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“Melanoma. That really got my attention.” That is how Mark Schoonover, 63, of Weyerhaeuser, Wisconsin, describes the moment he learned he had skin cancer in August 2015.
Schoonover, an avid pilot and outdoorsman who looks forward to clear skies, says he didn’t always remember to protect his scalp from the sun as his hair started to thin and recede. He started making annual visits to a dermatologist in his mid-50s. Previous biopsies had revealed no skin cancer. In 2015, Schoonover’s family became concerned about a dark spot on his scalp that was growing larger.
“I couldn’t see it,” Schoonover says. “My family felt strongly that it wasn’t right.” Mark’s wife decided to accompany him on a visit to his dermatologist. This time, a biopsy revealed melanoma. Mark’s dermatologist recommended Mohs surgery.
Mohs surgery, named for Dr. Frederick Mohs, the dermatologist who pioneered the procedure in the 1930s, is a technique used to remove skin cancer while leaving as much healthy tissue as possible untouched. The procedure is popular in cases where the affected area is visible, such as on the face, neck or head, in particularly sensitive areas of the body and if the margins of the tumor are poorly defined, such as with Schoonover’s tumor.
“We cut out a thin layer of the tissue,” says dermatologist Michael Colgan, M.D., who performed Schoonover’s surgery at Mayo Clinic Health System in Eau Claire. “Then, we examine it and determine whether we got all of the cancer or if we need to cut out more.”
Mohs surgery is more commonly used in cases of basal cell or squamous cell carcinoma, Dr. Colgan says, and about half of those patients only need one attempt to clear the tumor, which takes about two hours from start to finish. Few patients need more than two attempts. The edges of melanoma tumors are more difficult to define, though, and Schoonover required three sessions, spending a full day at the clinic.
It takes a skilled team to coordinate Mohs surgery, Dr. Colgan says. Scheduling nurses call patients to explain details and answer any questions. Surgical technicians meet patients at the clinic and guide them through the day from beginning to end.
A pair of key team members remains out of sight: the histotechnicians. They prepare tissue samples for Dr. Colgan to examine after each layer of tissue is removed.
“They’re the unsung heroes,” Dr. Colgan says. With this experienced team, Dr. Colgan performs around 1,000 of the procedures each year.
When the Dermatology Department moves from its Clairemont Campus clinic location to the Luther Campus at 1221 Whipple St. in Eau Claire in late June, Dr. Colgan says it will benefit from new, state-of-the-art equipment and will be able to better integrate with other departments located in the hospital.
As for Schoonover, he says he now is healed and is appreciative of the care he received.
“Melanoma is nothing to fool around with,” Schoonover says. “I’m very grateful for the services that were available to me at Mayo Clinic Health System. I got everything right there — the diagnosis, surgery and treatment — and will get the follow-up treatment in Eau Claire.” For that follow-up, Schoonover says he is glad that he can continue to see Dr. Colgan.