Mohs Micrographic Surgery Comes to Franciscan Hammond Clinic

A highly effective, specialized technique for the removal of skin cancer now is available in Munster.

Tarun Kukreja, M.D.

Tarun Kukreja, M.D., a dermatologist at Franciscan Hammond Clinic, provides patients the Mohs surgical technique.

Mohs surgery, which has a cure rate of up to 99-percent, permits immediate and complete microscopic examination of removed cancerous tissue. Through this process, all "roots" and extensions of the cancer can be eliminated. The surgery is performed as an outpatient procedure in the physician's office and requires no sedation.

The treatment has the highest reported cure rate, according to the American Society for Mohs Surgery. Aside from tracking and removal of cancerous "roots," the surgery spares normal tissue, providing for quicker recovery and minimal scar tissue.

Mohs surgery is not appropriate for all skin cancers, notes Dr. Kukreja, adding it is reserved for those that have recurred following previous treatment, or for cancers that are at a high risk for recurrence.

"The Franciscan Hammond Clinic has been very supportive in giving me the equipment and capacity to provide this state-of-the art procedure, which gives patients some of the highest cure rates possible, while minimizing the removal of normal tissue, leading to a smaller overall scar and quicker recovery. In addition, this procedure is more cost-effective than an inpatient-based procedure and does not require hospitalization," says Dr. Kukreja.

Dr. Kukreja performed Mohs surgery for three years in residency and is a member of the American Society of Mohs Surgeons.

How it works

Tarun Kukreja, M.D., performs a Mohs procedure.

Surgery begins with a treated area being cleansed, marked and injected with a local anesthetic. The surgeon removes the visible cancer, along with a thin layer of additional tissue, and the patient waits while the tissue is processed and examined.

Next, the removed tissue specimen is cut into sections, stained and marked on a diagram called a Mohs map. The tissue is frozen on a cryostat (a vessel used to maintain cryogenic temperatures) and the technician removes very thin slices from the edge and undersurface. The slices are placed on slides and examined under a microscope.

After examining the undersurface and edge of the specimen, all "roots" of the cancer are identified and pinpointed on the Mohs map. If residual cancer is found, the surgeon utilizes the map to direct the removal of additional tissue, but only where cancer is present. The process is repeated as many times as necessary to locate any remaining cancerous areas within the tissue specimen.