Welcome to The Division of Mohs Surgery

What is skin cancer?

Skin cancer is the growth of abnormal cells at an uncontrolled and unpredictable rate. As the cancer cells grow, they destroy the surrounding normal tissue. Although the cancer originates in the skin, if left untreated it can invade and destroy structures such as fat, muscle, cartilage, and bone.

The most common skin cancers we treat at the URMC Mohs Micrographic Surgery Division are basal cell carcinoma and squamous cell carcinoma. Melanoma, the third most common skin cancer, is usually treated with a wide excision and not necessarily Mohs Surgery.

  • Basal cell and squamous cell cancer most commonly occur on sun exposed areas such as the face and head. They often begin as a small bump, which continues to enlarge, sometimes bleeds and often does not heal completely. The cancer can be flesh colored, red or a darker color than the surrounding skin.
  • Basal cell cancer rarely metastasizes (spread beyond the site of original growth), but frequently grows larger and deeper, destroying the nearby tissue in its path.
  • Certain high-risk squamous cell cancers can spread from the skin to distant sites, such as lymph nodes and lungs, but this is rare.
  • Skin cancers originate in the upper-most layer of the skin. They can then grow downward, forming finger-like projections under the skin’s surface. At times, these “roots” are subtle and can be seen only with the help of a microscope. Therefore, what you see on your skin is sometimes only a small portion of the total tumor (like seeing only the tip of a large iceberg).
  • There are several different subtypes of basal cell carcinoma and squamous cell carcinoma. It is important to distinguish these types prior to treatment because different therapies may be required. For this reason, a biopsy is usually performed prior to treatment.

How is skin cancer treated?

There are many treatments for skin cancers including:

  • Excision (surgical removal and stitching).
  • Curettage (scraping with a sharp instrument).
  • Cryosurgery (freezing).
  • Radiation therapy (x-rays).
  • Topical creams.

For some skin cancers, these treatments give a success rate of greater than 90%. However, the success rate in treating recurrent skin cancer – a cancer that returns after one of the above-mentioned treatments – is only about 70 to 80% using conventional treatment methods and may be as low as 50% for more aggressive skin cancers. For these types of cancers, and for those in delicate locations such as the face, Mohs Micrographic Surgery is utilized.