Mohs surgery for skin cancer can't be beat
Peter Hofland is no stranger to the sun... or to skin cancer. A farmer in his younger days, then a machinery dealer, and always an avid fisherman, he's spent a good deal of time outdoors in his 75 years. "I'd be the first to tell you my skin cancer didn't happen overnight," he says from his home near New York Mills, Minn. "It came from years and years of exposure to the sun. I guess you might say I was a little careless... but I think I'm learning."
In the past 25 years Hofland has been treated for occasional bouts of skin cancer, mostly on his face. But, last summer he had a particularly troublesome sore on his right ear. It seemed to heal, would get worse again, and then the cycle would repeat itself. Tests at MeritCare indicated he had "basal cell carcinoma," the most common type of skin cancer. Typically found in people who are light-skinned and burn easily (Hofland fits this category), basal cell carcinoma is highly treatable.
Mohs surgery: The treatment of choice
"When they told me there was a 99 percent rate of cure for this, I was pretty tickled," says Hofland. The treatment that delivers this high rate of cure? Mohs surgery. Named after its developer Dr. Frederick Mohs, the procedure involves removing the cancerous skin layer by layer. As each layer is removed, it's checked microscopically; if cancerous cells still remain, another layer is removed. This process continues until the cancer is entirely gone.
"When they told me
there was a 99 percent
rate of cure for this, I
was pretty tickled."
An outpatient procedure that's done under local anesthesia, Mohs surgery works especially well for skin cancers in difficult-to-treat areas such as the nose, ears and around the eyes. At MeritCare, several dermatologists are trained in Mohs surgery and perform it regularly, including Paul Vandersteen, M.D., who is Hofland's dermatologist.
"Not only do we get an excellent cure rate with Mohs surgery, but we also conserve tissue," says Dr.Vandersteen. "Because the procedure is done in a microscopically-controlled fashion, we're able to precisely map out the area for removal and preserve the maximum amount of healthy skin." Usually it takes just one session to completely remove the cancerous tissue.
Prevention: Still best cure
Hofland's ear is now cancer free, but he and his doctors continue to watch for new evidence of skin cancer. He's also more protective of his skin. "I wear long sleeves, use quite a lot of that sunscreen — the number 30, and wear a hat whenever I can," he says. "The only problem is it keeps blowing off. That's a nuisance."
If you're concerned about skin cancer — and considering the increase at which it now occurs, everyone needs to be — here are some tips:
- Even in winter, take steps to protect your skin from the sun. (Snow reflects the sun, increasing its intensity.) Dr. Vandersteen recommends a sunscreen with a minimum SPF 15 rating. In addition, it should contain ParsolTM 1789, which protects against harmful UVA and UVB rays.
- A helpful way to guard against skin cancer is to do periodic self-examinations. Become familiar with your skin's pattern of moles, freckles and "beauty marks." Be alert to changes in number, size, shape and color. If you notice changes, it's worth it to check with your dermatologist. When caught early, even the most serious types of skin cancer can almost always be successfully treated.
Visit MeritCare's Dermatology Department
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