Mohs surgery is a treatment used often for the two most common forms of skin cancer: basal cell skin carcinoma and squamous cell carcinoma. While it is 99% effective at curing these skin cancers, there are risks and other factors to consider.

Mohs surgery can lead to infection, bleeding, and nerve damage. Mohs also leaves wounds and scars that need to be cared for during what may be a long recovery. You also need to consider if you are willing to quit smoking (if you smoke) and if you’re able to stop taking certain medicines before the surgery.

Surgeons and dermatologists have a responsibility to tell people with skin cancer what to expect with Mohs. Even when they do, the reality can be shocking.

Weighing all the factors and treatment options

It is also important to learn about the other ways that skin cancer can be treated. In fact, there are nearly 10 other surgery-free treatments for skin cancer. They may not all be options for you, but your doctors should tell you about the ones that may work to cure your skin cancer.

• Radiotherapy uses X-ray energy to kill the skin cancer cells without the need for cutting or numbing the skin or caring for wounds after treatment. There are 4 types of radiotherapy, including Image-Guided Superficial Radiotherapy. IG-SRT uses ultrasound images to map the cancer and watch it disappear.
• Cryotherapy uses liquid nitrogen to freeze and kill the skin cancer cells.
• During photodynamic therapy, a special chemical is put on or in the skin cancer before a blue light or pulsed-dye laser is shined over the area to kill the skin cancer cells.
• Chemotherapy is a medicine that kills the cancer cells. It can be given in an IV or put right onto the skin as a gel or cream.
• Immunotherapy uses your body’s immune system to fight the cancer. They are given either as an IV or a cream.
• Targeted therapies are treatments that find and kill specific types of cancer cells. They are given as pills.

Be a voice in the choice

If you or someone you care about is diagnosed with skin cancer, talk with your dermatologist about your treatment options. Think about what is important to you and what you want from treatment, other than a cure.

It may help to ask yourself questions like:

• Am I at risk for bleeding or infection?
• Can I give up a whole day for the procedure?
• Can I handle a treatment that takes many visits?
• Can I change bandages, apply creams, and take other steps to care for a wound?
• Am I okay with being in public with bandages?
• Would it bother me to have a scar in the place where my skin cancer is?
• Can I slow down or change my activities after surgery if I need to be careful while I heal?

Bring along a friend or relative who can listen to you talk with your doctor. He or she may be able to help you explain your feelings and what is important to you. If you are uncomfortable with what your doctor recommends, you can always get a second opinion.

There are many resources that can help you learn more about your skin cancer and how it can be treated. Use them to help you talk with your doctor and get the treatment that is best for you.