Is SRT the Mohs Alternative Manufacturers are Touting?

A skin cancer diagnosis can feel overwhelming on its own. While managing the emotional reaction to such a diagnosis, patients must simultaneously determine which method of treatment may best suit their needs and preferences. Board-certified dermatologists have long had numerous treatment options at their fingertips. Two that are in somewhat opposing corners at the moment are superficial radiation therapy and Mohs Micrographic Surgery. Here, we make a comparison.

Both radiation therapy and Mohs surgery were developed long ago. In fact, superficial radiation therapy (SRT) came first. One SRT device manufacturer has used the age of Mohs surgery as a minor deterrent. The idea here is that Mohs is antiquated and that SRT is a kind of “new and improved” method of treating nonmelanoma skin cancers. What research indicates is that, when Mohs became a standardized form of treatment mid-20th Century, more doctors and patients preferred this treatment method and SRT somewhat fell by the wayside. Now, it’s experiencing a resurgence.

The emergence of new SRT devices creates options as well as potential confusion. Before patients are presented with this as a “Mohs alternative” it is vital that the medical community do our due diligence in fully vetting SRT as a viable treatment option. One way we can do that is by observing statistics such as recurrence rates after treatment.


Based on data published by The Journal of Clinical and Aesthetic Dermatology, Mohs continues to be the highest standard of skin cancer treatment available. This data included cumulative findings of previously conducted studies on both Mohs and SRT. As investigators observed clinical information, they discovered that the recurrence rate for all nonmelanoma skin cancers was approximately 5.1 percent after SRT. Recurrence rates for primary tumors, both basal cell carcinomas and squamous cell carcinomas, is less than 1 percent with Mohs Micrographic Surgery.

Side Effects and Aesthetics

Virtually no treatment is without side effects. Mohs surgery may result in transient swelling and redness and may also require reconstructive surgery in some cases. Superficial radiation therapy is also not without potential side effects that doctors must be able to anticipate and educate their patients about. According to the study analysis, SRT caused hypopigmentation in 72% of patients, telangiectasias in 51%, erythema in nearly 45%, and hyperpigmentation in approximately 23% of patients. Slightly more than 6% of patients developed skin ulceration more than two months after the end of their SRT treatment protocol. Furthermore, using the Skin Cancer Index, studies have found that 94 percent of Mohs patients are satisfied or very satisfied with the cosmetic outcome of their procedure whereas satisfaction with the outcome of standard excision surgery and radiation therapy are much lower.

One More Thing

An additional point of interest when considering Mohs training versus the use of SRT and other standard treatments is that Mohs micrographic surgery has been achieving high success rates in the treatment of melanoma skin cancer on the face and body. The recurrence rate for each is less than 1%.

The American Society for Mohs Surgery is dedicated to the expansion of this proven procedure and education of board-certified physicians and their patients. To learn more about membership and courses, call (800) 616-2767.

Posted in: MOHS Surgery

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American Society for Mohs Surgery
6475 East Pacific Coast Highway, Box 700
Long Beach, CA 90803-4201
Telephone: (714) 379-6262 or
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