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Basal cell cancer is the most common malignant skin tumours. The malignancy develops from the basal cells of the epidermis. The disease affects men and women with the same frequency. About 90% of all cases occur in people over 50 years. The “gold standard” of basalioma treatment is Mohs surgery. Most patients have a favourable prognosis for oncological therapy. How and where patients with basal cell skin cancer are operated on? You can learn from this article.

 

Treatment of basal cell cancer 

Destruction of the tumour is the main purpose of cancer therapy. The choice of treatment methods depends on the biological type and histological form of the basalioma.


Mohs surgery is the main way to fight the pathology. This intervention is also called “Mohs micrographic surgery”. It is considered the most effective option for the treatment of basal cell cancer of the skin. 


New growths in critical areas (face, arms and legs) are removed under the control of a microscope. This minimises the risk of relapse and reduces the traumatisation of the intervention. 

базальноклеточный рак кожи

Who’s recommended Mohs surgery?

The Mohs surgery is indicated for the treatment of basal cell and flat cell skin carcinoma. It is suitable for removal of neoplasms, which are localized in cosmetic and functionally important areas:

 

    иконка галочки the eye area;

    иконка галочки on the nose and in the nasolabial folds;

    иконка галочки near the lips;

    иконка галочки on the auricles;

    иконка галочки on the scalp;

    иконка галочки on the extremities;

    иконка галочки on the fingers, hands and feet;

    иконка галочки on the genitals.


Mohs surgery is recommended to fight large and aggressive tumours that have unclear edges or have relapsed after previous treatment.


Mohs surgery 

хирургия моса за границей

Mohs surgery is a resection of a visible tumour with a small edge of healthy skin and subsequent laboratory testing of the sample. The operation is performed by a surgeon who specializes in resection of this tumour, an examination of the neoplasm and wound reconstruction. 

 

The surgery consists of several stages. Local anaesthesia is used for pain relief. The doctor dissects the tumour together with a slice of non-affected tissue.

 

После удаления слоя ткани доктор сразу осматривает его под микроскопом. Если раковые клетки остаются, вмешательство повторяют до тех пор, пока не образуются чистые края.


Thanks to Mohs surgery it is possible to completely get rid of 99% of first-treated basal cell carcinomas.


What happens during the surgery?

During Mohs surgery, the doctor slices off a thin layer of the tumour. The sample is immediately analyzed under a microscope. The assistant technician participating in the surgery freezes the sample and cuts it into thin slices. They are dyed and examined under the microscope. Following that, the doctor separates the operating area into segments, labels each one with different dyes, and makes a “map” of the site.

 

The surgeon investigates all the edges and bottom of the tissue on the slides. If there are any cancerous cells left, he marks their location on the map. The surgeon then removes another layer of tissue from the cancer site and submits it for examination. The whole process is repeated as many times as necessary to obtain a “clean” field. 


After the malignancy has been completely removed, the surgery team finishes the procedures. Depending on the location of the tumour and its size, they can apply stitches or use a skin graft. Small operation sites can heal on their own.

 

If more than two resections are required, the entire process can take up to several hours. Mohs surgery has the highest treatment efficiency. It preserves the largest amount of healthy tissue.

 

Advantages of Mohs Surgery

Conducting Mohs surgery to remove basal cell carcinoma has several advantages:

 

    иконка галочкиEfficient and economical treatment performed in one session in outpatient conditions. Tumour examination is done on-site. The patient does not spend money on long-term hospitalization and general anaesthesia.

    иконка галочки Accurate examination results – the doctor carefully checks the tumour edges under a microscope and the tumour is completely dissected.

    иконка галочкиHigh efficacy – after the operation, about 99% of patients who are undergoing their first treatment are completely cured. In the case of a recurrence of the tumour, repeated surgery can defeat cancer in 94% of cases.

    иконка галочки Good cosmetic effect – the surgeon gently dissects the area of malignancy, trying to leave as much healthy tissue as possible.

Alternative methods of basalioma treatment

Along with the Mohs operation, the following techniques are used to eliminate this pathology:

 

Curettage and electrodeposition (electrosurgery)

Removal of a tumour using a sharp tool with a ring tip – a curette. The surgeon scrapes the tumour and then uses heat or a chemical agent to destroy the remaining cancer cells. The procedure is repeated until the operating edges are free of cancerous cells. As a result of the surgery, a round whitish scar resembling a cigarette burn remains in the place of the tumour. This type of removal is suitable for small carcinomas. The effectiveness of the procedure is 95%.

Excision surgery

Using a scalpel, the surgeon removes the entire tumour along with the healthy surrounding tissue and sends it to the lab for analysis. The edge of the skin to be removed depends on the thickness and location of the tumour. If the lab finds that the cancerous cells are outside the field, the surgery is repeated. The effectiveness of the intervention is similar to curettage.

Photodynamic Therapy

During the procedure, the doctors inject a substance which makes the tumour sensitive to light. After that, it is treated with a special laser, which destroys the malignant site. Phototherapy is used to treat basal cell cancer of the face and head.

Laser surgery

Tumour destruction by laser radiation. This method is used as an auxiliary therapy for hard-to-treat carcinomas.

Cryosurgery

Removing the tumour by freezing it. The treatment efficacy rate ranges from 85-90%. This method is used to fight against invasive basalioma.

Radiotherapy

Application of radiation exposure for tumour destruction. Radiotherapy is indicated for the treatment of tumours that cannot be completely removed surgically. This method is also recommended for patients for whom surgery is contraindicated. The effectiveness of radiotherapy is less than 90%.


The prognosis for basal cell skin carcinoma

Basal cell carcinomas grow slowly and rarely metastasize. The treatment prognosis depends on the localization of the tumour and the stage of the disease. More than 90% of patients are completely cured of this disease. With local basalioma, the rate is close to 100%.


прогноз лечения базальноклеточного рака кожи

Where do they perform Mohs surgery abroad?

Foreign patients choose oncology centres and departments of leading clinics of Turkey, Spain, Israel, Germany, Korea, and China for basalioma removal. Among them are:

    Resume

    иконка галочки Basal cell cancer is the most common skin cancer. Malignant neoplasm develops from basal cells of the epidermis. The disease affects men and women with the same frequency. About 90% of all cases of this pathology occur in people over 50 years.

    иконка галочки Mohs surgery is the main way to combat the pathology. This intervention is also called “Mohs micrographic surgery”. It is considered the most effective option of basal cell cancer oncology.

    иконка галочки Basal cell carcinomas grow slowly and rarely metastasize. The treatment prognosis depends on the localization of the tumour and the stage of the disease. More than 90% of patients are completely cured of cancer. With local basalioma, this figure is close to 100%.

    иконка галочки Foreign patients choose oncological centres and departments of the leading clinics of Turkey, Spain, Israel, Germany, Korea and China for basalioma removal.

To arrange treatment of basal cell skin cancer abroad, contact the coordinating physicians of the MediGlobus international medical platform. Leave your contacts. Our coordinators will answer you as soon as possible.

Mohs surgery – 99% success in skin cancer treatment

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Sources:

 

  1. 1. Skin Cancer Foundation
  2. 2. National Center for Biotechnology Information
  3. 3. American Cancer Society
  4. 4. AMBOSS
  5. 5. National Institutes of Health (NIH)

 

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