Scripps Dermatologists Advancing Skin Cancer Care
Precision care in a leading Mohs surgery lab
Precision care in a leading Mohs surgery lab
It’s estimated that one in five people in the United States will develop skin cancer at some point in their lives.
When you factor in living in a sun-soaked city like San Diego and the outdoorsy lifestyle that comes with it, that figure can jump to as high as one in three, which makes early detection and intervention all the more important.
Scripps dermatologists are using innovative imaging methods and advanced surgical techniques to diagnose and treat skin cancer. For certain cancers in sensitive spots, like the face, dermatologists perform Mohs surgery, removing skin tissue layer by layer until reaching healthy, cancer-free tissue.
Hugh Greenway, MD, a dermatologist and founder of Bighorn Mohs Surgery and Dermatology Center at Scripps Clinic. Dr. Greenway has performed more than 60,000 Mohs surgeries and trained under the procedure’s creator, Dr. Frederic E. Mohs.
Why Mohs surgery is gold standard
Scripps has one of the most sophisticated Mohs surgery labs in the country.
“The key to treating cancer is early diagnosis. If we spot it early, then we can take care of it in a much easier fashion,” says Dr. Greenway.
He adds: “Mohs surgery is not for all skin cancers, but it has the highest cure rate and is the gold standard for those that are more challenging because of either their location or the tumor type.”
Advanced tissue analysis
Scripps has remained at the forefront of pathology in part by implementing innovative surgical techniques and technologies. Among the most impactful is the use of immunohistochemistry, an advanced way of examining tissue samples taken during Mohs surgery.
Immunohistochemistry allows dermatologists to view tissue samples in far greater detail than previous methods. In most cases, obtaining a tissue sample can be done in one procedure under local anesthesia. Information gleaned from the sample’s immunohistochemistry can be combined with a DNA tumor analysis and computer modeling to further personalize care.
“We have a very robust program and we see kinds of cancer that most places besides the largest universities don’t. Our ability to integrate immunohistochemistry has helped us out a lot,” adds Benjamin Kelley, MD, dermatologist and dermatopathologist specializing in micrographic surgery and dermatologic oncology, and head of Bighorn Mohs Surgery and Dermatology Center at Scripps Clinic.
“Mohs surgery is very accurate, but melanoma can be hard to see under a microscope. Immunohistochemistry works like a highlighter for the bad cells. It’s much more accurate,” he says. “We’ve taken immunohistochemistry to the next level over the past couple of years.”
Training the next generation of dermatologists
Scripps is teaching these innovative methods to the next generation of dermatologists. Dr. Greenway leads Scripps’ Mohs Micrographic Surgery and Dermatologic Oncology Fellowship and has trained more than 80 physicians from around the world, some of whom have gone on to establish their own training programs.
“We’re very proud of the program and the number of fellows that we’ve trained over the years,” says Dr. Greenway.
This content appeared in San Diego Health, a publication in partnership between Scripps and San Diego Magazine that celebrates the healthy spirit of San Diego.