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Mohs Surgery

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Memorial Day May 26, 2008
Remember The Fallen

Mohs Micrographic Surgery is a specialized in-office surgical procedure that effectively removes and cures many skin cancers while sparing healthy tissue and minimizing scarring. Mohs offers the highest potential for surgical removal, even for those areas in which the skin cancer has been previously treated.

Named after Dr. Frederic E. Mohs, MD, who developed the technique while still a medical student at the University of Wisconsin in the 1930’s, the Mohs procedure minimizes the chance of the cancer returning and lessens the potential for scarring or disfigurement.

Specifically designed to remove skin caner by tracking and removing the cancerous roots, Mohs allows specially trained dermatologists to see beyond the visible disease and precisely identify and remove the entire tumor, leaving healthy tissue unharmed. The procedure is most often used in treating two of the most common forms of skin cancer, basal cell carcinoma and squamous cell carcinoma.

Dr. Nancy L. Marchell is the Mohs surgeon specialist at the Palm Beach Dermatology Group. We have met on several occasions in her office when deeper digging was necessary, twice on my right leg, once on my nose and recently on my forehead. Not only did she have to work on me, but two spots necessitated leaving from her office and hustling over to plastic surgeon Dr. Raphael Cabrerra in Boca Raton for further cosmetic surgery.

Dr. Marchell operates in degrees. She takes a slice from the offending location and hands it to a lab technician who works side by side with her in the West Delray office. The slice is processed by horizontal frozen section which gives a more complete view of the tumor margins. The piece of skin containing the tumor is mapped, inked and processed by the technician. The patient is told to return to the waiting room for 30 to 45 minutes while the lab tech analyzes the specimen. That’s why Dr. Marchell always advises “Bring something to read.”

When the lab tech reports results to Dr. Marchell the patient is then called back into the examining room. The patient is told one of two things:

“We have to go deeper,” or “We got all the bad cells out and you can go home.”

If Dr. Marchell has to go deeper, she takes another slice for analysis and you are told to wait another half hour and you get to read some more—until the results she is seeking are obtained—the removal of the offending cells.

As with all forms of surgery, a scar will remain after the skin cancer is removed and the surgical area is completely healed. A Mohs-trained physician will, by definition, leave the smallest possible resultant scar on the skin of the afflicted area. They may also repair the area or, if extensive, consult with a plastic surgeon to ensure the best possible cosmetic result.

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