.ohs Surgery (microscopically controlled excision, formerly called chemosurgery) is a highly specialized procedure for the total removal of skin cancers.

......The ORIGINAL - A METHOD THAT IS RARELY USED NOW - procedure, as described/invented by Dr. Mohs, consisted of three steps:

THE CURRENT - MODERN WAY OF PERFORMING MOHS SURGERY

Over the years, the technique has been modified and improved. The painful chemical fixative is no longer necessary. However, much of the rest of the procedure, including marking with dyes and examination under the microscope, remains the same. Before the tissue is examined microscopically, it is cut into smaller sections and marked with colored dyes to distinguish right from left. The author has developed methods to improve the speed and quality of processing Mohs tissue samples. Each specimen is then cut into very thin horizontal sections to allow all of the deep and peripheral margins to be examined under a microscope. This method of cutting the specimen is far superior to standard pathology techniques (that cut the specimen vertically). Unfortunately, the standard techniques examine only small areas, usually less than 0.1% of the actual surgical margin. By using the Mohs cutting technique, rather than the standard technique, one can pinpoint the exact location of any remaining tumor during the microscopic examination. If more cancer is detected, the entire procedure is repeated, but only in the area of the remaining cancer.

Only by careful, systematic micro-scopic examination of the skin removed by Mohs Surgery, can one be as certain as possible that no cancer remains. The modern Mohs surgeon, if a member of the American COLLEGE of Mohs Micrographic Surgery and Cutaneous Oncology (please do not be confused with the "amazingly similar" name used by members American SOCIETY of Mohs Surgery), is specially trained to perform all phases of the operation including removal of the tissue, microscopic examination of the removed tissue and closure of the wound, when appropriate. Medicare of Florida has reaffirmed this definition in its new policy. Occasionally a Mohs surgeon may work with another specialist TO REPAIR THE FINAL MOHS DEFECT when dealing with unusually complicated tumors. In this unusual type of case, continuity of care is of prime importance.

As was mentioned previously, Regis Philbin of television's Live with Regis and Kathie Lee had Mohs Surgery on two separate skin cancers. Here are some of Regis' thoughts: "I lived in California for years and loved getting a tan. . . . When I used sunscreen, I never put it on my hands. . . . My first cancer, a squamous-cell cancer, was on my hand. . . . The treatment was done in the doctor's (American COLLEGE of Mohs Surgery Member) office and took about two hours. The carcinoma was taken off with . . . Mohs . . . in which every layer of the skin is studied under the microscope to see if it contains cancer cells. The surgery continues until it gets to a layer that is completely free of cancer. When the Mohs surgeon said the cancer was all out and would not come back, I was perfectly relieved. In fact, I didn't give a second thought to the possibility of future trouble. . . . My second cancer was on my face. This one was so big . . . that the doctor had to do a skin flap. A tremendous number of stitches was needed. . . . I was certainly happy to be back on the show four days after the treatment, looking pretty much the way I always do. That's how good the surgery was. It took a while for the scar to disappear completely, though I was able to hide it in the meantime with make-up. It's clean as a whistle now; you can't see a trace of it."

Note that all three: President Reagan, President Bush Sr., and Regis all went to American COLLEGE of Mohs Surgery Members for their surgery and avoided surgeons who were not members of that organization.