Questions to Ask Before Mohs Surgery

The questions

Open any question to see why it works.

1. 1

   What type of skin cancer is this, and what did the biopsy report say?

   Ask for the name in full and for a copy of the pathology report. Basal cell and squamous cell carcinomas behave differently, and within each there are subtypes that extend along paths under the skin, which is often part of why Mohs is being suggested.

2. 2

   Why is Mohs the recommendation here rather than another treatment?

   The usual reasons are the location, the size, an unclear border, a recurrence, or a subtype that reaches further than it looks. Hearing which of those applies to you makes the rest of the conversation easier to follow.

3. 3

   How large might the wound be once the margins are clear?

   The visible spot is often smaller than the area that has to be removed. Surgeons usually give a range rather than a number, and knowing the upper end of that range in advance makes the day less of a surprise.

4. 4

   How long should I expect to be at the clinic, and what happens between stages?

   Mohs is done in rounds, with tissue examined while you wait, so the appointment can run several hours even when everything goes smoothly. Ask whether you wait in the building, whether you can eat, and whether someone can wait with you.

5. 5

   Who examines the tissue, and where is that done?

   In Mohs the surgeon usually reads the slides themselves in a laboratory on site, which is what allows a same-day result. It is reasonable to ask about their training in this specific procedure and how long they have been doing it.

6. 6

   How will the wound be closed, and who will do that part?

   Options range from letting it heal open, to stitching it directly, to a flap or a graft. Sometimes the repair is done by the same surgeon and sometimes by another specialist on the same day or later, so ask which is planned for you.

7. 7

   Where will the scar sit, and which direction will it run?

   Surgeons plan closures along natural lines and creases where they can. Asking to see the likely line drawn on your skin, or photographs of similar repairs, gives you a clearer picture than any verbal description.

8. 8

   What anaesthetic will be used, and will I be awake?

   Mohs is normally done under local anaesthetic with you awake. Ask what the injections feel like, whether more is given between stages, and what to say if you feel anything during the removal.

9. 9

   Should I change or stop any of my medicines, and who decides that?

   Blood thinners and some supplements come up in this conversation. The decision is usually made together with the doctor who prescribed them rather than by the surgeon alone, so ask who will contact whom and by when.

10. 10

    What are the risks that are specific to this spot on my body?

    Risk depends heavily on location. Near the eye, lip, ear, or nose there are particular concerns about function and appearance, and on the lower leg or in someone with poor circulation, healing is the larger issue.

11. 11

    Is there any risk of numbness or nerve injury here?

    Some areas of the face and neck sit close to nerves that control sensation or movement. Ask whether any expected numbness is likely to be permanent, and how long temporary numbness usually lasts in this location.

12. 12

    What does wound care look like for the first two weeks?

    Ask who changes the first dressing, how often it is changed after that, whether the area can get wet, and what supplies you need at home. Getting it in writing avoids relying on memory afterwards.

13. 13

    What restrictions will I have on work, exercise, and lifting?

    Bending, straining, and exercise raise the chance of bleeding into a fresh wound. The time frame depends on the site and on how it was closed, so ask for your own numbers rather than general ones.

14. 14

    What should I expect the area to look like at one week, one month, and a year?

    Early appearance is not the final result. Redness, firmness, and a raised edge are common in the first months, and knowing the usual timeline tells you when concern is reasonable and when it is simply early.

15. 15

    What is the chance the cancer comes back in this spot?

    Ask for a figure for your tumour type and location rather than for skin cancer in general. It also opens the discussion of how often you will be examined and what a recurrence would look like.

16. 16

    What happens if the margins are still not clear after several stages?

    This does happen. The answer might involve continuing on another day, a referral, or a discussion about additional treatment, and it is easier to hear the plan now than in the middle of the procedure.

17. 17

    Will I need any further treatment or reconstruction after this?

    Ask whether anything is likely to follow, who would do it, and roughly when. Some repairs are staged over weeks, and some cases involve a discussion with other specialists once the pathology is complete.

18. 18

    What will this cost, and what has been checked with my insurer?

    The removal, the laboratory work, the repair, and any second surgeon may bill separately. Ask the practice who verifies coverage and whether anyone involved on the day is outside your plan.

19. 19

    Do I need someone to drive me home, and what should I bring?

    Even under local anaesthetic the day is long, and you may leave with a dressing over one eye or a bandage that makes driving awkward. Ask what to wear, what to eat beforehand, and whether a companion can stay.

20. 20

    Who do I call afterwards, and what number do I use outside office hours?

    Ask which signs should prompt a call: bleeding that does not stop with pressure, increasing pain, fever, or spreading redness. Write the out of hours number down before you leave.