Local doctor offers new skin cancer treatment

A new treatment option is available in Springfield for difficult-to-treat or recurrent skin cancers. The Mohs Micrographic surgery technique is offered by Dr. Craig Naugle, who opened his practice in July. His office, which is independent, is located in the Hulston Cancer Center.

Naugle said he is the first surgeon in southwest Missouri to offer the Mohs procedure, which is one of five standard methods for the treatment of skin cancer.

"In studies comparing different methods of skin cancer treatment, Mohs has the highest cure rate," Naugle said. Of all skin cancer treatments, Mohs has the lowest chance of re-growth, minimizes the potential for scarring or disfigurement and is the most exact and precise means of removal, he said.

The procedure consists of three steps: 1) surgical removal of the visible portion of the skin cancer; 2) surgical removal of a thin layer of tissue at the bed and complete outer margin of the cancer; and 3) examination of the excised tissue under the microscope.

More than 1.2 million people in the United States are diagnosed with skin cancer each year, Naugle said. There are several types of skin cancer, but the three most common are basal cell carcinoma, squamous cell carcinoma and melanoma.

Depending on the type of cancer, the Mohs procedure success rate is 97 percent to 99 percent, Naugle said.

"We have a 99 percent cure rate for basal cell carcinoma," he said.

Mohs surgery is effective for most types of skin cancer, but it is most often used to treat basal cell and squamous cell carcinomas, he said.

Naugle said the number of basal cell skin cancer cases has steadily increased over the last 30 years and it continues to rise.

"Basal cell skin cancer is what we treat most commonly," he said.

Naugle said using the Mohs procedure allows him to pinpoint the diseased tissue and remove only that area, while also tracing the cancer to its roots. The procedure is tissue-sparing, he said.

"The key is to only take the cancerous tissue and leave as much normal tissue as possible."

The surgery is most often performed on an outpatient basis, under local anesthesia.

Naugle said Mohs is most effective for cases when:

the cancer is large;

the edges of the cancer cannot be clearly defined;

the cancer is in an area of the body where it is important to preserve healthy tissue (for maximum functional and cosmetic result); and

prior treatment has failed.

The Mohs procedure is a good option for recurrent cancers, especially those on the face that have been treated by other methods, Naugle said. The cure rate is high because the surgery uses "complete systematic microscopic control" to search out the roots of the cancer, he said. More aggressive types of cancers are also good candidates for Mohs, he said.

The procedure is named after Dr. Frederick Mohs, a surgeon from Madison, Wis., who invented the technique in the 1940s. Naugle said the technique has been refined over the years.

Naugle chose to specialize in the Mohs procedure because it combines several areas of his medical expertise. "I like it because of the simple fact that you get to do pathology, surgery and dermatology all at once."

Naugle stressed the importance of sunscreen to avoid skin cancer altogether. People who sunburn easily should wear an SPF 30 sunscreen every day, he said. He added that tanning beds are not a healthy alternative.

"Any time you get a tan it's unhealthy because that's the body's defense mechanism from the sun," Naugle said.

Those who have a history of skin cancer or are at an increased risk should wear both sunscreen and a large brimmed hat when outside.

"Don't forget to cover the ears. We see a lot cancer of the ears in farmers who wear baseball caps," Naugle said.

A healthy diet may also be a deterrent against skin cancer, he added.

"You can, to some degree, minimize skin cancer through a healthy diet, especially with vitamins A, C and E, because of their antioxidant potential," Naugle said.