MOHS SURGERY FREQUENTLY ASKED QUESTIONS
1. What are the risks of surgery? a. As with any surgical procedure, the normal risks are permanent visible scar, bleeding/bruising, pain, infection, numbness and recurrence. We will discuss the risks in more detail at your consultation appointment.
2. Since the biopsy the area appears to have healed. Do I still need surgery? a. Most of the skin cancers have roots under the skin that cannot be seen with the naked eye. The biopsy is performed to sample the tumor, not to remove the entire tumor. Even though the surface of the skin has healed there is still tumor underneath.
3. I have a wedding/graduation/vacation/ reunion/special event within 2 weeks of the surgery; should I still have the surgery? a. This depends on how serious the tumor is. Most cases can be delayed by 2-3 weeks without problems. We prefer you not have surgery around the time of major events, as bandages and bruising can ruin a photograph.
4. Will I have pain afterwards? a. Most wounds are not very painful after surgery. If there is discomfort, then take an acetaminophen (Tylenol) based pain reliever, not aspirin or ibuprofen. If we suspect a wound will be more painful, we may give you a prescription strength pain reliever.
5. Will my cancer become a melanoma? a. Basal cell carcinoma, Squamous cell carcinoma and Melanoma are all completely different types of cancer. One does not become the other. Each of them has early stages and more advanced stages of the disease, but they are still their own cancers.
6. Why did it take so long for this cancer to be diagnosed? a. Your cancer may have been looked at by a doctor in the past that reassured you that it was nothing to worry about or that it was a pre-cancer and only needed a freezing treatment. It was not until the area began to change that the diagnosis was made. Some skin cancers are easy to spot; they look just like the pictures in the brochures and textbooks! But many are very difficult to detect; they can look just like non-cancerous skin growths or like areas of irritated skin and just take time to declare themselves. The important point is that the diagnosis was made and we are here to help you take care of it!
7. What would happen if I did not treat the biopsied skin cancer? a. There are rare instances where a biopsy may cure a cancer but by far the majority of tumors are not removed by the biopsy. If left alone, the cancer continues to grow. Basal cell carcinoma rarely spreads to other parts of the body, but it keeps growing locally and eats away at skin and surrounding tissues. Squamous cell carcinoma does have a risk of spreading to other body parts. The longer the tumor is left alone, the more this risk increases.
8. What are the chances of me getting another cancer? a. Research suggests that about 50% of people will get another skin cancer in the next 5 years. The cancer may not necessarily be on the face. Once you have had your surgery we do recommend regular skin checks with your primary skin provider. They will determine the frequency you are checked, but typically every 6-12 months. Some people with multiple tumors may have to be seen more often. The goal of doing frequent skin checks is to catch tumors at an early stage so they are easier to treat.
9. Why do I need to bring someone with me? a. It is preferable for you not to drive on the day of surgery. Some tumors on the face can require larger bandages on the first day that may interfere with vision or wearing glasses. Often people feel quite tired after having surgery and would rather have someone else drive. Usually it is fine to drive the next day as you will change to a smaller bandage.
10. What are the alternatives to Surgery? a. Mohs surgery is not appropriate for all types of skin cancer. There are many different ways of treating skin cancers. The decision to use Mohs depends on a number of factors relating to the cancer, its location, patient factors and prior treatments used. Some alternatives include radiation, chemotherapy creams, scraping and burning, freezing, and traditional excision. We will discuss other options during the informed consent process. Your doctor has referred you for Mohs Surgery as they feel that this is the most appropriate method of treatment for the type of tumor you have. If there is an alternative treatment that may be more appropriate, I will discuss this with you.