Treatment For Basal Cell Carcinoma: Mohs Surgery Removes This Skin Cancer With Smaller Incisions and More Certainty

Diagnosis: Before surgery, a dermatologist or skin specialist will diagnose the basal cell carcinoma. This is typically done through a skin biopsy, where a small sample of the affected area is removed and examined under a microscope to confirm the presence of cancerous cells.

Pre-operative evaluation: Once the diagnosis is confirmed, the patient’s overall health and the specific characteristics of the BCC, such as its size, location, and depth, are evaluated to determine the most appropriate surgical approach.

You are able to remove a very conservative margin around the cancer and study it in essentially real-time, explains Dr. Sumaira Aasi, Professor of Dermatology and Director of Mohs and Dermatologic Surgery at Stanford. If, when the surgeon examines the tissue under the microscope, cancer is found, the surgeon goes back and removes some more tissue.

The idea is that by making the tiniest cuts and evaluating them microscopically, the surgeon knows for certain that all the cancer is out when the last piece of tissue proves to be clear. It is often done as an outpatient procedure with local anesthetic.

Reconstruction: Depending on the size and location of the surgical site, reconstructive surgery may be necessary to optimize cosmetic outcomes and restore the function of the treated area. This could involve sutures, skin grafts, or other techniques.

Post-operative care: After the surgery, patients are typically given instructions for wound care, which may include keeping the area clean, changing dressings, and avoiding sun exposure to prevent further damage to the skin.

Follow-up: Regular follow-up appointments are essential to monitor the surgical site for any signs of recurrence and to address any concerns or complications.

Is Skin Cancer Surgery Covered by Insurance?

You may be worried that skin cancer surgery will not be covered by insurance because some providers may consider these procedures cosmetic. However, it is still a cancer surgery and most providers will cover it.

“Most surgery is covered by most insurance,” Dr. Jesse Lewin, System Chief of the Division of Dermatologic & Cosmetic Surgery at Mount Sinai, tells SurvivorNet. “…Even though the reconstruction is done in a cosmetically-sensitive way, it’s not a cosmetic procedure.

“[Patients] are not billed for a cosmetic procedure after the skin cancer is removed. One of the main advantages is you can see one surgeon who is trained in removing the cancer, looking under the microscope, and doing the reconstruction. So, you’re in one place … [and] awake for an outpatient procedure to cure your skin cancer.”

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