Hiya Becca...

I've had Mohs three times -- eyelid once, and "nose Mohs" twice -- but it was for basal cell and squamous cell CA.

Mohs takes tiny little slivers which they check under the microscope to be sure they got all the cancer. Thank goodness for Mohs (or should I say thank Dr. Mohs for Mohs) because I would have lost most of my nose; as it is, I have two tiny scars.

With melanoma, they traditionally take what they call "wide margins" because of the risk of recurrence with Mohs. (Basal and squamous cell can come back after Mohs too -- my uncle's did -- but they aren't life-threatening; squamous cell can be, but it takes years and years.)

I had no idea they were using Mohs for melanoma until you mentioned it, and what I'm finding is that it's "very controversial" at this point.

If it were me, I would avoid it like the plague... just like I would avoid a lumpectomy to spare a mastectomy. My individual parts just aren't that important to me if there's a risk of dying to save them.

I had a dear internet friend who got a very rare form of cancer in his forearm (it's a childhood cancer, and he was one of only six adults in the country who had it) (lest there be any misunderstanding, it was NOT melanoma or any type of skin cancer, nothing similar to what Jim has at all!!). It was *completely* localized, which they said was extremely rare -- "How lucky you are!" they chirped -- and they were "able to save his arm." I begged him to tell them he wanted his arm amputated ("It just ain't worth it," I said).

This is one place where I am anti-medical-profession (sorry, Dale), but I've seen it again and again... it was a *challenge* to save his arm, as far as I'm concerned. They were all so proud because it was unheard-of and he did so well. They were writing him up in the medical journals!

Then it came back, he had his arm amputated, but it was too late and he died without seeing his 40th birthday :-(

Another friend whose father had prostate cancer. He wanted it removed, they talked him into having radium implants instead ("must less radical")... to make a long story short, it came back and it was all downhill from there.

Of course Jim will have to decide what to do -- (I can't even believe I'm yapping on and on like this!) -- but I just believe it's *SUCH* a mistake to opt for "less is more" where cancer is concerned.

Good luck again, Jim!! I think you're going to do great -- I feel it in my Nose Mohs.

Luv,