceutical company Peplin is developing this as topical treatment for BCC.

Basal Cell

Radiation

Radiation therapy can be used to treat all type of basal cell carcinoma skin cancer.  The cure rate that radiation has is up to 95% for small tumor, or 80% for big tumor

Skin Cancer Treatment

Main Article: Basal Cell Carcinoma Skin cancer

Skin Cancer Fact

This Skin Cancer occurs mainly in fair-skinned patients with a family history of this cancer. A chemotherapeutic agent such as 5-Fluorouracil or Imiquimod, can prevent development of skin cancer. It is usually recommended to individuals with extensive sun damage, history of multiple skin cancers, or precancerous growths. It is often repeated every 2 to 3 years to further decrease the risk of skin cancer.

Skin Cancer Prevention

How to Diagnose?

Skin Cancer Fact

To diagnose basal cell carcinomas, a skin biopsy is taken for pathological study. The most common method is a shave biopsy under local anesthesia. Most nodular basal cell cancers can be diagnosed clinically; however, other variants can be very difficult to distinguish from benign lesions such as intradermal nevus, sebaceomas, fibrous papules, early acne scars, and hypertrophic scarring.

Basal Cell Carcinoma

Main Article – Basal Cell Carcinoma Skin Cancer Fact