Quality of life improves after Mohs surgery for nasal skin cancers

Patients treated with Mohs micrographic surgery for nasal skin cancers experienced significant quality of life improvements after reconstruction, according to a study.

“Skin cancer can negatively impact patient quality of life (QOL). Treatment of skin cancer with Mohs micrographic surgery (MMS) has been associated with improved QOL,” Tess M. Lukowiak, BS, of Drexel University College of Medicine, and colleagues wrote. “However, only 28.9% to 32.6% of tumors in studies of MMS were located on the central face, a location for which patient concerns and anxiety are highest.”

Using the Skin Cancer Index (SCI), a multicenter prospective survey study asked 15 QOL questions before surgery, 1 week after flap placement, 4 weeks after flap takedown and 16 weeks after flap takedown.

Questions were split into three subscales: emotion, appearance and social. The emotion subscale asked about anxiety and frustration, while the appearance portion asked about perceived attractiveness and frustration. The social section asked about attitudes toward meeting new people and public perception.

Of 169 subjects, 147 (mean age, 67.8 years; 51% men) completed both the first and last surveys. After 16 weeks, SCI scores improved by a mean of 13% (7.11 points; 95% CI, 5.48-8.76; P < .001). The emotion subscale had an increase of 14% (3.27 points; 95% CI, 2.35-4.18; P < .001), while the appearance subscale increased 16% (1.65 points; 95% CI, 1.12-2.18; P < .001) and the social subscale improved by 11% (2.1 points; 95% CI, 1.55-2.84; P < .001).

“Patient concerns about appearance and potential disfigurement from skin cancer surgery, particularly in cosmetically sensitive areas such as the face, can cause significant anxiety and have a negative effect on psychosocial functioning,” the authors wrote. “Despite patient anxiety and aesthetic concerns associated with complex reconstruction of nasal defects, physicians who refer patients for surgery on the nose should feel comfortable reassuring patients about their long-term QOL outcomes.”