Skin cancer is the abnormal growth of skin cells, usually caused by ultraviolet radiation exposure, leading to malignant tumours that can spread if untreated.
Skin cancer begins in the skin’s top or outermost layer – the epidermis. The epidermis is a thin layer that provides a protective cover for the body, keeps skin hydrated, produces new skin cells and contains melanin, which determines skin colour. There are three main types of cells in the epidermis:
What are the types of skin cancers?
Skin cancers are divided into melanoma (MSC) and non-melanoma skin cancer (NMSC).
Rare skin cancers
Skin cancer develops primarily on areas of sun-exposed skin, including the scalp, face, lips, ears, neck, chest, arms and hands. However, it can also form on areas that are rarely exposed to the sun, such as beneath the palm, fingernails or toenails and the genital area.
Melanoma skin cancer
Lopes, J., Rodrigues, C. M. P., Gaspar, M. M., & Reis, C. P. (2022). Melanoma Management: From Epidemiology to Treatment and Latest Advances. Cancers, 14(19), 4652. https://doi.org/10.3390/cancers14194652
Symptoms of melanoma skin cancer may include:
Non-melanoma skin cancer (NMSC)
Symptoms of non-melanoma skin cancers may include:
When should you see a doctor?
You should see a doctor if you notice any changes to your skin that concern you, particularly if a mole or spot changes in size, shape or colour; becomes itchy, painful or bleeds; develops an irregular border or uneven texture; or does not heal after several weeks.
Most skin cancers are preventable. There are several ways to lower the risk of skin cancer:
What causes skin cancer?
Skin cancer develops when skin cells undergo genetic mutations, leading to abnormal and uncontrolled growth. The primary cause is ultraviolet (UV) radiation from the sun or artificial sources like tanning beds, which damages DNA in skin cells over time. This damage disrupts normal cell function, allowing mutated cells to multiply unchecked. In some cases, genetic factors or exposure to harmful substances can also contribute to these mutations, triggering cancerous changes.
What are the risk factors for skin cancer?
Tests and procedures used to diagnose skin cancer include:
In some cases, skin cancer can be diagnosed and treated at the same time. The tumour is removed and tested and you may not need further treatment if the cancer is unlikely to spread.
In other cases, once skin cancer is confirmed, further tests may be needed to determine the extent (stage) of the cancer and the most suitable treatment. The tests may include:
There are a few effective treatment options for skin cancer. In general, treatment for skin cancer depends on the following factors:
The main treatment for skin cancer is surgery. However, some patients may also require other treatments such as chemotherapy, radiotherapy, or cryotherapy.
An individual with cancer should be assessed by a specialist to determine which treatment is best suited for them.
Surgery
If the skin defect after surgery is large, our surgical oncologists will work with a plastic surgeon to provide reconstructive services to restore a natural appearance. The multidisciplinary team will ensure good oncology treatment and aesthetic reconstruction for best outcomes.
Freezing (cryotherapy)
Cryotherapy refers to the use of liquid nitrogen to freeze and destroy pre-cancerous skin lesions (actinic keratosis) and some small early skin cancers. Freezing causes the cancerous tissue to die and form a scab that will naturally fall off in time.
Curettage and electrodessication
This is a simple and quick procedure used to treat basal cell cancers or thin squamous cell cancers. After removing most of the skin growth, the doctor scrapes away layers of cancer cells using a device with a circular blade (curet). An electric needle is then used to destroy any remaining cancer cells.
When necessary, this procedure may be used in combination with cryotherapy (see above).
Radiotherapy/ Radiation therapy
Radiotherapy also known as radiation therapy uses powerful energy beams to kill cancer cells. It may be used when the cancer cannot be completely removed during surgery.
Systemic therapy
For skin cancers confined to the top layers of the skin, topical treatments such as creams or lotions containing anti-cancer agents may be applied directly to the affected area.
However, when the cancer is more advanced or has spread beyond the skin, systemic therapy may be needed. Systemic therapy refers to treatments that circulate throughout the body to target cancer cells wherever they may be. This includes:
For the rest of the body, chemotherapy (injected into a vein or taken orally) can be used to treat skin cancers that have spread to other parts of the body.
In patients with advanced skin cancer, chemotherapy may be used alone or with surgery, immunotherapy and radiotherapy.
Photodynamic therapy
Photodynamic therapy destroys skin cancer cells with a combination of laser light and drugs that makes cancer cells sensitive to light.
How can you prepare for skin cancer surgery?
If surgery is required, your surgeon will perform comprehensive medical assessments including blood tests and scans, to see if you are suitable and advise on the risks involved. Your treatment recommendation is often based on consensus by a group of medical specialists' opinions (the tumour board), who come together to discuss the benefits and limitations of every treatment strategy.
The anaesthesia team will also assess your fitness for surgery and advise you on various aspects of general anaesthesia and pain control after surgery.
Specialist nurses will also provide pre-surgery counselling so that you know what to expect.
What can you expect after skin cancer surgery?
After surgery, you will be given regular outpatient appointments to see your team of doctors. During these appointments, you may have blood tests and scans to check if the cancer recurs.
It is important to follow your doctor's advice, keep to your clinic visits and do the recommended scans, so that timely treatment can be administered if the cancer or other problems occur.
|
The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth.
Department
Dermatology
Department
Plastic and Reconstructive Surgery
Department
Division of Oncologic Imaging
Department
Division of Medical Oncology
Department
Division of Radiation Oncology
Department
Division of Surgery & Surgical Oncology
Department
Dermatology
Department
Department of General Medicine
Department
Department of Surgery
Get to know our doctors at SingHealth Hospitals in Singapore.
Get to know our doctors at SingHealth Hospitals in Singapore. here.