Mohs Surgery

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The gold standard for treating skin cancer

Mohs Surgery is one of the most advanced and effective ways of removing skin cancers with a low risk of recurrence. If you are interested, we can perform this procedure for you at our Arlington office, our Chelmsford office, and our Natick office.

What is Mohs Micrographic Surgery?

Mohs Surgery, otherwise known as Mohs Micrographic Surgery, is the most advanced, precise, and effective technique for treating the two most common forms of skin cancer: basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs). In this state-of-the-art procedure, the dermatologist is trained to serve as the surgeon, the pathologist, and the reconstructive surgeon simultaneously. Moreover, using this technique to treat skin cancer has a unique benefit that is not possible with other treatment types – during surgery, the dermatologist has the ability to see precisely where the cancer ends. Mohs Surgery therefore offers the highest potential for recovery, even if the skin cancer has been previously treated, and an entire tumor can be identified and safely removed while preserving the surrounding, healthy tissue in an outpatient office setting.

What are the Advantages of Mohs Surgery?

The unique ability to locate exactly where the cancer stops gives the Mohs procedure two important advantages: the highest cure rate of all treatments for skin cancer (up to 99 percent even when other forms of treatment have failed), and the ability to preserve as much healthy tissue as possible. This is especially important in areas with very little tissue beneath such as the eyelids or hands. Furthermore, Mohs Surgery, the most exact and precise method of skin cancer removal, also minimizes the chance of regrowth and lessens the potential for scarring or disfigurement.

Mohs Skin Cancer Surgery provides several additional advantages for people with skin cancer – this procedure maximizes the functional and the cosmetic outcomes resulting from surgery, it can be safely performed in a medical office or surgical suite (in most cases), and it also minimizes the risk of recurrence. Therefore, Mohs Surgery reduces and frequently eliminates the costs of larger, more serious surgeries for recurrent skin cancers. This means that it is not only an efficient procedure, but it is also a cost-effective one.

To summarize, Mohs Surgery provides the following advantages for people with skin cancer:

  • Ensures complete cancer removal during surgery and provides the highest success rates compared to other treatments.
  • Preserves the surrounding healthy tissue.
  • Maximizes the functional and cosmetic outcomes resulting from surgery.
  • Removes skin cancer, and provides the confirmation of negative margins and the repairing of the site of cancer in the same appointment (i.e. the Mohs procedure is a single-visit outpatient surgery, in most cases, and lab work is done on-site).
  • Minimizes the risk of recurrence and therefore reduces and frequently eliminates the costs of larger, more serious surgeries for recurrent skin cancers.

What to Expect During Mohs Surgery

The Mohs procedure involves surgically removing skin cancer layer by layer and examining the tissue under a microscope until healthy, cancer-free tissue around the tumor is reached (otherwise known as clear margins). This procedure is a single-visit outpatient surgery under local anesthesia, and therefore eliminates the risks and costs associated with general anesthesia. Finally, since this is a single-visit outpatient surgery, immediate microscopic examination and evaluation of excised tissue is completed during the visit while the patient waits. Rest assured, the wound is temporarily bandaged as the lab work begins.

Mohs Surgery is also done in stages and this is what significantly differentiates it from other skin cancer removal procedures. Upon removing a layer of tissue, the dermatologist examines it under a microscope in an on-site lab to determine whether any cancer cells remain. If they do, the dermatologist then knows precisely where the cells are and thus proceeds to remove another layer of tissue from that exact location (while sparing as much healthy tissue as possible). This process is repeated as many times as necessary until no cancer cells remain. Thereafter, the dermatologist will decide on the best course of action to treat the wound. For instance, some wounds heal better without stitches, and others will require a skin graft to minimize the scar. In most cases, however, the dermatologist will repair the wound immediately upon obtaining clear margins. For more details on the step-by-step process, you can visit the American College of Mohs Surgery website.

Skin Cancers that are Best Treated with Mohs Surgery

Mohs Skin Cancer Surgery is considered the most advanced and precise technique for treating the two most common forms of skin cancer: basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs). This includes treating those that develop in areas where preserving cosmetic appearance and function are important (i.e. head, face, neck, hands, feet, and genitalia). The Mohs procedure is recommended for BCCs or SCCs that are recurrent and/or have been previously treated, that are located in scar tissue and/or have ill-defined edges, and that are large, aggressive and/or growing rapidly. Although Mohs Skin Cancer Surgery is most commonly used for BCCs or SCCs, virtually any skin cancer can be treated with this technique, including certain cases of melanoma.

To summarize, Mohs Surgery is especially appropriate for skin cancers that:

  • Are located in cosmetically and functionally important areas, as well as areas where it is important to preserve as much healthy tissue as possible.
  • Have recurred after previous treatment or have a high risk of recurrence.
  • Are located in scar tissue, and/or have ill-defined edges.
  • Are large, grow rapidly, and have aggressive pathology features.

MEET THE TEAM

Dr. Helen Raynham MOHS Surgeon

Christine M. Hayes, M.D. MOHS Surgeon

Jeffrey Medical Assistant

Kim Registered Nurse

Leila Medical Assitant

Michelle Medical Assistant

Nicole Medical Assistant

Shannon MOHS Histotech

PATIENT  TESTIMONIALS

This group of physicians are great . I have had Mohs surgery there twice and it is always a successful operation . Office staff are accommodating and professional . Thank you Dermcare for cleaning me up.
Jane Lynch, Arlington
I am 70 and wish I had found Dr Raynham years ago when I had squamous cell carcinoma removed by Mohs . I have been to many physicians over the course of my life, and Dr Raynham is absolutely the best of the best ! She does very thorough exams, spends as much time as you need to answer questions .. which would be excellent enough but additionally she is so very compassionate! I was in the room 2 years ago when Dr Raynham performed Mohs surgery on my husband’s cheek. She and her nurse talked to him gently and in detail describing every step of the procedure as they were doing it… calming any anxiety he or I may have had. I was so impressed!!!! One would NEVER know that she had had to make a very large incision to get it all- she does miraculous work. Our gratitude to have her as our physician/surgeon is immense—- we know that she is keeping us safe by her thorough exams and when something needs to be removed – she does excellent work!
Wenda Gantz, Cambridge
I recently had a Mohs procedure at Dermcare in Natick and cannot say enough good things about the experience . It started with my nurse, Kimberley. She went above and beyond my expectations in helping me feel comfortable and relaxed. She even gave me a heated blanket ! Her warm and caring manner as well as her clinical expertise helped to put me at ease . She explained every single step and answered all of my questions. Before we left, she made sure that I understood all of my post op directions and answered all of my questions to help insure a smooth recovery / outcome. Dr Rayhnam was also wonderful ! In addtion to her clinical expertise, her caring personality and soothing voice helped me to feel relaxed. She also did a great job of continously checking in with me and making sure that I was not in pain. They are both great conversationalists which always heps me feel relaxed. I feel quite fortunate to have had the ” A ” team !
Susan Moody, Cambridge
3 Mohs surgeries over 6 week span. All results exceeded expectations. I highly recommend Dr Raynham!!!
Jeff Sargent, Natick
I had Mohs surgery done by Dr. Raynham. Besides being personable and efficient, her work was top-notch. I knew what to expect and how to deal with the recovery. I highly recommend her and her practice.
Susan Green, Natick
I have had two MOHS procedures performed by Dr. Helen Raynham in the last two months. I have been completely happy with the results of both surgeries. The professionalism, expertise, and patient care of Dr. Raynham and her team of nurses and technical assistants are truly extraordinary. The office is beautiful and well equipped for patient comfort during the wait for pathology analysis which is undertaken within the practice. I give Dr. Raynham and her whole staff at Dermcare my highest recommendation.
Stephen Ridge, Natick
I was treated by Dr. Raynham and Dr. Hayes with Mohs surgery for squamous cell carcinoma of the scalp. The entire staff I dealt with were outstanding, and made it clear if I had any problems to call, no matter what time it was. During the procedure, they made me aware of each step they were performing. I had bleeding afterwards due to the fact I am on blood thinners. I called after hours and was connected directly to Dr. Raynham’s cell phone. (unheard of). They saw me right away the next day and I saw Dr. Hayes. She was as compassionate and friendly as Dr. Raynham, and redid my bandage. I go back next week for them to check my wound. I would highly recommend them.
Oliver Hernandez, Natick
Today, Dr. Helen Raynham, assisted by nurse Johanna Ortiz-Gidney performed MOHS surgery on my cheek. I would be remiss if I did not comment on how pleased I was with the quality of care I received. It is so reassuring to be treated by such competent, caring, compassionate professionals.
Jack Kushinsky, Natick

If you are interested, we can perform this procedure for you at our Arlington office, our Chelmsford office, and our Natick office.