Mohs surgery continues as one of the most effective skin cancer treatments

Among the types of skin cancer is melanoma.

Dra. Sheila Valentín Nogueras, dermatologist. Photo: Supplied.

At the beginning of the season of the year where more emphasis is placed on the need to take care of ultraviolet rays as a preventive method against skin cancer, dermatology emphasizes the novelty and importance of Mohs surgery as one of the most effective modalities against this type of condition.

According to Dr. Sheila Valentín Nogueras, past president of the Puerto Rican Society of Dermatology, This procedure continues to be one of the most effective against this type of affections, because in addition to directly removing the tissue affected by cancer, it seeks to preserve healthy tissue of the patient.

Skin cancers include non-melanoma skin cancer, basal cell carcinoma, squamous cell carcinoma of the skin, and melanoma.

The Mohs surgery It is a surgical procedure used to remove skin cancer in various stages and Dr. Valentín, also an associate professor of the Department of Surgery of the Medical Sciences Campus (RCM), is among six specialists in dermatology to perform this type intervention in Puerto Rico.

“The technique is specialized in skin cancer. There are several ways in which these skin cancers are treated, however this surgery remains one of the most precise and effective ways as the treatment of choice for skin cancer. In this surgery, instead of estimating how wide or deep the skin cancer is, a small margin is removed and the tissue is examined the same day in the laboratory in the same office. If cancer cells are identified in that tissue, then the surgical process is restarted and carried out in stages until we remove the skin cancer completely, ”explained the specialist in an interview with Medicine and Public Health (MSP).

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According to the National Cancer Institute, in 2021 around 106,110 new cases of skin cancer have been diagnosed, representing an increase of 5.6% in the diagnosis of this disease, which among the most prominent risk factors is prolonged exposure to the sun.

The death estimate holds it at 7,180, and points to a 1.2% increase in fatalities.

Precisely, the procedure continues to be the choice when faced with the appearance of basal cell cancer, constituting around 30% of skin cancers, as well as squamous type cancers, explained the dermatologist.

“Surgery is still chosen as a treatment for tumors in the eyelids, nose, lips, ears, hands, feet, genitals, they are some of those that qualify for this type of intervention. Likewise, pathologies that have recurred in one or more areas ”, he added, emphasizing that the recurrence rate of skin tumors is lower thanks to this type of procedure, compared to other conventional treatments.

“However over the years we have seen that it has other indications for certain types of rare skin tumors. Among them are protuberant dermatofibrosarcoma, microcystic adnexal carcinoma, some atypical dysplastic moles, and in recent decades it has begun to be used in melanoma ”, he pointed out.

Precisely melanoma continues to be a challenging cancer for medicine. The World Health Organization estimated in 2008 an incidence of skin cancer (melanomas only) worldwide for the year 2.8 cases per 100,000 people.

Meanwhile, in the United States, an estimated 14.3 new cases per 100,000 people, being more common in men than in women. The fatality has been estimated at 1.7 deaths per 100,000 people, according to the Puerto Rico Cancer Registry.

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According to the same organization, the average incidence of melanomas reported in Puerto Rico has been estimated at 3.3 new cases per 100,000 people.

“Precisely one of the achievements during the last decade is the incorporation of this surgery for melanoma. Melanoma is a tumor that is difficult to evaluate under a microscope due to its characteristics, and was previously not considered viable with this surgery. However, with immunohistochemistry, melanocytes are identified under the microscope. During these last years we have had studies that support the use of Mohs surgery for the treatment of melanoma, which has resulted in lower rates of tumor recurrence, “he concluded.

See the full interview

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