One type of surgery for skin cancer saves face

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OVERLAND PARK, Kan. -- With the sun season getting underway -- a reminder that one in five people will have skin cancer at some time in their lives.

"I've never worn a hat. I wore a bill cap, but that's all," says Howard Gillogly who's had a lot of sun exposure as a farmer.

Howard has had two common basal cell cancers removed from his nose. He's about to have another removed from his face.

Dr. Holly McCoppin of College Park Specialty Center will do Mohs micrographic surgery. It spares healthy tissue while almost always resulting in a cure.

"In Mohs surgery, we don't take a margin of normal skin. When we do the cancer removal, we take out just that specimen," says Dr. McCoppin.

She positions the tissue in a dish just as it was on the face. Then she takes it to the lab where a tech cuts the tissue into sections and slices it into layers as thin as a hair. The Mohs surgeon looks at them under the microscope and sees some cancer remains at the base of the specimen on the right side.

That means Howard, who's been waiting, will need more tissue removed, but just a layer from that side. The precision of Mohs spares healthy skin.

The process is repeated until Dr. McCoppin is certain no more cancer cells remain. Risks of Mohs surgery include bleeding and infection. But after his spot is stitched, Howard should have minimal scarring.

A new study in JAMA Internal Medicine suggests skin cancer surgeries are overused in very old people who have other health problems. After all, these common skin cancers aren't going to take their lives. But Dr. McCoppin says if those patients have problems from the cancer such as oozing and bleeding, surgery may be a reasonable option.

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