Mohs surgery skin cancer

Dr Johann de Wet brings gold standard skin cancer surgery technique with 99% cure rate to the Cape Winelands

Dr Johann de Wet, leading dermatologist and skin cancer expert recently opened the first dedicated Mohs Micrographic Surgery unit in the Cape Winelands area.

Mohs surgery is a precise surgical technique with a near 100% cure rate recommended by international skin cancer guidelines and considered the gold standard when treating specific forms of skin cancer.

The new unit is based at the Advanced Vergelegen Surgical Centre in Somerset West and forms part of the national SkinMatters Mohs and Reconstructive Unit. Collectively the unit has performed over 6 000 Mohs micrographic surgery cases.

High cure rates with optimal cosmetic and functional outcome

Dr De Wet, a fellowship-trained Mohs Micrographic Surgeon through the American Society of Dermatological Surgery, explains: “During Mohs surgery, thin layers of cancer-containing skin are removed in stages and microscopically examined until only cancer-free tissue remains. The goal of Mohs surgery is to remove the skin cancer, while causing minimal damage to surrounding healthy tissue, leading to smaller defects, and maximising the functional and cosmetic outcome that results from surgery.”

Mohs surgery has been proven to provide the highest cure rates, being the most cost-effective and associated with best cosmetic outcomes when treating skin cancer.

Dr De Wet says that there is an epidemic of skin cancer in the world and South Africa is no exception. Although Mohs Surgery is well established in other parts of the world, it is only recently that South Africans have been able to benefit from this specialised treatment.

According to Dr De Wet, traditional surgery has the limitation that it is essentially “blind”. As a result, parts of the tumor could be left behind.  To reduce that risk, the surgeon must often sacrifice additional surrounding healthy tissue, leading to larger defects and reconstructions.  Even then, he says complete tumour removal is a challenge as conventional histopathological sections assess less than 1% of the tumour margin.

World class facility

This world class, state of the art histopathology laboratory within the theatre complex at Advanced Vergelegen Surgical Centre, is the first of its kind in the Western Cape. The first Mohs procedure at the new unit was performed on Friday 9 October and, according to Dr De Wet, was a great success.

The Mohs surgery service is supported by a multi-professional team of medical specialists comprising of plastic and reconstructive surgeons, oculoplastic surgeons, head-and-neck cancer specialists and general surgeons specialising in cancer treatment. The vision of the unit is to establish itself as a centre of excellence for skin cancer treatment.

Patients who will benefit from Mohs surgery are those with larger cancers, cancers with more aggressive growth patterns, cancers recurring following previous treatment, incompletely removed cancers, or cancers involving important cosmetic and functional areas such as the face.

A dermatologist will be able to assess the skin cancer and based on its location, clinical features and the histological subtype can then determine if the patient is a suitable candidate for the procedure.

Mohs surgery and reconstruction is a same day procedure performed in a day hospital setting and covered by most medical aids.

Patients interested in the treatment can contact the Dermatology and Skin Cancer Institute in Stellenbosch where Dr De Wet is based for a consultation.

Call  021 111 0460 or for more information visit