As skin cancer rates continue to rise, particularly in regions like South Florida, medical professionals are evaluating the continued effectiveness of Mohs micrographic surgery as a treatment option.
At Sylvester Comprehensive Cancer Center, recent technological advancements and broader applications have strengthened Mohs surgery’s position as a leading method for treating non-melanoma skin cancers. The procedure, which has been in use for nearly 100 years, removes cancerous tissue layer by layer while preserving healthy skin. This approach results in cure rates up to 99% for basal cell carcinoma and 97% for squamous cell carcinoma.
Recent innovations at Sylvester include the use of molecular techniques to improve diagnosis and tumor mapping. These tools help reduce the number of surgical stages required and lower recurrence rates. Surgeons also utilize optical coherence tomography and immunohistochemical staining to guide treatment decisions in real time.
“Skin cancer is the most common cancer, and tools including AI are under development to assist clinicians and caregivers in appropriate referral to dermatologists to diagnose skin cancer early,” says Robert Kirsner, M.D., Ph.D., a member of Sylvester, the endowed Harvey Blank Professor and Chair in the Dr. Phillip Frost Dermatology in the Department of Dermatology and Cutaneous Surgery and professor of Public Health Sciences at the University of Miami Miller School of Medicine.
Mohs surgery is now being used beyond facial lesions, including complex cases such as anogenital squamous cell carcinomas where maintaining function is important. These advancements offer significant benefits for patients in South Florida who require precise care.
“For large or recurrent tumors, those cancers in cosmetically sensitive areas or when tissue sparing is critical, Mohs surgery might be the best choice for a patient. The high cure rate and tissue-sparing nature of the procedure make it quite attractive,” said Dr. Kirsner.
However, Mohs surgery may not be necessary for all cases. For example, less invasive excision methods can be effective for low-risk basal cell carcinomas on less sensitive parts of the body. Physicians at Sylvester stress that each case should be evaluated individually based on factors such as type, size, location of cancer, recurrence status, other health issues, and patient preferences.
“A variety of treatments exist for skin cancer, and a personalized approach considering the type, size, and location of the skin cancer, whether the cancer is new or recurrent as well as the patient’s other medical problems and preferences all help decide what type of treatment is best for which patient and when,” says Dr. Kirsner.
Despite ongoing research into new therapies that could one day replace current options with something faster or less invasive, Mohs surgery remains central to Sylvester’s approach.
“The ideal treatment for skin cancer, one that is fast, easy, painless, low cost, doesn’t scar and is 100% effective, does not currently exist, but scientists, researchers and innovators are hard at work to make patient care better,” says Dr. Kirsner. “For now, working with your doctor and understanding what’s best for you remains the gold standard approach to care.”
