What You Need to Know About Skin Cancer and Mohs Surgery

QandA With Dr. Matthew Halpern, Windsor Dermatology

What is the typical Mohs patient?

The demographic used to skew much older, around 60 years of age or older. It could affect either gender, but usually the patients have light skin and fair eyes. But now we’re sadly seeing an increase in the younger population. People in their 20s and 30s are coming in for Mohs Surgery. It’s a nationally recognized trend that has come about within the last 10 years. It’s mainly attributed to tanning. 

How long have you been performing Mohs surgery? 

I’ve been performing Mohs for six years and about 1,000 cases per year. Mohs surgery is one of our highest ranking search terms. What would you say to a patient who is nervous about getting Mohs surgery? 

The Mohs procedure is similar to the biopsy a patient would have already had, and sometimes it’s less painful. Most people are surprised at how painless it is. As with any procedure, sometimes the anticipation is the worst part. But what would be worse overall is not treating the skin cancer. Some people delay treatment which can make things more complicated and they can require more extensive procedures. 

What is the success rate of Mohs? 

The success rate is really the advantage of getting Mohs Surgery done—it has the highest cure rates of any treatment for non-melanoma skin cancer. For a first time basal cell skin cancer patient, it has a 99% cure rate, and that is the most common form of the disease. For a first time squamous cell skin cancer patient, the cure rate is 97%.

Why is Mohs better than other skin cancer treatment methods? 

Mohs is the best treatment because it will leave the least amount of scarring possible and it almost always eliminates recurrence. So it has obvious medical advantages, as well as cosmetic advantages. It is really the ideal treatment for this disease. With Mohs surgery, it is an outpatient procedure, the stitches come out in a week or two and then you usually have a one month follow-up appointment.

Other treatments include ED&C (or electrodesiccation and curettage), which can be used based on the location of the cancer. We stick to the guidelines put forth by the American Academy of Dermatology (AAD) for Mohs Surgery indications to know when it’s appropriate. 

What do you think patients get by going to Windsor Dermatology that they don’t get elsewhere? 

Our strengths are our expertise, but perhaps more importantly, our emphasis on patient comfort. The whole team is really good at making sure patient questions are answered and the patient knows what to expect. We have a consultation beforehand and make them physically as comfortable as possible with recliners in the waiting room, snacks and a television to watch. I call my patients after their procedure to make sure that they are doing okay. We want them to feel like they are not just a number here. 

Now that so much information is available about the causes of skin cancer, do you think more patients are taking preventative measures to protect against skin cancer? 

People are definitely better protected and are doing a better job at preventing skin cancer. You can tell that many members of the older generation have passed on their experiences to their loved ones who are learning from that. It has cut down on the risk significantly. But even though people are being vigilant about sunscreen and sun-protective clothing, it’s still important to be checked by a dermatologist.