Skin Cancer

What is skin cancer?

Skin cancer is an abnormal growth of the skin cells caused by damage to the skin, usually from repeated exposure to the sun’s ultraviolet rays. 1 In Singapore,  skin cancer is the sixth most common cancer for males and seventh most common cancer for females.2

The three main types of skin cancer are; 1

  • Melanoma
  • Squamous cell carcinoma (SCC)
  • Basal cell carcinoma (BCC)

Squamous cell carcinoma and basal cell carcinoma are both non-melanoma skin cancers. Melanomas are among the deadliest cancers, accounting for 75 per cent of all skin cancer deaths.3 Less common kinds of skin cancer include Kaposi’s sarcoma, Merkel cell carcinoma and sebaceous gland carcinoma.3

Stages of skin cancer

Melanoma stages

Melanoma is separated into stages from 0 to IV, which focuses on the depth (or thickness) of the melanoma and if it has spread to the lymph nodes and other organs: 5

  • Stage 0 = less than 0.1mm
  • Stage I = less than 2mm
  • Stage II = greater than 2mm
  • Stage III = the melanoma has spread to the lymph nodes
  • Stage IV = spread to other areas of the body

Non-melanoma stages

If a skin cancer is suspected, your doctor may perform a biopsy under local anaesthetic to determine the stage of the cancer.1

They may also use the TNM system to stage the cancer, TNM stands for: 6

  • Tumour – the degree to which the tumour has affected other tissue.
  • Node – is a measure of whether lymph nodes have been affected.
  • Metastasis – the degree to which the cancer has spread to other organs of the body.

Melanoma signs and symptoms

Melanoma often appears as a dark brown or black skin growth or ulcer. It may look like an ordinary mole, but unlike the common mole: 1

It grows more rapidly and shows features of change over time

Its surface may have varying shades of colour

Its surface may be thick and irregular

Its margin may be irregular

Squamous cell carcinoma signs and symptoms

Squamous cell carcinoma (SCC) appears as a firm irregular fleshy growth that tends to grow quickly over a few weeks or months.1

Symptoms include:6

A thick, scaly red spot

A lump that grows quickly

Tender or sore to touch

A sore that doesn’t seem to heal

Basal cell carcinoma signs and symptoms

Basal cell carcinoma (BCC) makes up about 60 per cent of all skin cancers.3

Symptoms include: 3

Flat, indurated whitish or reddish scar

Skin coloured nodule with slight pigmentation and tiny blood vessels

and which frequently ulcerates

Thin red plaque

Treatment

Frequently asked questions

How common is skin cancer?

In Singapore, skin cancer is the sixth most common cancer for males and seventh most common cancer for females.2

Should you protect your eyes as well as your skin from the sun?

Yes. Unprotected sun exposure can result in burns to the eyes, just like the skin, resulting in and cancer of the cornea (the outermost layer of the eye) or conjunctiva (thin layer that covers the front part of the eye and the inner surface of the eyelids) and increases the risk of cataracts.

Some measures to protect skin include:
  • Avoiding the sun during the hottest part of the day
  • Wearing long and protective clothing outdoors to protect the skin
  • Wearing a wide-brimmed hat to protect your face and neck
  • Using a sunscreen with a skin protection factor (SPF) of at least 15 daily
  • Wearing sunglasses to protect your eyes
What about the benefits of sun exposure to our skin for vitamin D levels?

There is strong evidence to suggest that vitamin D is essential in making strong bones and maintaining skeletal health.4  Whilst some vitamin D can be obtained from the diet, our main source of vitamin D is from the sun.

The following recommendations have been made for the general healthy population:

  • When the UV index is below 3:
    • It is not recommended to use sun protection
    • It is recommended to spend some time outside in the middle of the day on most days to aid vitamin D production.
  • When the UV index is 3 or above:
    • It is recommended to use sun protection in the form of; wide brimmed hats, sunglasses, sunscreen and shade if you are going to be outside for more than a few minutes

References

For a full list of references, click here.
  1. Skin Cancer. (2019). Health Hub. Retrieved on 27 May 2019 from https://www.healthhub.sg/a-z/diseases-and-conditions/84/skincancer
  2. Singapore Cancer Register Annual Report 2015. (2015). National Registry of Diseases Office
    (NRDO). Retrieved on 27 May 2019 from https://www.nrdo.gov.sg/docs/librariesprovider3/Publications-Cancer/cancer-registry-annual-report-2015_web.pdf?sfvrsn=10
  3. Skin Cancer: Types And Symptoms. (n.d). HealthXchange. Retrieved on 27 May 2019 from https://www.healthxchange.sg/cancer/skin-cancer/skin-cancer-types-symptoms
  4. Position statement – Sun exposure and vitamin D – risks and benefits. Cancer Council Australia. (2016). Retrieved on 15 February 2019 from https://wiki.cancer.org.au/policy/Position_statement_-_Risks_and_benefits_of_sun_exposure#_ga=2.57635938.951883041.1550113604-621921889.1543095613
  5. Melanoma. (2019). Cancer Council. Retrieved on 15 February 2019 from https://www.cancer.org.au/about-cancer/types-of-cancer/skin-cancer/melanoma.html
  6. TNM System (2016). Cancer Council. Retrieved on 15 February 2019 from https://www.cancer.org.au/about-cancer/types-of-cancer/tnm-system.html

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