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Mohs Micrographic Surgery: The Most Effective Way to Fight Skin Cancer

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During the colder months, protecting your skin from the sun’s damaging ultraviolet (UV) rays may not be foremost in your mind, but it’s just as important to safeguard your skin as it is in the summer.

New Skin Cancer Cases on the Rise

According to the United States Environmental Protection Agency, the sun causes about 90 percent of nonmelanoma skin cancers and 65 percent of melanomas. More than 1.2 million new cases of skin cancer are diagnosed each year in the US. Melanoma, the deadliest form of skin cancer, kills one person every hour.

Alarmingly, skin cancer rates are on the rise in this country and the Skin Cancer Foundation predicts that one in five Americans will develop skin cancer during their lifetime. Those ages 65 and older are at particular risk because sun damage is cumulative.

“Repeated exposure to the sun’s UV rays damages DNA in the skin. If the body can’t repair this damage, cancer can develop,” said Jeffrey Ellis, MD, director of dermatological surgery at North Shore University Hospital and LIJ Medical Center, and director of the North Shore-LIJ Mohs Surgery Center in Lake Success. “Most skin cancers could be prevented by following year-round sun-safe practices.”

Fortunately, for people diagnosed with skin cancer, the disease is highly curable with early detection and proper treatment, said Dr. Ellis.

Dr. Ellis, whose specialized training includes dermatology, pathology and surgery, has extensive experience in Mohs micrographic surgery, a state-of-the-art procedure to treat skin cancer. The procedure offers the highest potential for cure.

More Complete Removal of Tumors

Mohs micrographic surgery (named for Frederic Mohs, MD, who developed the procedure) involves a systematic microscopic search that traces skin cancer down to its roots (see accompanying graphic, left). The Mohs procedure offers the highest probability for complete removal of the tumor while sparing the normal surrounding tissue. Its success rate is up to 99 percent for some skin cancers. The Mohs procedure is especially effective for cancers of the face and other sensitive areas.

Reduced Risk for Scarring

Dr. Ellis precisely identifies the tumor, removes it with minimal damage to the surrounding healthy tissue and reconstructs the incision. The Mohs technique allows him to see beyond the visible disease to pinpoint and remove the entire tumor layer by layer, while leaving the surrounding healthy tissue intact and unharmed. The tumor-removal procedure minimizes the chance of regrowth and reduces the risk for scarring or disfigurement.

Blanche Dolan, a 67-yearold active grandmother who lives in East Valley Stream, was diagnosed with a common form of skin cancer on her face — basal cell carcinoma. The small cancerous areas were located on her lip, nose, cheek and temple, which made her a good candidate for Mohs surgery. In 2007 and 2008, Dr. Ellis performed successful Mohs surgery on Ms. Dolan. Some of her procedures were also performed by Prajoy Kadkade, MD, an otolaryngologist (ear/nose/throat specialist) at North Shore University Hospital, with whom Dr. Ellis works frequently.

“I was surprised with the recent skin cancer diagnosis because I was never one to sit in the sun,” said Ms. Dolan, adding that she used sunscreen consistently whenever outdoors. She was particularly diligent about covering up in the sun because she was diagnosed with skin cancer in 1975 when she was 33, and then later again in the 1990’s — both times on her face. Ms. Dolan underwent surgery in New York City, where she lived at the time.

Ms. Dolan reported that she was very comfortable during her Mohs micrographic surgery, and the same-day procedure was explained every step of the way. “Dr. Ellis did a beautiful job; I don’t have any scars,” she said. “The main thing is that he got all the cancer.”

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+Dr. Ellis is among an elite group of specially trained Mohs surgeons.

To learn more about the Mohs technique for removal of skin cancer, please call (866) 690-2008.

The Mohs Surgery Process

Figure 1: The roots of a skin cancer may extend beyond the visible portion of the tumor. If these roots are not removed, the cancer will recur.

Figure 2: The visible portion of the tumor is surgically removed.

Figure 3: A layer of skin is removed and divided into sections. An American College of Mohs Surgery (ACMS) surgeon then color codes each of these sections with dyes and makes reference marks on the skin to show the source of these sections. A map of the surgical site is then drawn.

Figure 4: The undersurface and edges of each section are microscopically examined for evidence of remaining cancer.

Figure 5: If cancer cells are found under the microscope, the ACMS surgeon marks their location on the “map” and returns to the patient to remove another layer of skin — but only from precisely where the cancer cells remain.

The removal process stops when there is no longer any evidence of cancer remaining in the surgical site. Because Mohs surgery removes only tissue containing cancer, it ensures that the maximum amount of healthy tissue is kept intact.


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