Mohs and Melanoma: a Step-by-Step Transition
- Posted on: Jan 15 2017
Any skin cancer diagnosis can be heartbreaking for a patient. So many questions come to mind that it may be difficult to articulate them right away. Patients rely on their physicians for answers – sometimes to questions they don’t even know they have. For instance, today’s dermatologist is expected to know about Mohs surgery. More specifically, how to perform this meticulous procedure, and in what situations.
Historically, Mohs has been performed primarily on basal cell and squamous cell carcinomas that are located in highly visible places on the body. Lesions within scar tissue, or related to skin cancer recurrence are also best treated with the layer by layer approach taken during the Mohs procedure. But what about melanoma? This is the most concerning skin cancer diagnosis a patient can receive; one with a stubbornly consistent mortality rate. One would think that the proven track record of Mohs would match well with the need for full removal of melanoma cancer cells. The fact is, the transition has been slow. Fortunately, it has been steady.
New Hope for Melanoma Patients
Early in 2016, surgeons at Stanford Health Care in California adopted the use of the Mohs technique in specific cases. Specifically, Mohs is now being used in this facility to remove a melanoma in situ, or Stage 0 melanoma that is localized in the upper layers of the epidermis. Until recently, this method of care was not a possibility for melanoma patients. This had to do with the appropriate preparation of tissue samples.
Mohs is an excellent treatment option for basal cell and squamous cell carcinomas because the cells are relatively easy to visualize with dye. Melanoma cells have been more difficult to pinpoint. It was only about 15 years ago that researchers were able to formulate the right immunohistochemistry stain that correlated with the biomarkers of this type of cancer cell. A notable advance in cancer treatment, there was still work to do. At the time the dye was developed, it was made for formalin slides, not for the frozen-section slides used in the Mohs procedure.
Today, all that needs to be aligned is, and melanoma patients are finding new hope for a more affordable, less invasive, and more successful treatment option.
The American Society for Mohs Surgery offers courses and professional development for surgeons interested in the Mohs procedure. For more information, call (800) 616-2767.
Posted in: MOHS Surgery