Saturday, January 11, 2020

Study reveals 95% satisfaction rate with Mohs surgery

According to a recent study, patients who received Mohs surgery to treat the most serious form of skin cancer, melanoma, reported a 95 % long-term satisfaction rate with their results.

The study is the 1st to poll patients satisfaction for Mohs surgery. The findings complement previous scientific studies that found Mohs surgery is as effective as wide local excision for early melanomas, says the Dr. Srivastava. She says her caseload of Mohs surgeries for melanoma has doubled in that time.


Patient satisfaction is becoming such an important part of medicine these days, so we wanted to look to see what we can do to get patients more satisfied with the care that they're getting for their skin cancer treatment. That's a big area of interest for a lot of the sub-specialties, she says.


More people are diagnosed with skin cancer each year in the U.S. than all other cancers combined, but how they attack their cancer is wildly different. We're working to determine what treatments garner the highest satisfaction to better inform guidelines and decision-making, she says.


Named after the late Frederic Mohs, Mohs micrographic surgery is a highly precise excision technique in which the cancer is removed in stages, one tissue layer at a time. After each removal step, the layer is examined under a microscope to determine whether cancer remains in the patient's skin and, if present, where exactly it is located so that the surgeon can pinpoint where to remove the remaining skin cancer. This allows for the smallest scar and best cosmetic result.


You're looking at 100 % of the margin under the microscope, she says. You''re really tracking cancer out so you're giving people a great cure rate, and it's all done under local anesthetic so it's very safe.
UT Southern researchers surveyed 42 of its patients who underwent this technique. The majority of patients were white men with a mean age of 69. The highest percentage of U.S. patients diagnosed with melanoma are white men over age 55. Three-quarters of the tumours were located on the face. The remaining were on the scalp, extremities and neck.


This small survey suggests patients are finding that the long-term benefits of excision with 100 % margin control using Mohs surgery greatly outweigh any potential perceived inconvenience. At UT Southwestern, dermatological surgeons also provide immediate local tissue reconstruction, using advanced reconstruction techniques to diminish the appearance of scars.


Mohs surgery has a nearly 99% cure rate for early melanoma and results in minimal scarring, Patients follow up with their dermatologists every 3 months for 2 years post-surgery.


Dermatologists expect the need for Mohs surgery to increase as the baby boomer population ages. The surgery can also be used to remove basal cell carcinoma and squamous cell carcinoma which are the 2 most common types of skin cancers.


Once you've one melanoma, you're at risk for more. It's a marker that you've had a lot of sun exposure in your life, she says.


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Tuesday, January 06, 2015

Hand-held device can detect deadly skin cancer

A new hand-held device that uses lasers and sound waves may change the way doctors treat and diagnose the deadly skin cancermelanoma, says new research.

The instrument can be used directly on a patient and accurately measure how deep a melanoma tumour extends into the skin, providing valuable information for treatment, diagnosis or prognosis.

The technique relies on the photoacoustic effect in which light is converted into vibrations.

In the case of the new device, a laser beam shines into the skin at the site of a tumour.

Melanin, the skin pigment that's also in tumours, absorbs the light whose energy is transferred into high-frequency acoustic waves.

Unlike light, acoustic waves do not scatter as much when traveling through skin.

Tumour cells will produce more melanin than the surrounding healthy skin cells, and as a result, the acoustic waves can be used to map the entire tumour with high resolution.

The device has a detector that can then turn the acoustic signal into a three-dimensional image on a screen.

"Being able to measure the depth of the tumour in vivo enables doctors to determine prognoses more accurately a" potentially at the time of initial evaluation a" and plan treatments and surgeries accordingly," said dermatologist Lynn Cornelius from Washington University in St Louis.

The latest version is not only hand-held but it also delivers light around and below the tumour, which generates a bright image of the tumour's bottom and an accurate measurement of its depth, researchers added.

The paper was published in the journal Optics Letters.


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