For basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), Mohs micrographic surgery offers the highest cure rate (99%). This guide covers when to choose Mohs vs excision, pathology reporting, costs, and safe international travel for skin cancer treatment.
Common Skin Cancers
| Type | Incidence | Behaviour | Treatment |
|---|---|---|---|
| Basal Cell Carcinoma (BCC) | Most common (80%) | Locally invasive, very rarely metastasises | Excision, Mohs, cryotherapy |
| Squamous Cell Carcinoma (SCC) | Second most common (15%) | Can metastasise if neglected | Excision, Mohs, radiation |
| Melanoma | Most dangerous (5%) | High metastatic potential | Wide excision, sentinel node biopsy, immunotherapy |
Mohs micrographic surgery is the gold standard for BCC and SCC, especially on the face, ears, hands, and other cosmetically sensitive areas.
What Is Mohs Surgery?
Mohs surgery removes skin cancer layer by layer. After each layer is removed, it's immediately examined under a microscope. If cancer cells remain at the margins, another layer is removed from that specific area only. This continues until all margins are clear.
Key advantages:
- Highest cure rate — 99% for primary BCC, 95% for recurrent BCC
- Tissue-sparing — removes only cancerous tissue, preserving maximum healthy skin
- Same-day result — no waiting for pathology reports; you leave knowing margins are clear
Mohs vs Standard Excision
| Feature | Mohs Surgery | Standard Excision |
|---|---|---|
| Margin examination | 100% of margin examined | ~1% of margin sampled (bread-loafing) |
| Cure rate (primary BCC) | 99% | 95% |
| Tissue removed | Minimal (only cancer + 1mm) | Standard margins (4–6mm) |
| Best for | Face, ears, fingers, recurrent cancers | Trunk, limbs (non-critical areas) |
| Duration | 2–4 hours (multiple stages) | 30–60 minutes |
Planning Treatment Abroad
- Bring your biopsy report and slides — the overseas dermatologist must verify the diagnosis
- Schedule 2–3 days at the destination (Mohs may need reconstruction on a second day)
- For melanoma, Mohs is NOT recommended — wide excision with sentinel node biopsy is standard
- Post-Mohs wound may be closed with stitches, flap, graft, or left to heal by secondary intention
Cost Comparison
| Procedure | India | UK (private) | USA |
|---|---|---|---|
| Mohs surgery (single site) | $500–$1,500 | $2,000–$4,000 | $3,000–$5,000 |
| Standard excision + pathology | $200–$600 | $500–$1,500 | $1,000–$3,000 |
| Reconstruction (flap/graft) | $300–$1,000 | $1,000–$3,000 | $2,000–$5,000 |
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