How We Treat Melanoma Effectively With Mohs Surgery

Of all the human cancers, skin cancer is the most common cancer. It accounts for over three million people being diagnosed with basal cell or squamous cell carcinomas and in need of treatment annually, according to the American Cancer Society. Further statistics from ACS show that this year approximately 73,000 people will die from melanoma, the most aggressive form of the cancer. With skin cancer rates continuing to rise exponentially, it’s no wonder that the most effective surgical treatment would be the one most chosen. These days, that distinction belongs to the technique known as Mohs micrographic surgery. It wasn’t always so.

How does Mohs surgery treat skin cancer?

Dr. Frederic Mohs developed what became his eponymous method during the 1930s while a practicing general surgeon at the University of Wisconsin. Initially, he utilized a chemical composition containing zinc chloride to annihilate cancerous tissue by layers under precise microscopic control. Although Dr. Mohs’ continued experimentation favorably resulted in less chemical use and more microscopic analysis, Mohs surgery wasn’t considered viable for certain melanomas. Surgeons thought that some microscopic melanoma cells might be inadvertently missed with the technique and eventually metastasize.

Intensive research and refinements over recent decades have helped to facilitate the identification of melanoma cells. This advancement is due to special stains that were formulated to precisely highlight melanocytes, the actual pigment-producing cells.

Referred to as rapid counter MART-1immunostains, their composition permits a direct adhesion to melanocytes. Thus, the surgeon can quickly see the presence of melanoma under the microscope much more easily. Before the introduction of the MART-1 process, a hematoxylin and eosin compound stain was used. The H&E dye-crystalline combination couldn’t sufficiently produce accurate interpretations of frozen specimen sections. As a supplement to the historical stains, MART-1this drawback was nearly eliminated.