To Mohs or Not to Mohs: Considering the Elderly Patient
Mohs micrographic surgery is a common procedure used to treat nonmelanoma skin cancers. With a clearance rate of approximately 98% in small primary basal cell carcinomas and approximately 97% in small primary squamous cell carcinomas, it is the gold standard of care. When considering a Mohs procedure, several criteria are reviewed and evaluated to make sure that Mohs is an appropriate treatment option for the specific tumor, and that the patient is an appropriate candidate to undergo Mohs. However, there are no such criteria for a specific age or functional status at which Mohs is deemed inappropriate (Connolly et al., 2012). Some may argue that patients in their 90s with a nonfatal skin cancer should not undergo an invasive surgery, as their quality of life may be impacted. Others may argue that, if they are healthy, surgery is the best answer. It is necessary for elderly patients and their caregivers to be fully informed about what type of skin cancer the patient has, its prognosis, and how it affects the patient's quality of life. All possible treatment regimens should be explained by the provider with opinions and advice given in respect to the patients' current health status and wishes in mind. Ultimately, care of the elderly patient regarding having or not having Mohs surgery should be a decision made between patient and provider, with the patient's preference as the priority.
Journal of the Dermatology Nurses' Association
Digital Object Identifier (DOI)
Crumpton, K. (2019) To Mohs or Not to Mohs: Considering the Elderly Patient. Journal of the Dermatology Nurses' Association, 11(2), 71-74.