Avera Medical Minute: Mohs surgery removes cancerous skin

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SIOUX FALLS, S.D. (KSFY) - A cancer diagnosis of any kind is not something anyone wants to hear.

One of the most common cancers is on the skin. It is also one of the most treatable.

More than 4 million people are diagnosed each year with basal cell carcinoma, and just six months ago, KSFY's Courtney Collen was one of them.

But with a precise surgical technique called Mohs treatment and recovery is quick.

Reporter Michaela Feldmann helps tell her story as a warning for others.

For most of her life, Collen knew skin cancer was always a possibility.

"With the skin type I have, skin cancer runs in the family, so I knew that at some point if I wasn't taking care of my skin, this was likely going to happen," she said.

Having grown up in Arizona, she spent a lot of time in the sun.

But even though she took care of her skin -- wearing sunscreen and getting routine body checks at the dermatologist -- the doctor noticed something concerning in July.

"There was one spot on my face that was small, it was pink, and it was just kind of flat," she said. "It was never like a pimple or like a scar, it raised some concerns, and so she biopsied it and that took about a week and it came back as cancerous."

Jenny Nelson is a dermatological surgeon at Avera. She removed Collen's cancerous skin with a procedure called Mohs.

"So Mohs surgery is used for skin cancers, primarily of the face or of areas that are cosmetically sensitive like hands, feet, where you really want to keep your margins small, but get a good curate," Nelson said.

"My mom had had it done like three or four times all over her body, so I knew what it was," Collen said. "I knew that this was something I could easily have removed with no troubles."

Once the area is numbed and the cancerous area is taken out, doctors get right to work.

"The lab techs have to freeze the tissue, slice it, stain it, and then I have to look at it under a microscope," Nelson said. "So that can 30 to 60 minutes. It's also variable on how easy it is for the tissue to cut, how large the tissue is."

Nelson said the biggest benefit of Mohs surgery is how it is looked at under a microscope.

With a standard incision, doctors cut it like a loaf of bread. Then a couple of those slices are looked at.

"But with Mohs surgery we look at almost at a pie crust, so we look around and under the whole specimen we take out," Nelson said. "So when we are positive, we're often positive just by a few cells, one hair follicle going off as a tentacle in one direction."

"Many, many times I look at a spot on somebody and say 'well that's a skin cancer,' but patients say 'well I never even thought about it being a skin cancer,' so it's hard," Nelson said.

"I knew that it would be an easy process, but the only concern for me was, I'm a news anchor so having a huge scar on my face wasn't really ideal at the time," Collen said.

Nearly five months later, you can hardly see a scar. With time and proper care, it will continue to fade.

Collen said she is thankful her Avera dermatologist caught it early.

"What if I had waited or not gotten my skin checked? I mean who knows what this small spot would have done on my forehead in 20 years," she said. "So I'm just thankful that I've always been told to go get my skin checked."