When Dealing With Cancer, Sometimes Less Means Mohs

Next month, P. Kim Phillips, MD, one of very few fellowship-trained, board-certified procedural dermatologists in southeastern Wisconsin, will be stepping into a brand new Dermatology Outpatient Surgery Center at the Aurora Health Center in Waukesha on Hwy 164. There, she will pull quadruple duty as dermatologist, cancer surgeon, pathologist and reconstructive surgeon as well. Each of these skills is required of specialists like Phillips who are trained to use Mohs surgical techniques to treat advanced and complicated skin cancers.

Mohs micrographic surgery is the most advanced and effective treatment procedure for skin cancer available today – ideal for when the cancer is large, the edges of the cancer cannot be clearly defined, the cancer is in an area of the body where it is important to preserve healthy tissue for the maximum functional and cosmetic result, or is likely to recur if treated by common methods.

Initially developed by Dr. Frederic E. Mohs, the procedure is a state-of-the-art treatment that has been continuously refined over 70 years. With the Mohs technique, physicians are able to see beyond the visible disease, to precisely identify and remove the entire tumor layer by layer while leaving the surrounding healthy tissue intact and unharmed. As the most exact and precise method of tumor removal, it minimizes the chance of re-growth and lessens the potential for scarring or disfigurement.

Because the physician is specially trained in surgery, pathology, and reconstruction, Mohs surgery has the highest success rate of all treatments for skin cancer - up to 99 percent. The Mohs technique is also the treatment of choice for cancers of the face and other sensitive areas as it relies on the accuracy of microscopic examination of tissue to trace the edges of the cancer and ensure complete removal of all tumors down to the roots.

Dr. Phillips said the Mohs technique is called micrographic because of use of a microscope to control the margins and the creation of a “map” or drawing of each removed layer to use as a guide to the precise location of any remaining cancer cells. The map, which notes north, south, east and west, also keeps the sample oriented to marks made on the patient's skin.

Mohs surgery is ideal for removing basal cell and squamous cell carcinomas because they are unifocal, Phillips said. Any reconstruction required can be done immediately.

Dr. Phillips said Mohs surgery is an excellent therapy for a tumor that recurs after surgery or radiation therapy. “We can deal with recurrent tumors with other techniques but there is a much higher cure rate with Mohs surgery because of the way we examine the sample.” Because excision, slide preparation and examination of each layer takes about an hour, Phillips tells her patients to be prepared to spend the morning at the clinic. Sometimes, a tumor is large and deep and multiple layers must be removed over several hours.

In addition to her work in Mohs surgical procedures, Dr. Phillips offers a number of other treatments and services including chemical peels, filler injection, cosmetic laser surgery, and Botox injection.

Dr. Phillips earned her medical degree from the University of Michigan Medical School in Ann Arbor. At the Mayo Graduate School of Medicine in Rochester, Minn., she completed her residency in dermatology and was fellowship trained in Cutaneous Micrographic Surgery and Oncology.

To make an appointment or to learn more, please call Aurora Health Center in Waukesha at 262-896-6350.