Joshua Farhadian, MD, is a Mohs micrographic surgeon who is skilled in the diagnosis, management, and prevention of skin cancer. He treats patients for a variety of cutaneous malignancies, including basal cell carcinoma, squamous cell carcinoma, atypical fibroxanthoma, and melanoma.
Dr. Farhadian has always been fascinated by the microscope and its ability to magnify objects that are invisible to the naked eye. “As a child, I remember being absolutely captivated by a toy microscope that I had received as a birthday gift,” he says. “Years later, in medical school, I gravitated towards the surgical specialties, as I enjoyed the ability to use my hands and dexterity to heal patients.”
Those two interests led him to pursue a specialization in Mohs surgery, a skin cancer treatment that is unique in that the surgeon both performs the procedure and interprets the pathology under the microscope. Mohs surgery is done in stages that are all completed during a single office visit. The surgeon first removes the skin cancer and evaluates it under the microscope to ensure that the margins are clear. If residual tumor is noted, then additional layers of skin are removed and examined until no cancer remains. By using the microscope to selectively excise cancerous skin, the surgeon is able to preserve healthy tissue and minimize risk of recurrence. The recurrence rate after Mohs surgery is less than 3%, Dr. Farhadian says, adding that it’s rewarding to provide patients with a tissue-sparing treatment that maintains a high cure rate.
Skin cancer prevention is a key aspect of Dr. Farhadian's practice. "Once a patient has been diagnosed with their first skin cancer, they have a 40% chance of developing another skin cancer in the next 5 years," he says. "I work with my patients to ensure that all steps are taken to minimize that risk." In addition to counseling them on sun protection, he prescribes topical creams, oral medications, and light-based therapies to help treat sun damaged skin.