Veva Vesper has dealt with more than her fair share of skin cancer in the last 25 years. The 69-year-old Ohio resident has had more than 500 squamous cell carcinomas removed since the late 1980s, when the immunosuppressant medication she was taking for a kidney transplant caused her to develop them all over her body — everywhere from the corner of her eye to her legs.
While Vesper’s story is unusual, skin cancer is the most common cancer in the United States. In fact, it’s currently estimated that one in five Americans will get skin cancer in his or her lifetime.
Mike Davis, a 65-year-old retired cop, and like Vesper, a patient at The Skin Cancer Center in Cincinnati, Ohio, has a more familiar story. Earlier this year, he had a basal cell carcinoma removed from his left ear — the side of his face most exposed to UV damage when driving on patrol.
The buildup of sun exposure over your lifetime puts you at greater risk for developing basal and squamous cell skin carcinomas as you age. Both Vesper and Davis had Mohs surgery, the most effective and precise way to remove the two most common types of skin cancer.
“The benefits of Mohs surgery are twofold: One, you’re going to remove just the cells you need to without having to take a lot of unnecessary tissue, and two, Mohs surgery can tout cure rates of 99 percent,” says Dendy Engelman, MD, a dermatologist and Mohs surgeon in New York City and the director of dermatologic surgery at New York Medical College.
We asked top experts to answer the most common questions about Mohs surgery.
1. What exactly is it?
Mohs surgery is named after Frederic Mohs, a professor of surgery at the University of Wisconsin, who developed the treatment in the 1930s. “It’s a very tissue-sparing technique, where we go layer by layer, examining 100 percent of the margin in order to trace out the cancer using a microscope,” says Engelman.
You’ll be awake for the procedure, which is done under local anesthesia. The surgeon starts by cutting out a small piece of the tumor with a scalpel. A lab technician then freezes and stains the tissues for the surgeon to look at under a microscope.
“Cancer grows like roots of a tree,” explains Brett Coldiron, MD, the founder of The Skin Cancer Center in Cincinnati and an assistant clinical professor at the University of Cincinnati. “What we do [during Mohs surgery] is cut out a disc of skin and check for roots poking through. It’s very obvious under the microscope.”