If you’ve been diagnosed with skin cancer, you may hear about two common treatment options: Mohs surgery and superficial radiation therapy (SRT). Both can be effective in the right situations, but they work in very different ways. Understanding the differences can help you feel more confident in your treatment plan.
What Is Mohs Surgery?
Mohs surgery is a specialized surgical technique used to remove skin cancer one thin layer at a time. Each layer is examined under a microscope right away to make sure all the cancer is gone before the procedure is finished.
It is most often used for common skin cancers like basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), especially when they are located on the face, ears, scalp, hands, or other areas where preserving healthy skin is important.
Mohs surgery is considered the standard of care for many non-melanoma skin cancers because of its high success rate and ability to preserve healthy tissue.
What Is Superficial Radiation Therapy (SRT)?
Superficial radiation therapy (SRT) is a non-surgical treatment that uses targeted, low-dose radiation to destroy cancer cells in the skin.
Instead of removing the cancer physically, SRT treats it gradually over time.
It may be used for patients who:
- Cannot have surgery due to other medical conditions
- Prefer a non-surgical approach
- Have certain low-risk skin cancers
Differences Between Mohs Surgery and SRT
Mohs surgery and superficial radiation therapy (SRT) differ in several important ways, including how they are performed, how long treatment takes, and how precisely they treat skin cancer.
1. Number of Visits
Mohs Surgery: Typically completed in a single visit, although the procedure can take several hours depending on the complexity. Patients leave knowing whether the cancer was fully removed.
SRT: Requires multiple treatments, usually 2–4 sessions per week over several weeks. This can add up to 15–30 sessions in total, depending on the size and type of cancer.
2. Cure and Recurrence Rates
Mohs Surgery: Offers the highest cure rates—up to 99% for primary basal cell carcinomas (BCCs). For squamous cell carcinomas (SCCs), Mohs achieves cure rates of 97–99% for primary tumors, making it highly effective. Recurrence is very rare when performed by a skilled Mohs surgeon.
SRT: Can be effective in select skin cancers, with cure rates ranging from 84-95% for early-stage BCCs and SCCs. Given the lower cure rates, most patients will opt for Mohs, but SRT remains an option for patients who cannot undergo surgery due to underlying comorbidities.
3. Margin Control
Mohs Surgery: Known for its precise margin control. The surgeon examines 100% of the tissue edges under a microscope during the procedure, ensuring no cancer cells are left behind. This is why Mohs is so successful in preserving healthy tissue and minimizing skin cancer recurrence.
SRT: Lacks direct margin control. Treatment relies on imaging and clinical judgment rather than microscopic analysis. This can sometimes leave a small risk of residual cancer cells.
4. Provider Education and Board Certification
Mohs Surgery: Must be performed by a fellowship-trained Mohs surgeon who is board-certified in dermatology. These physicians undergo extensive additional training to ensure precision, safety, and excellent outcomes.
SRT: Can be administered by healthcare providers with varying levels of training. While some may have significant expertise, formal certification or fellowship training is not required for administering superficial radiation.
5. When to Consider Each Treatment Option
Mohs Surgery: Ideal for most patients, when preserving function and appearance is critical. It’s also preferred for cancers that have recurred after other treatments.
SRT: A good option for patients who cannot tolerate surgery or have multiple medical comorbidities that make surgery a risky option.
Other Skin Cancer Treatment Options
In addition to Mohs surgery and SRT, there are several other ways skin cancer may be treated depending on the type, size, and location of the cancer:
- Standard surgical excision – The cancer is cut out along with a margin of healthy skin and then stitched closed.
- Topical medications – Prescription creams used for very early or superficial skin cancers or precancerous lesions.
- Cryotherapy – Freezing the cancer cells with liquid nitrogen, often used for precancerous spots.
- Photodynamic therapy (PDT) – A light-activated treatment that targets abnormal skin cells, often used for early or superficial lesions.
- Electrodesiccation and curettage (ED&C) – The cancer is scraped away and the area is lightly burned to destroy remaining cells, commonly used for low-risk cancers.
Your dermatology provider will help determine whether any of these options are appropriate for your specific situation.
The Best Treatment for Your Skin Cancer
Mohs surgery remains the most precise and effective treatment for many types of skin cancer, especially when complete removal and cosmetic outcome are important. Superficial radiation therapy can be a useful alternative for patients who cannot undergo surgery.
The best treatment always depends on your diagnosis, medical history, and personal preferences. Your dermatology provider will guide you through the options and help you choose the approach that fits your needs best.
If you have a skin concern, don’t wait! Skin cancer is highly treatable when caught early. Call us at 719-355-1585 or schedule an appointment online today.
