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What is Mohs surgery?
Mohs surgery is a specialized, highly effective technique for removing skin cancers. It was developed in the 1930s by Dr. Frederic Mohs at the University of Wisconsin and is now practiced throughout the world. Mohs surgery differs from other skin cancer treatments in that it permits the immediate and complete microscopic examination of the removed cancer tissue so that all roots and extensions of the cancer can be eliminated. Mohs surgery has the highest reported cure rate of all treatments for skin cancer.
While Mohs surgery is an effective option, treating all skin cancers with Mohs surgery is not necessary. Mohs surgery is reserved for skin cancers that grow back after previous treatment, cancers that are at high risk of reoccurring, or cancers that are located in cosmetic areas where preservation of the maximum amount of normal skin is important.
How is Mohs surgery done?
1. The skin is numbed using local anesthetic. The visible cancer is removed with a thin layer of additional tissue. This takes only a few minutes.
2. The specimen is color coded to distinguish top from bottom and left from right. A technician freezes the tissue and removes very thin slices from the entire edge and undersurface. These slices are placed on microscope slides and stained for examination under a microscope. This is the most time consuming part of the procedure, often requiring an hour or more to complete.
3. Dr. Bennion then carefully examines these slides under the microscope. This allows examination of the entire surgical margin of the removed tissue. That is, the entire undersurface and the complete edge of the specimen is examined. All microscopic roots of the cancer can thus be precisely identified and pinpointed.
Why remove skin cancer with Mohs surgery?
Some skin cancers are deceptively large-far bigger under the skin than they appear to be from the surface. These cancers may have "roots" in the skin or along blood vessels, nerves, or cartilage. Also, skin cancers that recur after previous treatments may send out extensions deep under the scar tissue that has formed. Mohs surgery is specifically designed to remove these cancers by tracking and removing these cancerous "roots."
Recently there has been a surge of anti-screen rants on the internet. Multiple websites suggest that sunscreens can cause cancer, affect your hormonal balance and even kill coral reefs. Here are some facts:
Broad spectrum sunscreens prevent premature skin aging and cancer caused by the ultraviolet rays (UVR) of the sun. There are literally hundreds of scientific studies demonstrating the protective effects of sunscreens.
There are many studies suggesting that UV sunscreens are very safe but the ultimate test of safety for any product is the widespread use without ill effects in the general population. When drugs and medical products safety studies are evaluated by the FDA, there typically are thousands of study test subjects. Even though the drugs are determined “safe” by the FDA, the ultimate test of the drug occurs when it is released to the public and tens of thousands of patients start using it. Only then can doctors determine the real safety of a drug. The safety of sunscreens is a case in point. Sun screens have been used by millions of individuals over decades without evidence of their use causing any serious problems such as cancer or other diseases.
Recently Hawaii has banned oxybenzone, a very effective sun screen component, because of lab studies demonstrating it is toxic to coral and may cause “coral bleaching." Recent studies of the actual concentrations of this sunscreen in beaches where it is used demonstrate very low concentrations incapable of causing coral damage.
It appears that there is a mini-epidemic of hand-foot and mouth disease in Casper. The cause of this illness is viral usually involving coxsackie or enteroviruses. It begins with tender vesicles on the tongue, gingiva and the lining of the mouth. Usually it occurs in children under 15 but it can occur in anyone. There is a mild fever and as the disease progresses small grey vesicles develop on the hands and feet. The eruption can occur on the buttocks especially in infants and small children who wear diapers. The treatment is supportive with no medication found to be curative. There have been reports of acyclovir helping but no formal studies have been done to determine if acyclovir has an effect on this disease. It is contagious and appears to be spread via the oral fecal route, wash your hands after coming in contact with an infected person.
There has been an ongoing mythical campaign against the use of vaccines. Experience with all vaccines over the many decades of use have demonstrated that the protective effects of vaccines far outweighs any possible risks of getting vaccinated against an infectious agent. This winter this years flu type, H3N2, has killed 30 kids and more adults. Typically the deaths from flu in the US number in the tens of thousands. The most recent story was of a teenage boy who was healthy who started coughing and died within a week--he hadn't been vaccinated. This year's vaccine has protective effects on both H1N1 and H3N2 influenza. Each year the vaccine is produced to cover the virus that is most prevalent in that year. Usually the types change so if one gets vaccinated each year there will be more protection than if you only get vaccinated occasionally. There are some super bad flu types waiting in the wings; a bird flu(H7N9) in Asia which is resistant to tamiflu and very deadly has been recently identified. Vaccination over years will probably give you some protection against these very virulent flu viruses. And getting vaccinated not only protects you but those around you such as family members. So get vaccinated--its safe and effective and protects you and those you love from a potentially lethal disease. More about vaccines for warts and shingles later.
It seems that aesthetic clinics are showing up on every corner. Along with them comes the enticing “bargain deals.” Botox and fillers for cheap, facials for next to nothing, the pull can be tempting. But ask yourself, “Is it worth the risk?”
Cheap treatments never mean best treatments especially when it comes to an asset as important as your face. A good provider will consult with you about your skin concerns and then take a medical approach that is right for your specific skin needs. When it comes to proper skin treatments, one shoe does not fit all. If you find yourself in a clinic that does not consult with you and listen to your concerns, hand tailoring a regimen suited JUST FOR YOU, take your business elsewhere.
The most important thing to ask yourself before getting any procedure done is, “What are the credentials of this provider?” With something as important as your face, the individual to whom you entrust it to should be one that has several things, proper credentialing, licensure, experience, and positive results. There seems to be an abundance of inexperienced individuals doing procedures. Don’t fall for it! Discounting your face is not worth the risk.