Skin Cancer: Types, Symptoms, Diagnosis, Treatment

Skin cancer occurs when the skin cells begin to grow rapidly and multiply uncontrollably. Skin exposed to the sun is most susceptible to developing skin cancer. However, this cancer can also develop on parts of the skin that is rarely exposed to the sun.

The World Health Organization reported 3 cases of melanoma in every 1000 new cases of cancer among Malaysians in 2020. Although skin cancers are relatively uncommon, early detection and treatment are crucial as the cancer cells can grow deep into the nerves and bones, leading to damage and disfigurement.

Types of skin cancer

There are three main types of skin cancer:

• Basal cell carcinoma (BCC) is the most common type of skin cancer, usually as a result of long-term frequent sun exposure or indoor tanning.
• Squamous cell carcinoma (SCC) is the second most common type of skin cancer, usually found on skin that is frequently exposed to the sun, such as the rim of the ear, face, neck, and arms.
• Melanoma (malignant melanoma) is the most serious skin cancer because it tends to spread. It can develop within an existing mole or appear suddenly as a dark spot on the skin.

Risk factors of skin cancer

The risk factors for skin cancer are as follows:

• Overexposure to UV radiation
• Moles or freckles
• Blonde hair, freckled skin, or light-coloured eyes
• Family history of skin cancer
• Personal history of skin cancer
• Weak immune system
• History of sunburn
• Exposure to radiation through radiation treatment for skin conditions

Signs and symptoms of skin cancer

Squamous cell carcinoma

This cancer is characterised by a firm and pink lump with a rough or crusty exterior. The lump may bleed and be painful, leading to the development of an ulcer.

Basal cell carcinoma

This cancer typically manifests as a tiny, pink, or pearly-white, transparent, or waxy nodule. It may also manifest as a scaly and red patch. There is occasionally brown or black pigment within the spot. The growth may bleed, become crusty, or develop into a painless ulcer.

Melanoma

Melanoma can form anywhere on the skin, although they tend to begin on the legs in women and the chest and back in men. The neck and cheeks are also prominent locations.

The warning signs for melanoma include:

• Asymmetry - The spots on the skin are not identical
• Border - The edges are irregular, jagged, blurred or notched
• Colour - The colour is inconsistent
• Diameter - The diameter of the spot is more than 6 mm
• Evolving - The spot is changing colour, size, or shape

Consult your doctor if you observe any warning signs of melanoma, a new growth, an unhealed sore, or a change in an existing growth.

Diagnosis of skin cancer

A diagnosis is made based on various investigations. Your doctor will first evaluate your medical history and symptoms prior to conducting a physical examination.

A biopsy may be conducted to confirm skin cancer. A dermatologist will numb the skin, before removing of a sample of abnormal cells for laboratory testing.

Learn more about the different types of screening and diagnostic procedures performed to diagnose skin cancer.

Treatment options for skin cancer

The treatment of choice for skin cancer depends on the type of cancer and the stage of cancer. The key treatment options are surgery, chemotherapy, and radiotherapy.

• Surgery may be the only treatment needed if the cancer is caught early.
• Wide excision is conducted by numbing the affected area using a local anaesthetic, before removing a tumorous portion along with an area of normal-looking skin. Then, the remaining skin is stitched together, leaving a scar.
• Mohs surgery removes thin layers of skin slowly with the tumours, and each layer is examined under the microscope, until signs of cancer are not seen. This method is often used for cancer that develops on the face, neck, or hands, where the skin layers are thinner.
• Curettage and electrodesiccation involve removal of the cancerous portion carefully with a curette, followed by with electrodes to destroy any remaining cancer cells.
• Immunotherapy uses medications to stimulate the immune system to target and destroy cancer cells.
• Targeted therapy target cancer cells and temporarily shrink cancer.
• Chemotherapy employs potent cancer-killing medications. This treatment can help slow cancer spread and relieve symptoms or shrink tumours.
• Radiotherapy uses high-energy radiation to shrink tumours and destroy cancer cells. It is used to relieve symptoms associated with advanced cancer, or sometimes used in the early stages of melanoma when surgery is not possible.
• Cryosurgery uses an extremely cold substance, for example liquid nitrogen, to kill the cancer cells in squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). It can be an option when SCC is detected early, or if surgical removal is not feasible.

Learn more about the different types of treatment technologies to treat skin cancer.

Prevention of skin cancer

Avoid exposure to sunlight or any harmful sources of ultraviolet (UV) radiation for an extended period to reduce the risk of skin cancer.

Other effective ways to reduce the risk of skin cancer include:

• Avoid sunlamps and tanning beds.
• Avoid direct exposure to the sun during the middle of the day (from 9 AM to 3 PM).
• Apply lip balm and sunscreen with broad-spectrum SPF 30 or higher at least half an hour before sun exposure.
• Wear a wide-brimmed hat while doing outdoor activities.
• Wear dark, tightly woven clothing that covers the arms and legs.

Detect to Protect!

It is possible to detect skin cancers early, at a stage where they are easiest to treat.

Skin self-exam to check your skin is recommended, preferably once a month. In a well-lit room using a mirror, check all areas of your skin, including the palms and soles, scalp, ears, nails and back. Alert your doctor if you see any spots on the skin that are new, or changing in size, shape, or colour.

Exam by a healthcare professional is necessary for individuals at high risk of skin cancer, including those with a strong history of melanoma, or had melanoma before. Individuals with many moles may be advised to take full-body photos to keep track of these moles over time. Discuss with your doctor on the frequency for skin examination.

Make an appointment at Gleneagles Hospitals

If you are experiencing any of the symptoms of skin cancer, get in touch with us to find out more about our Oncology Services at your nearest Gleneagles Hospital.

Gleneagles Hospital works with oncologists to assist patients through cancer treatment. The caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care.