Is Mohs Surgery Overreaching for a Tiny Basal Cell Cancer?

Mohs is a very specialized surgery which is indicated for treatment of certain skin cancers based on their size, biologic behavior, location, and if they are in high risk areas or are already recurrent.  Alternative treatments may be appropriate for a BCC if it does not fit the guidelines.  You will need to discuss these with your dermatolgist and make an informed decision based on information received.  As much as I love 5FU for treatment of precancerous actinic keratoses I have never been inclined to encourage patients to use 5FU for BCCs unless they are very superficial and in an area where the 5FU can be used for longer periods of time and sometimes under occlusion if it is possible.

There are many good indications for Mohs surgery including recurrent skin cancers, locations on areas important for tissue preservation and at higher risk of recurrence (e.g. nose, eyelids, ears, lips), aggressive types of skin cancer (e.g. morpheaform, infiltrative basal cell carcinoma), large size, poorly defined margins, immunosuppressed patients.

Best option is to discuss with your dermatologist what is the best option for you and for your skin cancer and why. Mohs provides the highest cure rate and preserves the greatest amount of healthy tissue, but there may be other options that would be better given other factors.

Most of my patients wait about 1- 1 1/2 weeks before they go back to playing golf. Good luck.