Skin Cancer

Skin cancers are malignant growths on the skin. The commonest skin cancers are basal cell carcinoma, squamous cell carcinoma and malignant melanoma.

Basal Cell Carcinoma (BCC)

Basal Cell Carcinoma (BCC) is a slow growing skin cancer. It usually presents as a painless but persistent growth on the skin. Sometimes, the surface may have an ulcer and the edges may be raised and have a ‘pearly’ appearance. In Asians, the basal cell carcinoma may be pigmented. It commonly affects the face and chronic sun exposure may predispose to its development. Untreated, the cancer can gradually enlarge and destroy the surrounding skin and underlying structures such as muscle and bone.

Malignant Melanoma

Malignant Melanoma is a cancer of the pigment cells (melanocytes) of the skin, and is a dangerous type of skin cancer. It often presents as a dark brown or black skin growth or ulcer. It may look like ordinary moles. But unlike the common mole:

 

1. It grows more rapidly.

2. Its surface may have varying shades of colour.

3. Its surface may be thick and irregular.

4. Its margin may be irregular.

5. It may show features of change over time.

 

Melanomas may occur spontaneously, or they may arise from a pre-existing “normal” mole. People born with large moles (giant congenital nevi) or have positive family histories of melanoma are at increased risk. Melanoma is more common among Caucasians and less common in Asians and people with a darker skin type. It can occur on any site, including the nails, the palms and soles. Excessive exposure to the sun and a history of sunburns are predisposing factors.

 

Melanomas have a tendency to spread (metastasise) to surrounding lymph nodes or other parts of the body, leading to morbidity and mortality. As such, early detection and treatment of this condition is important.

Squamous Cell Carcinoma (SCC)

Squamous Cell Carcinoma (SCC) often presents as a firm irregular fleshy growth and is more commonly seen on the sun exposed skin. It can grow and increase in size and it often may have an overlying ulcer. If untreated, the cancer may spread to the surrounding lymph nodes.

 

Squamous cell carcinoma usually appears in elderly patients. Chronic sun exposure is an important contributing factor in the development of this type of skin cancer.

 

Some people who have had chronic arsenical exposure in the past may also develop these cancers later in life.

 

A pre-malignant stage (early stage) of this is Bowen’s Disease. It commonly presents as a scaly plaque which does not respond to treatment.

Any skin lesion that is progressively enlarging should be assessed and examined by a trained doctor. Contrary to popular belief, malignant skin tumours do not always cause pain, so this symptom is not reliable. If a skin cancer is suspected, your doctor may advise and order a biopsy under local anaesthetic for microscopic examination. Upon confirmation of a malignant skin tumour, the doctor can assess and advise the best option for treatment. Alternatively, the entire lesion can be removed at the outset and sent for examination and confirmation of cancer.

The most common form of treatment of a malignant skin tumour is excision, a process which involves removing the entire skin lesion. In certain situations whereby complete excision may not be feasible, other forms of therapy such as radiotherapy, photodynamic therapy (PDT), ablative therapy e.g. electrocautery, cryotherapy or topical therapy (creams) or may be used.

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