PUNE: The city-based Columbia Asia hospital, led by dermatologist and cosmetologist Dr Kusumika Kanak, has successfully conducted Pune’s first Mohs Micrographic Surgery (MMS), a highly specialised procedure to remove skin cancers from the face, head, neck and the shins.
The surgery, considered a gold standard for the treatment of common skin cancers such as basal cell carcinoma, squamous cell carcinoma and some other types of skin cancers, was performed on a 46-year old man earlier this month to treat basal cell carcinoma on his face.
Dr Kanak said, “This type of skin cancer is common among both foreigners visiting India and Indians. It caused mainly due to prolonged exposure to the sun without sunscreen. We have received nearly seven cases in the past couple of months.”
“Those who work outdoors for long hours may be affected by the disease. Besides, the cancer can be caused by a genetic reason such as vitiligo or an environmental reason such as arsenic exposure. This is the first Mohs surgery done in Pune and was completed in two parts,” Dr Kanak said.
“While some of the cases of skin cancer can be treated superficially by using anti-cancer creams, radio frequency and laser, these are blindfolded processes. We cannot be sure if the cancer has been removed completely. The Mohs surgery is the best way to treat cancers which spreads deeper in the skin and show high chances of recurrence,” said Dr Kanak.
She said initially, the first layer of the skin was removed from the affected area, in which cryosections were performed in the pathology lab and each part of the tissue (skin) was examined under the microscope to identify cancer cells.
“After the first layer was examined and cancer cells were found to be present in normal-looking skin, the process was repeated which helped in removing all cancer cells,” said Dr Kanak.
The team of doctors included Plastic Surgeon Dr Sumit Saxena and Consultant (Internal Medicine) Dr Prathibha Walde, along with pathologists and the hospital staff. After the skin layer was free of cancer cells, the plastic surgeon performed the flap surgery, which is a reconstruction process.
Since multiple layers were removed during the previous process, reconstruction with the minimal intervention was done so that the patient has the least cosmetic defect.
“A history of long outdoor hours or excess sun exposure without using sunscreen and spurt in size and number of moles are the warning signs of the disease,” said Dr Kanak.
She said the practice of sunbath can increase chances of basal cell carcinoma by 100 per cent, but Indians are relatively less affected due to more melanin in their skin that acts as a protection.
“Though such cancers are not fatal, they can cause significant morbidity and psychological impact due to the disfigurement of a body part and poor quality of life. If anyone requires long exposure to the sun, they should visit the dermatologist every six months to get tested. Those who already have been treated should visit every three to five months for tests,” added Dr Kanak.
The patient was discharged on the second day after surgery.
