LANDSTUHL, Germany – For nearly two decades, Richard Reed traveled seven times from Germany to the Walter Reed National Military Medical Center. These weren’t vacation trips but rather medical evacuations for her cancer treatment.
Reed’s treatments required a specialist dermatologist trained in Mohs surgery, which until now has not been available in Germany to US citizens living abroad. Recently, the Landstuhl Regional Medical Center reintroduced the service for skin cancer patients, which had been lacking for decades.
“There hasn’t been a Mohs surgeon here for many, many years,” said US Air Force Maj. Shannon Buck, a dermatologist specially trained in Mohs surgery. “The population of retirees who have not had access to this service is enormous. All (service members) from Europe, Africa and the Middle East would generally have to return to the (continental United States) thus causing a long absence from combat. Having him here not only simplifies the process, it gets them back to their jobs, to war much faster. “
Mohs surgery is considered the most effective technique for treating basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), two of the most common types of skin cancer. The procedure has a 99% cure rate for cancers that have not been treated before. In addition, the precise technique leaves the smallest possible scar while removing the entire tumor.
“The technique has evolved over time, but involves the surgeon cutting out the skin cancer with a very narrow margin and then processing (the tumor) in a lab which is usually located within the clinic,” Buck said. . “The good thing about surgery is the way the tissue is prepared, you can actually see 100% of the margin, which is different from other surgical techniques for removing cancer, and the surgeon is the pathologist too. . “
While the patient waits for the results, a team of healthcare professionals work to present the surgeon with sectioned microscopic samples of the tumor. After analyzing the tissue, Mohs’ surgeon can determine if all cancer cells have been removed or if another removal is needed. After the cancer cells are completely removed, Mohs surgeons then perform wound repair by allowing the skin to heal itself or by using various reconstruction methods.
In addition to being an outpatient procedure, Buck notes that other benefits for patients include the ability to walk and eat while the tissue is being processed, less medication needed during the process, which allows for faster recovery, and less medication. minimal scarring.
“Ideally, we get cures by doing this procedure for skin cancer, and we also keep the scars as small as possible which is usually in very cosmetically very sensitive areas, as most of these cases are on the head and neck, ”Buck said.
Reed, a retired US Army Warrant Officer, has a long history with skin cancer, dating back to the 1970s. Although his health insurance covered the costs of accommodation and transportation during his first two evacuations health, policy changes forced him to cover the costs of subsequent treatments. In addition, her treatment, along with many others who have the operation while living abroad, requires a three-day stay close to the treatment facility. Reed notes that the procedure in German health care systems is not faster.
“(Going to the United States from Germany), we spend three or four days doing this,” said Reed, 81, from Niagara Falls, New York. “(At LRMC) it’s a day, less than a day. It is essentially an outpatient visit. I don’t have to worry about getting on the plane, I don’t have to worry about going back and forth. I drive right here in the morning and go home in the afternoon.
“I think it will be a good thing for LRMC and a good thing for our patients. That’s why we’re here: to care for our active-duty military, their families and our retirees, ”Buck said. “We want to make sure they are receiving high quality care that is both really good and convenient for them. “
Buck and the LRMC Dermatology Clinic are working to improve access to care for people requiring Mohs surgery and are planning opportunities for other beneficiaries soon.