Importance of Mohs micrographic surgery to prevent cancer recurrence

This type of surgery has allowed us to have an advantage, since the compromised tissue is removed, preventing recurrence.

Dr. Hiram Ruiz, Dermatologist Specialized in Mohs surgery. Photo: Medicine and Public Health Magazine / Fabiola Plaza.

Skin cancer is one of the issues that is most highlighted every summer, since most vacation spaces require exposure to ultraviolet rays, which is why the use of sunscreen, good hydration and, above all, have always been recommended. reduce the amount of exposure time.

The word cancer comes with a social burden and a collective imaginary that is associated with loss, pain and death; although currently treatments and forms of diagnosis have been developed that allow optimizing response time and guarantee life for patients.

“In Puerto Rico, thank God, melanoma is not as common as in the United States, but everything is a relationship, even if you don’t have a fair complexion, if you expose yourself to the sun enough you will develop cancer,” says Dr. Hiram Ruiz, Dermatologist Specialized in Mohs surgery, in an interview with the Journal of Medicine and Public Health.

there are three types of skin cancer which are the best known and which are currently prevalent are Vasocellular Carcinoma, Squamous Cell Carcinoma and Melanoma.

Vascular Cell Carcinoma

This most common type of skin cancer, which should not metastasize, only affects the structures and organs close to where it started, but does not spread to the rest of the body, in order to carry out the process of metastasis, it must pass many years in the body without treatment, or it could happen in patients whose immune system is too compromised.

Squamous cell carcinoma

It acquires this name because the lesion the tumor has scales, in this case, when the tumor exceeds a certain diameter, it has a greater possibility of metastasizing, in this type of cancer a higher percentage of older adults die, so it presents a higher mortality higher than melanoma itself.


This type of cancer is the best known and associated with the highest risk, due to its mole shape, but it also has a lower incidence because it is rare and develops more in young patients; If it is treated in time, a remission can be achieved, but if it is not detected in time, it can metastasize and end the life of the patient.

In Puerto Rico, it is presented lower incidence of cases of Melanoma compared to the United Stateswhile the skin has more melanin, more will be the natural protection factorthis is how ‘redheaded’ people present a higher risk factorbecause their melanin is considered defective, since there is no natural skin protectionand its prolonged exposure to the sun’s rays can develop some type of cancer.

There are different risk factors that occur, there are genetic factors, infectious (HPV, HIV…), family, but always the main factor will be sun exposure vs. patient pigmentation.

It is important to bear in mind that in the face of any suspicion, it is best to go to a specialist, and especially if there are wounds that, despite generating scabs on the temporary tissue, do not heal and the process is repeated over and over again. It must be taken into account that any mole that begins an asymmetrical growth process and that does not have any resemblance to the rest of the patient’s moles is an analysis factor.

Mohs micrographic surgery

With this type of procedure, the doctor in turn can fulfill the mission of surgeon and pathologist in order to guarantee an advantage over the cancer.

“It is the most effective way to treat skin cancer, it is not the only one, it is almost always reserved for head and neck tumors, tumors that do not have well-defined borders, or tumors that have not worked in other methods and have recurred. ”, says Dr. Ruiz.

Since this procedure guarantees that during the process itself, the amount of compromised tissue is removed with great effectiveness, since at that very moment it allows to verify if the composition of the extracted tissue and if it has a root or cell that cannot be seen. naked eye. Ensuring that the patient who goes into remission does not have a recurrence, because it is done at the correct margin.

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