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How Many Stages of Mohs Surgery Will My Skin Cancer Need?

After finding that Mohs Micrographic Sugery is the best option to treat your skin cancer, patients often have many questions about the procedure and what they should expect the day of their surgery. Mohs surgery removes skin cancers layer by layer down to their roots, and follows the tumor until all the roots are removed and normal health skin is left behind. Each layer that is removed is referred to as a “stage.”

“Patients frequently ask me how many stages they will need to cure their cancer, or how many times I will have to ‘go back in’ to ensure their tumor has been completely removed,” says Dr. Adam Mamelak, a board-certified Dermatologist and Mohs Micrographic Surgeon at Sanova Dermatology in Austin, TX. In fact, how many stages a skin cancer will need is one of the most frequently asked questions during the Mohs surgery consultation.


“The answer,” says Dr. Mamelak, “is that it is actually difficult to predict.”

Many skin cancers can grow like trees with roots under the skin. On occasion, the pathology report for the patient’s initial biopsy can indicate how extensive the root system might be. For example, sclerosing or infiltrative basal cell carcinoma skin cancer tends to have a more developed and extensive root system, as these tumors grow into the skin as projecting strands of cells. The more extensive the roots, the more stages that may be required to track these roots down to their ends and ensure that they are completely removed.

Because of the manner in which these cancerous roots are removed, the success rate of Mohs Surgery is over 99% in selected tumors. “But is a root is left behind, that’s when we get a recurrence,” explains Dr. Mamelak. Thankfully, studies on Mohs surgery have demonstrated that this can happen less than 1% of the time.

Still patients want to be able to prepare for their surgery and want to know what to expect. “I find it takes an average of two stages to clear most skin cancers,” says Dr. Mamelak. “That means some will take three or four stages, but also that some can be cleared in just one.” Dr. Mamelak doesn’t like to make these kinds of predictions. He says he prefers to know that the cancer is completely gone and that it will never come back, regardless of how many stages might be involved. “That’s the commitment I try to make to my patients.”

One issue that Dr. Mamelak does caution his patients about is not recurrence, but the development of additional tumors. “Once a patient has been diagnosed with skin cancer, their chance of getting another goes up.” Patients that are prone to this type of cancer, or have had excessive exposure to sun, are capable of having more than one instance of skin cancer,” notes Dr. Mamelak. “This can potentially lead to additional Mohs surgeries to ensure that the new cancer is removed, with the same precision and care.”

While there is no real way to predict how many ‘stages’ of Mohs Surgery you might need, it is important to get your skin checked if you have any suspicions or concerns. The earlier a skin cancer is detected, the easier it is to treat and the greater the chance  it can be removed cleanly without addition effects on your health.

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If you have been diagnosed with skin cancer or have question about Mohs surgery, please contact us today. Our experience physicians are trained in the latest techniques and advanced treatments to optimize your health and well being.

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