Once patients hear that Mohs surgery has the highest cure rate for skin cancers, they naturally wonder why it’s not the standard treatment for invasive melanoma, the most dangerous of skin cancers.

Dr. Bryce Cowan explains why the use of Mohs surgery is considered controversial for treating invasive melanomas.

The treatment of invasive melanoma with Mohs surgery is considered controversial. The principle behind Mohs surgery is to identify cancer roots from its source. Most skin cancers grow from a root and expand out. Like a root system on a tree, all the branches eventually trace back to the trunk. With Mohs surgery, the cancer is cut and then identified by histological examination. As long as the tumour cells are connected, identifying the entirety of the cancer is possible.

With invasive melanoma, the tumour is disconnected. The tumour breaks up into small tumour islands. As there is no connection between one area of a cancer and another, it’s difficult to visualize the cancer growth in its entirety. Currently, standard wide excisions using international guidelines based on the depth of the biopsied melanoma is considered the standard procedure for treating invasive melanoma.

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In this video series one of Canada's leading Mohs surgeons, Dr. Bryce Cowan explains the Mohs surgery procedure, expectation, and the facts and myths surrounding this advanced treatment procedure for removing skin cancer.