Why Doctors Chose Mohs Surgery for President Biden — and What It Means for Cancer Patients

Former President Joe Biden has gone under the knife to remove skin cancer lesions just a few months after revealing his prostate cancer diagnosis.

Biden, 82, sparked concern after he was seen with a large scar on his forehead while greeting people in Rehoboth, Delaware, over Labor Day weekend.

His spokesperson, Kelly Scully, confirmed that he had undergone Mohs surgery, a procedure used to cut away skin cancer cells until no evidence of cancer remains.

Joe Biden shaking hands with a woman.

Biden sparked concern after he was seen with a large wound on his forehead while greeting people in Rehoboth, Delaware, over Labor Day weekend. Instagram/@fredkarger

What is Mohs surgery for skin cancer?

Named for Frederic E. Mohs, the originator of the procedure, Mohs surgery is used to treat skin cancer such as basal cell carcinoma, squamous cell carcinoma, melanoma and other less common skin cancers.

Also known as micrographic surgery, it is a highly technical procedure that involves removing skin in layers and examining each layer under a microscope until all cancerous cells are removed, while preserving as much healthy tissue as possible.

Mohs surgery enables surgeons to confirm that the cancer cells in question are entirely removed, thereby reducing the need for additional treatment.

It is a prevalent treatment for high-risk skin cancer because it has a cure rate of up to 99%.

According to the Mayo Clinic, Mohs surgery is recommended for skin cancers that have a high risk of recurrence or have returned after previous treatment, are large, fast-growing, or have edges that are hard to define.

In addition, it’s often used to treat skin cancer that affects parts of the body where the preservation of healthy tissue is imperative, such as areas around the eyes, ears, nose, mouth, hands, feet and genitals.

It is typically an outpatient procedure that takes, on average, less than four hours.

Illustration of Mohs surgery steps: tumor removal and microscopic examination.

Mohs surgery enables surgeons to confirm that the cancer cells in question are entirely removed, thereby reducing the need for additional treatment. Pepermpron – stock.adobe.com

After administering a local anesthetic to numb the surgical area, a surgeon uses a scalpel to remove the visible portion of the cancer as well as a thin layer of tissue that surrounds it.

These tissues are then taken to a lab and analyzed under a microscope. The surgeon then makes a map of the removal area so that if cancer is detected, they know precisely where to continue the operation.

“Melanoma has cells that can be visible on slides under the microscope extending beyond what you can see with the naked eye,”  Dr. Jesse Miller Lewin, vice chair of surgical operations of the Division of Dermatologic and Cosmetic Surgery at Mount Sinai Health System, previously told The Post. “If cells are left behind, the melanoma can get deeper or spread to lymph nodes.”

What is the recovery time for Mohs surgery?

If more cancer is detected during the procedure, additional layers of tissue are removed and taken to the lab for analysis. This process continues until the last sample removed is deemed cancer-free.

President Biden at a funeral.

Biden’s spokesperson, Kelly Scully, confirmed that Biden had undergone Mohs surgery, a procedure used to cut away skin until no evidence of cancer remains. William Bretzger-Delaware News Journal / USA TODAY NETWORK via Imagn Images

After the procedure, and depending on the extent of removal, the surgeon will decide how the wounds will be addressed. Treatment can include stitches, a skin graft, or opting to allow the wound to heal on its own.

One of the primary advantages of Mohs surgery is that results are immediately available, and the patient doesn’t leave the office until all of the cancerous cells have been removed.

Most patients report mild discomfort in the first few days after the procedure, while any incision scars will continue to heal for 12 to 18 months post-op.

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