Mohs Surgery vs. Radiation for Skin Cancer Treatment: What’s the Difference and Which Should You Choose?

Here in the Treasure Coast of Florida, residents are drawn to our year-long warmth and sunshine, as well as the outdoor activities that come along with being in the Sunshine State. However, this also means more exposure to the harmful effects of UV radiation. 

Skin cancer, unfortunately, is one of the most common types of cancer worldwide, and especially prevalent in sunny locations like Martin County. Thankfully, medical advancements have provided us with various treatment options, each tailored to the specific needs of the patient and the type of cancer they're facing.

Two prominent treatments for skin cancer are Mohs surgery and radiation therapy. While both are effective, they differ significantly in their approach and potential side effects. One of the biggest questions we get from skin cancer patients at McKay Dermatology is “Which skin cancer treatment should I do: Mohs surgery or radiation?” 

Here we'll delve into the dissimilarities between Mohs surgery and radiation, highlighting why we prefer Mohs surgery for its targeted efficacy and minimal impact on the body.

What is Mohs?

Mohs micrographic surgery, named after its inventor Dr. Frederic Mohs in the 1930s, is a precise surgical technique primarily used to treat skin cancer. It's renowned for its high cure rates and tissue preservation capabilities. Here's how it works:

1. Layer-by-Layer Removal

   Mohs surgery involves the systematic removal of thin layers of cancerous tissue. Each layer is immediately examined under a microscope to check for cancer cells. This process continues until no cancer cells are detected, ensuring minimal removal of healthy tissue.

2. Precision and Efficacy

   By examining tissue layers in real-time, Mohs surgery offers unparalleled precision, ensuring that cancerous cells are completely removed while sparing healthy tissue. This significantly reduces the risk of cancer recurrence and minimizes scarring.

3. Optimal Cosmetic Outcome

   Due to its tissue-sparing nature, Mohs surgery is particularly advantageous for treating skin cancer on delicate areas such as the face, where preserving aesthetics is crucial. It allows for the removal of cancerous cells with minimal impact on appearance, leading to better cosmetic outcomes.

What is Radiation Therapy:

Radiation therapy, on the other hand, utilizes high-energy radiation beams to destroy cancer cells. While effective, it differs from Mohs surgery in several key aspects:

1. Non-Surgical Approach

   Radiation therapy is a non-invasive treatment that doesn't involve cutting or removal of tissue. Instead, it targets cancer cells from outside the body using focused radiation beams.

2. Multiple Sessions

   Unlike Mohs surgery, which is typically completed in a single session, radiation therapy often requires multiple sessions spread over several weeks. This can be inconvenient for patients and may prolong the treatment process.

3. Potential Side Effects

   Radiation therapy may induce various side effects, including skin irritation, localized hair loss, redness, and fatigue, some of which can linger beyond the treatment period. Moreover, radiation holds the potential to harm adjacent healthy cells, such as the saliva-producing glands, leading to prolonged dry mouth, or affecting teeth integrity, potentially resulting in decay, especially when targeting cancers in close proximity to these areas.

Why Mohs Surgery is Preferred:

When comparing Mohs surgery to radiation therapy for skin cancer treatment, several factors make Mohs surgery the preferred choice for many patients and dermatologists:

1. Higher Cure Rates

   Mohs surgery boasts the highest cure rates, with studies showing cure rates exceeding 97% for primary basal cell carcinomas and squamous cell carcinomas. Its meticulous approach ensures thorough removal of cancerous cells, reducing the likelihood of recurrence, and is the only treatment recommended for use on aggressive types of basal cell carcinomas and squamous cell carcinomas. Radiation therapy, due to its lower cure rate, is only recommended for use on low-risk tumors.

2. Tissue Preservation

   Mohs surgery preserves healthy tissue to a greater extent compared to radiation therapy, minimizing scarring and optimizing cosmetic outcomes, especially for cancers located in cosmetically sensitive areas.

3. Single Session Treatment

   Unlike radiation therapy, which requires multiple sessions, Mohs surgery is typically completed in a single session, offering convenience and efficiency for patients.

4. Immediate Results

   With Mohs surgery, pathology is examined in real-time, allowing for immediate confirmation of tumor clearance. This provides reassurance to both patients and surgeons during the procedure.

5. Less Harsh Side Effects

   While all medical procedures carry some risk of side effects, Mohs surgery generally has fewer and less severe side effects compared to radiation therapy. Patients undergoing Mohs surgery typically experience minimal pain and discomfort, with most able to resume normal activities shortly after the procedure.

In conclusion, both Mohs surgery and radiation therapy are valuable treatment options for skin cancer, each with its advantages and limitations. However, Mohs surgery stands out as the preferred choice for many patients and dermatologists due to its having the highest cure rates, tissue preservation capabilities, single-session treatment, and minimal impact on the body. By understanding the differences between these treatment modalities, patients can make informed decisions about their skin cancer treatment options, ultimately leading to better outcomes and quality of life.

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About McKay Dermatology and MedSpa

McKay Dermatology and Medspa is a premier destination in the Stuart, Florida for the latest and most advanced treatments in skin cancer removal, Mohs surgery, laser treatments, skincare, wrinkle relaxers, massage, and more — all designed to rejuvenate and revitalize your skin while preventing future damage. Their team loves serving patients from all over the Treasure Coast — Palm City, Stuart, Jensen Beach, Port St. Lucie. Their professional, warm, and friendly atmosphere ensures you’ll receive the best personal attention as they help you look and feel your best.