Detailed resources and procedural information.
Genital and perineal cancers—including squamous cell carcinoma (SCC) and extramammary Paget's disease (EMPD)—can be particularly challenging to treat because the involved tissue is often located in areas where even a small amount of unnecessary tissue removal can have significant functional and cosmetic consequences.
Our approach emphasizes complete cancer removal while preserving as much healthy tissue as possible. When appropriate, we work closely with experienced Mohs micrographic surgeons to precisely identify and remove the cancer while minimizing the amount of normal tissue that needs to be sacrificed.
The goal is not simply to remove the cancer. It is to achieve reliable oncologic control while preserving genital anatomy, urinary and sexual function, and quality of life.
Treatment is tailored to the type, location, and extent of the malignancy.
For many patients, particularly those with EMPD or selected SCCs, Mohs micrographic surgery provides an important tissue-sparing approach. The Mohs surgeon removes the tumor in carefully controlled stages, examining the margins microscopically as the procedure progresses. This allows the diseased tissue to be removed while limiting unnecessary removal of healthy surrounding tissue.
Once the extent of the disease has been established and the cancer has been removed, reconstruction is planned based on the resulting defect and the structures that need to be preserved. This may involve local tissue rearrangement, skin grafting, or more complex genital and perineal reconstruction depending on the size and location of the defect.
Genital reconstruction requires careful planning because the goal is to restore more than appearance. Reconstruction should provide durable tissue coverage while preserving the anatomy and function that matter most to the patient.
Our reconstructive approach prioritizes:
Whenever possible, we use the simplest reconstructive technique that provides a durable result. More extensive reconstruction is reserved for larger or deeper defects where it is necessary to achieve a reliable outcome.
Because these cancers can require removal of tissue from highly functional and sensitive areas, close coordination between the cancer and reconstructive teams is essential. Combining precise tumor removal with thoughtful reconstruction allows us to treat the cancer aggressively while preserving as much normal anatomy and function as possible.