Spire Leeds consultant dermatologist, Dr Walayat Hussain, is on a mission to raise awareness
of Mohs surgical treatment for non-melanoma skin cancer, which he believes is the most effective treatment available today.
Dr Walayat Hussain, who works at Spire Leeds Hospital, is one of the UK’s leading dermatological surgeons and one of only a few doctors in the country trained in the highly specialised technique. He is also the only Mohs surgeon in Yorkshire to be accredited by the world’s leading Mohs institution, the American College of Mohs Surgery
“Mohs surgery, also known as ‘Mohs micrographic surgery’, is one of the most effective and advanced treatments for non-melanoma facial skin cancer today yet most doctors know very little about it, said Dr Hussain.* “When dealing with skin cancer, what you see on the skin can be just the tip of the iceberg. Mohs surgery enables all the roots of the skin cancer to be very precisely removed and by only removing cancerous tissue and sparing normal skin, it can often offer an improved cosmetic result and may work where other treatments have failed.”
A microscope is used during the surgery to ensure the roots of skin cancer, which are not visible to the naked eye, are removed. Dr Hussain explains the procedure. “First of all, the visible part of the skin cancer is removed and analysed under the microscope. If any roots of the skin cancer remain the precise location of these roots is marked and another layer of skin is then removed precisely where the cancer was seen. After all of the cancer cells are removed I will then reconstruct the wound endeavoring to provide the best cosmetic outcome possible.”
“The Mohs surgeon is the one who removes the skin cancer, analyses it under the microscope and repairs the wound,” said Dr Hussain. “Mohs surgery is considered the ‘gold-standard’ treatment for non-melanoma skin cancers when it is felt there is a high risk of the cancer returning and especially when the skin cancer is on the face as it allows the hole to be kept as small as possible. This is particularly important around the eyes, ears, nose and mouth. Take the lips for example, it’s vital that a patient’s ability to open their mouth, eat, smile and speak are not affected.”
This was the case with Margery Benn, a retired director of a publishing and distribution company in her hometown, Wetherby. She underwent Mohs surgery to remove two lesions from her lip and chin last July under the care of Dr Hussain.
Margery, 74, who is married with two grown up children, said she had found various spots (lesions) on her face during the previous 18 months and they were treated by various other means. “They were not painful but they were unsightly and they would not heal. It was only when I saw another dermatologist who suggested they were cancerous and would keep growing that I became concerned and was referred for Mohs surgery, which I had never heard of,” she said.
When Margery learned about the waiting list for NHS surgery she checked her health insurance and discovered she would be covered to have this procedure done privately. She then chose to have surgery at the earliest opportunity at a time and date that suited her.
Dr Hussain said, “The area had been previously treated by another doctor but had recurred following this. It was initially thought to be an area of sun damage, however she actually had a basal cell carcinoma, which is the commonest type of skin cancer and related to sun exposure”. He chose this treatment for Margery as the best way to ensure the cancer would be fully removed. “The surgery was challenging given that she had previously been treated causing the skin cancer roots to be buried deeper in the skin”.
Margery underwent the procedure as a day patient and the dressing was removed the following day. “Dr Hussain assured me the swelling and redness would fade within a week – and it did. The treatment I received from Dr Hussain was exceptional and I would certainly recommend it to others with a similar condition. My family and friends are amazed at the way the scar has healed so I am feeling very content.”
Dr Hussain said that rates of skin cancer continue to rise in the UK. “I have treated patients as young as 18 with Mohs surgery and that’s why it’s so important to raise awareness of this treatment amongst doctors and the public alike”.
* Dr Hussain recently published an article in the British Journal of Dermatology supporting the finding that GPs know very little about Mohs surgery and Mohs surgeons: ‘Mohs micrographic surgery in primary care: knowledge of the technique and perceptions of Mohs surgeons among general practitioners in one U.K. region’.
Kapadia A, Hussain W. Br J Dermatol. 2012 Oct;167(4):961-3.