Goodskin – Peter E. Goodkin, MD, PC – Dermasurgeon
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For more information about Mohs surgery and skin cancer treatment at our Clackamas, Oregon office, contact us today for a consultation.






Peter Goodkin M.D.
 9775 SE Sunnyside Road #500
Clackamas, Oregon 97015
P / 503-654-7546
F / 503-786-3542

American Society for Dermatologic Surgery
A member of the ACMMSCO©™
About Our Practice

Mohs Surgery Skin Cancer Treatment in Oregon

Mohs micrographic surgery is performed to remove skin cancer. Dr. Peter Goodkin performs Mohs micrographic surgery as a skin cancer treatment in his Oregon office near Portland, and he has done this procedure on thousands of skin cancers since 1978. It offers both the highest possible chance of cure and the maximum preservation of normal skin tissue. Mohs surgery is named after Dr. Frederic Mohs. Dr. Goodkin studied with Dr. Mohs in Madison, Wisconsin to learn this technique. Dr. Goodkin was also the head of the Mohs Surgery Unit at Oregon Health and Science University (OHSU) for 10 years.

Many skin cancers have invisible roots that extend into the normal-appearing surrounding skin. If your doctor could tell how big the skin cancer was by just looking at it, you wouldn’t need Mohs surgery. Mohs surgery is an advanced technique that allows those roots to be followed.

Other treatment methods for skin cancers are:

  • Simple surgical excision (cut the cancer out and stitch up what's left behind)
  • Not-so-simple excision (plastic surgery), often performed in a hospital, with some ability to check the cancer's margins
  • Curettage and electrodessication (scraping and cauterizing)
  • Radiation therapy
  • Cryotherapy (freezing with liquid nitrogen)

Mohs surgery is a more precise method of skin cancer removal. It minimizes the chance of cancer regrowth and the potential for scarring. For more about Mohs surgery and skin cancer treatment at our Oregon office in Clackamas, please contact Dr. Peter Goodkin for a consultation.

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Indications for Mohs micrographic surgery

Mohs micrographic surgery is used for the treatment of:

  • Basal cell skin cancer (carcinoma)
  • Squamous cell skin cancer (carcinoma)
  • Malignant melanoma
  • Other rare forms of skin cancer

Basal cell carcinoma is the most common type of skin cancer. It is very slow-growing and only very rarely leads to death. It does not metastasize (spread elsewhere); however, if left alone basal cell carcinoma can eat away a nose, a lip, an ear, or even an eye (this would usually require many years).

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Squamous cell carcinoma is the second most common type of skin cancer. It's responsible for 8,000—10,000 deaths annually in the United States alone. In sun-exposed areas, squamous cell carcinomas usually grow slowly, but some can grow more quickly. The lip and ear are especially vulnerable spots for squamous cell carcinoma.

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The Mohs surgery procedure

Mohs surgery at our Clackamas, Oregon office is scheduled on Wednesdays and Thursdays. Here is the procedure:

  • A local anesthetic is used to thoroughly numb the area of the cancer. We don’t go forward until the surgical area is completely numb!
  • Once the area is numb, the soft part of the cancer is scraped away (the main part of the cancer is often softer than the surrounding skin).
  • A thin layer of tissue (about 2–3 mm thick) is then surgically removed from around and under the area.
  • Green, black, blue, and red dyes are added so that later, under the microscope, Dr. Goodkin can tell top from bottom and left from right. A diagram is drawn showing the color codes.
  • The area is bandaged.
  • You are free to wait in the waiting room, or to enjoy a cup of coffee or a pastry next door at the Milky Way Café.
  • Initial results are usually back within 30–45 minutes.

The tissue removed is frozen, sliced into thin layers, placed on glass slides, and stained. Dr. Goodkin then examines the slides under a microscope. If there is any remaining cancer, he marks its location in red pencil on a diagram of the skin cancer area.

  • You return to the surgery room. Instead of more tissue being removed all the way around and under the wound, tissue is removed just from the place or places that are still positive.
  • You are bandaged and wait again.
  • When the next set of slides is ready, Dr. Goodkin examines them; if any cancer remains, he marks its location.
  • You come back in and, once again, more tissue is removed just from those areas.

The process could go all day long — which would be unusual. It's much more likely that you'd be finished before lunchtime. It all depends on the cancer and how far it extends into the normal-appearing tissue.

When the procedure is finished, we can tell you (with as much certainty as anyone can have) that all of the cancer is gone. Mohs surgery is the method that offers the highest possible chance of cure. Ask Dr. Goodkin about your chances of recurrence. For more information regarding Mohs skin cancer treatment in Oregon, contact our dermatology office today.

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After the surgery

We haven’t removed any more tissue than was necessary to remove the cancer. However, there is an ugly hole where the cancer used to be. The final size, shape and depth of the hole is determined by the roots of the cancer. The hole can be allowed to heal by itself, or it can be repaired with plastic surgery techniques. We decide which plastic surgery method to use after we see the final wound.

Plastic Surgery Repair

  • Sometimes, depending on size and location, the wound can be stitched up in a straight line.
  • Sometimes a skin graft is necessary (borrowing skin from elsewhere and sewing in a patch).
  • A skin flap is sometimes the best way (using and rearranging the skin next to the wound, while maintaining its blood supply).

Dr. Goodkin is a dermasurgeon, certified by the American Board of Dermatology, and he will be happy to discuss these options with you.

These are the risks of any minor surgery: bleeding, infection, and scarring. There are also risks related to the specific location of the tumor, and risks related to your specific health problems. Dr. Goodkin will discuss all of these risks with you.

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Before-surgery precautions

A few simple precautions are advised before undergoing Mohs skin cancer treatment at our Oregon office near Portland. Please tell Dr. Goodkin about all of the medications you are taking.

For two weeks before surgery, avoid:

  • Aspirin (or anything with aspirin in it)
  • Vitamin E
  • Gingko Biloba
  • Ginseng
  • Feverfew, garlic or ginger capsules

For two days before surgery, avoid:

  • Ibuprofen (Motrin, Advil)
  • Other arthritis drugs
  • Ephedra

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Wound care after Mohs surgery

Wound care after Mohs surgery is different depending on whether you have stitches or not. You will be given detailed written instructions according to your wound care needs.

If You Have Stitches

  • The bandage is kept clean and dry until we remove the stitches, which would be five to seven days after the surgery for wounds on the face. This usually means you can’t shampoo in the shower. You can shower from the neck down and possibly do your hair backwards in the sink or at the beauty parlor.
  • To decrease the chance of a black eye after facial surgery, we often recommend that you go home, sit up in a chair, and hold an ice pack on the surgical area on and off (mostly on) until bedtime that night.
  • No heavy bending or lifting for two to three days.
  • Avoid aerobic exercise for two weeks.

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If You Have No Stitches

  • Cleanse the wound twice daily. We suggest moistening a cotton-tipped applicator with 0.9 percent saline solution (easily found as contact lens solution) and gently rubbing (not rolling) the wound with it.
  • Cut out a circle of a non-stick wound dressing (Telfa®, Release™, or the like), and cover it with Vaseline®; apply it with paper tape to the wound.
  • It’s OK to get the wound wet in the shower.
  • Exercise is fine.

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Follow-up after Mohs surgery

After the healing from your Mohs surgery at our Clackamas, Oregon facility is complete, you need to be checked:

  • Every three months the first year
  • Every six months the second year
  • Yearly until five years have passed

These follow-up visits are required mainly for three reasons:

  1. To check for recurrence of the cancer (this is unlikely but still possible)
  2. To work on prevention (including sun protection and the treatment of any pre-cancerous spots that may appear)
  3. To detect any new skin cancer at an earlier stage. Getting a skin cancer gives you a 50 percent chance of growing another one in the next three to five years.

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Mohs skin cancer treatment for the Oregon area patients of Dr. Goodkin is a simple and very effective way to deal with your skin cancer. Don't hesitate to ask questions and get reassurance from Dr. Goodkin; he's happy to address all your concerns. Contact us today about Mohs surgery at our Oregon office to get started.