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& www.tcvcg.com www.veininstitutenj.com & # " $ ! ! ! $ ! ! % " $ ! ! ! $ ! ! # Westfield • Morristown • Li vingston • Princeton Landing • Shrewsbury • Clifton • Rockaway 908-224- 0735 MOHS SURGERY By: Rebecca Lu, MD, Elite SkinMD Mohs and Dermatologic Surgeon Mohs surgery is a highly specialized treatment for most types of skin can- cer, such as basal cell carcinoma and squamous cell carcinoma, as well as other forms of skin cancer. Originally developed by Dr. Frederic Mohs in the 1930s, Mohs surgery has evolved into the most advanced method to treat skin cancer that results in the highest cure rate when compared to other treatment modalities. Since Mohs sur- gery is so precise, the cure rate for most skin cancers approaches 99%. Mohs surgery is different from other treatment modalities because the can- cer is removed layer by layer, and examined under the microscope by the Mohs surgeon in a certified lab on site. With this technique, the cancer cells are visualized and additional tissue is removed where necessary. This ensures the cancer cells are removed while pre- serving as much normal tissue as possi- ble, maximizing the cure rate and cos- metic outcome. Other treatments for skin cancer use blind estimated mar- gins, without checking the margins during the process, which leads to potentially excess tissue removed unnecessarily as well as a higher rate of the skin cancer growing back if any cells are left behind. The Mohs procedure step by step: 1. Since Mohs surgery is an office pro- cedure, only local anesthetic is nec- essary, avoiding the risks associated with general anesthesia. Once the site is identified and confirmed with the patient, the area is anesthetized with an injection of local anesthetic, typically lidocaine. 2. The surgeon then removes the visi- ble part of the tumor using a spe- cialized Mohs technique. Since it is not possible to see with the naked eye the “roots” of the skin cancer, it is not possible to predict how many layers will be necessary to remove the skin cancer in its entire- ty. Sometimes the “roots” extend deeply and sometimes they extend broadly, and sometimes both deeply and broadly. These “roots” are microscopic and can only be visualized under the microscope using special stains. 3. The removed tissue is divided, color coded, and mapped out to indicate orientation. With the help of a his- totechnician, the tissue is then processed, mounted on slides, then stained in a meticulous process. 4. The Mohs surgeon then examines the slides under the microscope, checking the undersurface and edges of each specimen for residual cancer cells. 5. If residual cancer cells are noted, then the surgeon marks the corre- sponding area on the map and pre- cisely removes tissue only from that area, minimizing the amount of unnecessary tissue removed to give the smallest scar possible. 6. The process repeats until no more cancer cells remain. Once that occurs, the wound is repaired using various reconstructive techniques. Most patients find Mohs surgery and recovery to be very tolerable, requiring only over the counter medications such as Tylenol for discomfort. Your doctor will review specific post-opera- tive instructions with you depending on your situation. When choosing a Mohs surgeon, it is important to look for a qualified fel- lowship-trained Mohs surgeon. The American College of Mohs Surgeon is the only nationally recognized profes- sional organization that requires its members to be trained in an accredited program ensuring the best outcome for patients. If you have been diag- nosed with a skin cancer or have ques- tions about skin cancer, please check out www.skincancer.org o r the Ameri- can College of Mohs Surgery website at www.mohscollege.com. Dr. Rebecca Lu is a board-certified der- matologist and fellowship-trained Mohs surgeon, a fellow of the Ameri- can Board of Dermatology and Ameri- can College of Mohs Surgery, with an office located at 7 Mt Bethel Road in Warren, NJ, 908-787-8088. Dr. Lu spe- cializes in the treatment of skin cancer, skin cancer screenings, as well as laser and cosmetic procedures. Please call our caring and friendly office to make an appointment.Reduce Pain & Stress
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United Acupuncture
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Peter Ng, LAc, NY, CA, NJ
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Xin Zheng, LAc, NY, CA, NJ
NCCAOM Board Certified; On Faculty of Eastern School of Acupuncture;
On Faculty of Pacific College of Oriental Medicine
