Mohs Surgery in Delhi, India

A good candidate for Mohs surgery is generally someone suffering from specific types of skin cancers like basal cell carcinoma and squamous cell cancer. In some cases, it can also be used to treat less common tumours, such as melanomas. That said, the following conditions make a good candidate for Mohs surgery: 

• Recurring skin cancer: Mohs surgery is usually suitable for recurring skin cancer. The treatment helps to minimise the chances of skin cancer reappearing

• Fast-Growing Cancer: If the skin cancer is early-detected and fast-growing, then Mohs surgery makes sense. This is primarily because Mohs surgery helps to eliminate almost all the cancer cells and prevent them from spreading to other areas

• Cancer borders cannot be clearly defined: There are many instances in some types of skin cancers where the tumour lacks clear borders. In this scenario, the surgeon will suggest going with the Mohs surgery. 
• Patients with Genetic Conditions: Patients with genetic conditions like Rombo syndrome, Xeroderma pigmentosum, etc., make them more vulnerable to skin cancers. In this scenario, Mohs surgery is the best-suited option. 

The following candidates may not be considered for Mohs surgery:

• Skin cancer that can be treated with other treatment
• No recurring skin cancer
• Weak immune system
• Heart condition
• History of medical conditions

Like with any other surgery, one should first discuss the surgical procedure in detail, its risks and its benefits. It is important to tell the doctor about allergies or a family history of the medical condition. The doctor may also order a skin biopsy to check for the stage of the skin cancer. 

It is important to note that Mohs surgery generally lasts longer, and one stays awake during the whole process. The surgery can easily take four hours or longer. One may have to wait, so bring something like a book, magazine, and more. Apart from this, other preparations for Mohs surgery may require the following: 

• Avoid taking anti-inflammatory drugs
• Wear loose clothing
• Remove contact lenses or dentures before the surgery
• Bring something to pass the time during the waiting period
• Avoid alcohol or smoking 
• Stop taking blood-thinning medications for two weeks before the surgery
• Not to eat or drink after midnight before the surgery

The Mohs surgery is performed in different stages, with a waiting period between each stage. The surgeon first marks the area of the skin cancer with a pen for reference. The surgeon then injects local anaesthesia, which numbs the area completely. The patient generally stays awake through the surgical procedure. 

The surgeon uses a scalpel, removes a thin layer of the cancer tissue, cuts it into sections, colour codes it with dye, and creates a map of the surgical site for reference. The tissue is then sent to the lab, where the lab technician prepares the tissues to watch it under a microscope. This process generally takes time. Once done, the surgeon then examines all the edges of tissues and checks whether the cancer cells are present or not. 

If still there are cancer cells present, the surgeon repeats the whole process till no cancer cells appear under the microscope. Once the surgical site is clear of cancer cells, the surgeon may close it using stitches. In some cases, the surgeon may also reconstruct the wound with a skin flap or using a skin graft. 

Mohs surgery is considered a gold standard for treating skin cancer. However, all surgeries come with a fair share of risks and complications, and Mohs surgery is no different. Patients may experience complications like bleeding, infection, or reaction to anaesthesia. Other complications may include:

• Blood clots
• Bleeding from the surgical site
• Infection at the surgical site
• Scarring
• Severe pain
• Skin discolouration
• Failed skin flap or graft
• Necrosis
• Nerve damage
• Swelling 
• Damage to an organ or blood vessel
• Recurrence of skin cancer

Mohs surgery has a success rate of almost 99 per cent, making it one of the most effective treatments to remove skin cancer cells. The wounds usually take two to four weeks to heal. Just after the surgery, patients may experience pain and discomfort. The surgical site will be covered with a pressure dressing, which should be left in place for at least 24 hours. Apart from this, other post-operative care includes: 

• Avoid sun exposure  
• Avoid putting makeup or harsh chemicals on the wound site
• Avoid indulging in strenuous physical activities
• Keep the incision area clean 
• Avoid alcohol or smoking for a few weeks
• Follow up with the doctor to examine the skin every six months to check the healing or any sign of skin cancer recurrence