my research on the web keeps leading me to the conclusion that mohs surgery is the best technique for treating skin cancer on the nose. Is this true? Are there any reasonable alternatives to be considered?
Mohs Surgery for Skin Cancer
Doctor Answers 14
Is Mohs Surgery "THE BEST"
Mohs surgery for skin cancer on the nose
Mohs surgery is typically recommended for skin cancers on the nose, which are usually basal cell cancer or squamous cell cancer. Mohs surgery has the highest cure rate. That said, there are times when alternative treatments can be considered. Imiquimod cream can be considered for certain lower risk skin cancers such as superficial basal cell cancer or squamous cell cancer in situ. Other treatments which are sometimes performed are standard excision, electrodessication and curettage (scrape and burn) or radiation treatment.
Mohs Surgery: Highest Cure Rate and Greatest Preservation of Healthy Tissue
Mohs surgery provides the highest cure rate for skin cancer. With cure rates approaching 99% for previously untreated basal cell carcinoma and 95% for basal cell carcinomas that have been treated before but recurred, Mohs surgery provides a higher cure rate than any other form of treatment including standard excision, curettage and electrodesiccation (scraping and burning), radiation or topical therapies. At the same time by starting with as small of a surgical margin as possible and then tracing out the roots of the skin cancer, Mohs surgery preserves the greatest amount of healthy tissue. For this reason Mohs is particularly useful in areas where tissue preservation is of paramount importance, such as the eyelids, nose, lips, ears, hands and genitalia.
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Mohs surgery is the gold standard for treating skin cancer on the nose
Mohs surgery is the gold standard for treating certain skin cancers of the nose including the most common types: basal cell carcinoma and squamous cell carcinoma. It provides the highest cure rate with the least amount of tissue removed which results in the best possible cosmetic result. The Mohs surgeon is able to concisely remove small sections of skin to visualize under a microscope in order to map out the entire tumor so there is no guess work. The goal is to make sure all the skin cancer is removed but also to avoid removing any more tissue than is absolutely necessary in order to keep the defect size as small as possible.
The high cure rate of Mohs can only be achieved by going to a qualified and trained Mohs surgeon. There are many doctors who advertise doing Mohs who have not gone thru the rigors of a formal fellowship program. The American College of Mohs Surgery (ACMS) is the only organization that requires its members to have successfully completed an extensive one- to two-year ACMS-approved fellowship training program after they have completed their years of residency training.
Is Mohs Best for Skin Cancer of the Nose?
The biggest advantage of Mohs is the ability to meticulously and carefully map and remove a skin cancer on a critical area with a high cure rate and avoiding taking too much tissue. The nose certainly falls into this category since this is an important cosmetic unit and avoiding anatomical distortion is very important since everyone looks at your nose. The type of tumor is also important since some are more aggressive and tumor clearance with microscopic mapping is ideal. A lot of information regarding the technique of Mohs Surgery is available from the American Academy of Dermatology, the American Society for Mohs Surgery. If a patient for health reasons is unable to have Mohs, radiation with an experienced radiation oncologist is always an option.
Mohs surgery for skin cancer
Without a doubt Mohs micrographic surgery offers the best treatment for a skin cancer. Using a meticulous surgical and microscopic technique, a Mohs surgeon removes the cancer and spares healthy tissue around it. Given lower risk of recurrence and lack of incomplete excision, Mohs surgery is also the most cost effective treatment. As far as reconstruction of a cosmetically sensitive area is concerned, look for a Mohs surgeon with experience in such reconstructions. For example, a fellowship-trained Mohs surgeons spend an extra year perfecting Mohs technique and reconstructive surgery. Ask to see before and after photos if you still have any doubts. Or, if a defect is very challenging, i.e. involving bone, then a multi-specialty approach involving plastic surgeons, ENT, or oculoplastic surgeon may be necessary.
Mohs provides the best cure rate
Mohs surgery does provide patients with the best cure rate or least chance of a cancer recurring following removal. Additionally, Mohs surgery has the possibility of providing a cure with the least amount of skin removed because it utilizes careful mapping and analysis of the tissue specimen during surgery. In many cases, especially in cosmetically sensitive areas such as the face, it can help to minimize scarring.
Mohs surgery is appropriate for basal cell carcinoma, squamous cell carcinoma, early melanomas and many other types of rare skin cancers. Make sure that you locate a fellowship-trained surgeon who is a fellow of the American College of Mohs Surgeons in order to assure the highest level of training in both tumor removal as well as in facial plastic reconstruction. Typically the tumor removal and the high quality reconstruction is provided by the same surgeon during the same visit making it ideal for the patient.
Mohs surgery is the best treatment option for you
Mohs micrographic surgery gives you the best "cure" rate (we should say lowest recurrance rate) with the most amount of normal tissue sparing- this is important given the location on your nose and the need to preserve tissue for reconstruction. I would recommend that you locate a nearby college trained Mohs micrographic surgeon (mohscollege.org) for your treatment.
Mohs surgery is the best method for treatment of basal cell and squamous cell skin cancer of the nose
Mohs surgery, named after Dr. Frederic Mohs who is its innovator, is the most effective treatment for basal cell carcinoma and squamous cell carcinoma of the nose. Studies have shown that these neoplasms have a higher chance of recurring in this location as well as when they are located on the ears, temples, lips and a few other areas. Mohs surgery is indicated because of the location, but also for tissue conservation (produce the smallest hole possible), with the highest chance of cure by examining, not a representative margin, but 100% of the margin. Reconstruction is often done after the Mohs surgery to produce the best functional and aesthetic outcome.
Skin Cancer on the nose
Mohs surgery is ideal for skin cancer on the nose. However, alternatives do exist based upon histology of the tumor and size of the tumor at the time of diagnosis. Alternatives such as radiation for squamous cell cancer or aldara cream for superficial basal cell cancer are alternatives for patients that are not ideal for undergoing surgery.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.