Skin Cancer Signs

Skin Cancer Signs: How To Spot Them Early

Noticed random patches on the skin, or some skin discoloration not caused by any other known factors? Well, they might or might not be signs of skin cancer.

Skin cancer is a common disease and yet it can be prevented. In Singapore, skin cancer ranks 6th in male cancers and 7th in female cancers.

According to the Trends in Cancer Incidence in Singapore 2014-2018 (Singapore Cancer Registry), there were a total of over 3,500 reported skin cancer cases – where 1,975 cases were men, and 1,568 cases were women respectively. 

Everyone has some risk of developing skin cancer, but you may have a higher risk if you have light skin and a lot of moles or freckles. If you already know what to look for, you can easily spot warning signs of skin cancer and detecting them early. Finding it early, when it’s small and has not spread, makes skin cancer much easier to treat.

It is therefore very important to get to know your own skin so that you can recognise any signs of change that may be a potential skin cancer or pre-cancerous skin legion.

What is Skin Cancer?

Skin cancer is the abnormal growth of skin cells. It will develop when there are mutations in the DNA of skin cells, and this can cause the cells to quickly grow out of control and turn into a huge group of cancer cells that attack the existing healthy cells.

Skin cancer can be categorised into two main types:

  • Non-Melanoma Skin Cancers (NMSC)
    • Basal cell carcinoma: skin cancer that most often develops on areas of skin exposed to the sun, such as the face
    • Squamous cell carcinoma: skin cancer that develops in the squamous cells that make up the middle and outer layers of the skin.
  • Melanoma Skin Cancer: more serious type 

There are also other rare forms of skin cancer.

Symptoms of Skin Cancer

Changes in the skin are the main warning sign for skin cancer. Most skin cancers usually develop on areas of the body that are more exposed to the sun. These include the face, arms, hands, neck, scalp and lower legs. 

However, do not mistaken, some signs of skin cancer can also develop in areas that are not commonly exposed to the sun – which involves the genitals and existing moles. One can almost always find signs of sun-induced damage on the surrounding skin, such as irregular pigmentation and wrinkles.

Symptoms of skin cancer can include certain changes in the skin. Here are some of the types of skin cancer:

  • Basal cell carcinoma (Makes up 60% of all skin cancer)
  1. Type of skin cancer that most often develops on areas of skin exposed to the sun, such as the face.
  2. 2 or more of following features may be present:
    1. Skin coloured nodule (growth of abnormal tissue) with slight pigmentation and tiny blood vessels, frequently develops into or becomes affected by an ulcer.
    2. Red and thin plaque.
    3. Flat, indurated whitish or reddish scar/ a reddish, raised patch or irritated area that may crust or itch, but rarely hurts.
    4. An open sore that bleeds, oozes, or crusts and remains open for several weeks.
    5. A shiny pink, red, pearly white, or translucent bump/ pink growth.
    6. A scar-like, white, yellow, or waxy area, often with a poorly defined border
  3. If left untreated, some may extend and destroy surrounding structures such as the nose or eyelid.
  • Squamous cell carcinoma
  1. A common form of skin cancer that develops in the squamous cells that make up the middle and outer layers of the skin.
  2. Is treatable and usually not life-threatening, though it can be aggressive.
  3. Wart-like growth.
  4. persistent, scaly red patch with irregular borders that may bleed easily.
  5. Red, scaly nodule that may develop into or becomes affected by an ulcer.
  • Melanoma
  1. A form of skin cancer that begins in the cells (melanocytes) that control the pigment in your skin.
  2. Brown to black patches or plaques with irregular borders
  3. An existing mole or birthmark that changes in shape, size, texture and colour

Here are some ways to prevent skin cancer by spotting the signs early. 

Skin cancer usually forms due to too much exposure to ultraviolet (UV) radiation from the sun. Another common cause is exposure to artificial UV radiation from tanning beds. 

Skin cancer can be hard to spot, but it is important to keep track and watch for changes in your moles. Most skin cancers don’t cause painful symptoms until they grow quite large. 

When skin cancer does cause pain, it means that the cancer spreads along a nerve, where it can cause itchiness, pain, tingling, or numbness.

What to look out for:

  • Size
  • Shape
  • Colour
  • Itching or bleeding in affected spots
  • Dark spots
  • Different appearance of existing and new moles

Dermatologists often advise to use the “ABCDE rule” to look for some of the common signs of melanoma:

Asymmetry: A standard mole is small and circular. One part of a mole or birthmark doesn’t match the other(s). A melanoma lesion looks odd and strange, like a splotch of paint.

Border: Non-cancerous moles have even borders, while others have edges that are irregular, ragged, notched, or blurred.

Colour: The colours of the mole/ patches/ marks are not the same all over and may include shades of brown or black, sometimes with patches of red, pink, white, or blue. If the bump on your skin consist of multiple shades, this could be a warning sign of melanoma.

Diameter: If something seems off/ odd about your mole, you might want to measure it. Some lesions caused by melanoma are usually 6 millimetres. Pay attention if the spot is larger than a quarter inch across – about the size of a pencil eraser – although melanomas can sometimes be smaller than this.

Evolving: A healthy mole doesn’t change over time. However, try to have regular skin checks. Some prompts that you might want to check is if the mole is changing in size, shape, or colour.

If there are any changes in your skin, or if you have a suspicious mark on your skin even if it doesn’t hurt, always get it checked by a doctor right away. 

Risk Factors of getting Skin Cancer

While we have listed some of the symptoms of skin cancer and although anyone can develop skin cancer, we have some individuals that are more prone to the risk of getting skin cancer than others. 

These will be the fair-skinned individuals. They are the people who have less melanin in their skin and are at higher risk because their bodies produce less protection against UV rays. These people will also get sunburn easily and will also more likely to develop skin cancer. 

People with red or blond hair also have higher risks of getting skin cancer.

  • Too much sun/ UV exposure
  • People who work outdoors, regularly use tanning beds or sunbathe frequently are more prone to skin cancer, what more to those who aren’t using a sunscreen lotion.
  • If you have experienced or suffered severe sunburns in your life, including blistering or bleeding skin, you may be at higher risk of developing skin cancer. Research shows that even one blistering sunburn during childhood or adolescence can nearly double a person’s chance of developing melanoma during their lifetime.
  • Existences of moles
  • If you have many moles on your skin, you are at an elevated risk of skin cancer. 
  • Moles that are larger and in irregular shapes are also more likely to become cancerous.
  • A family history of skin cancer
  • Radiation Exposure
  • Radiation treatments for eczema, acne and other skin conditions can increase the risk of skin cancer, especially basal cell carcinoma.
  • Precancerous skin lesions
  • These skin growths appear as rough, scaly patches on the face, head and hands
  • Previous melanoma
  • Individuals who have had more than one melanoma have an increased risk of again developing melanoma and other cancers, including breast, prostate and thyroid cancer.

How is Skin Cancer diagnosed?

Diagnosing skin cancer will happen in a few steps. When you go to a doctor, he or she will examine your skin and understand your medical history. They will move on to asking when the mark first appeared, if it has changed its appearance; other related questions on the mark can include if the mark is painful or itchy, and if it bleeds.

Your doctor will also touch on your family history and to eliminate or consider any other risk factors. They will then move on to check the rest of the body for any atypical moles and spots and feel the lymph nodes to determine if they are enlarged or not.

Next would be the referral to a dermatologist, or a skin doctor – where they will examine the mark with a magnifying device, take a small sample of the skin and send it to the lab for further checking.

Treatment for Skin Cancer

The most common treatment for skin cancer is surgery, where the cells are surgically removed at the dermatologist’s office. In most cases of skin cancer, this will cure the disease. 

Depending on the amount of skin that needs to be removed, it is a quick procedure. There will be no anaesthesia, but the skin will be numbed.

For bigger skin lesions, or marks with unclear borders, or aggressive cancers, they will require a more extensive type of surgery where it is to remove the cancerous tumour and possibly the lymph nodes as well. This involves microscopic analysis of the tissue cells that have been removed while the surgery is taking place.

As for non-surgical options, these may be applicable for certain forms of cancer or depending on the patient profile, it will be recommended accordingly. The options include radiation therapy, topical agents, or even targeted therapy/ immunotherapy for certain advanced skin cancers.

In more complicated cases, the patient will discuss different types of treatments with a multidisciplinary team of doctors to improve chances of curing or controlling the disease.

How to Prevent Skin Cancer?

Here are some suggested actions you can do to reduce the risk of developing skin cancer:

  • Minimise sun exposure from 10 am to 4 pm. This is when the sun is at its peak. The best is just stay out of the sun.
  • Always wear sunscreen with an SPF of at least 30. They might not be able to block off all harmful UV radiation, but it provides a layer of protection compared to none.
  • While outdoors, wear protective clothing and a hat. Wear sunglasses that have UVA and UVB protection.
  • Stop suntanning/ using tanning beds.
  • Check your skin for new or unusual growths/ marks/ moles.

When to see a Dermatologist?

We would advise you to see a dermatologist as soon as possible, especially during your self-examination, you find out some abnormalities to your skin that are worrying. 

Nevertheless, not all skin changes point to skin cancer. Your dermatologist will evaluate your skin changes to identify the cause and prepare a plan of treatment. Remember to also inform your dermatologist about all medications you take. Some medicines can increase the skin’s sensitivity to sunlight, including varieties of antibiotics.

Early detection of skin cancer is the key to proper treatment and survival. Almost all skin cancers respond favourably to treatment – when and if detected early enough.

Here is the checklist that you can inform your doctor:

  • New spots
  • Changes on a mole’s surface/ appearance of a lump or bump
  • Spots that don’t look like the others on your body
  • Sores that don’t heal
  • Redness/ swelling beyond the border of a mole
  • Colour that spreads to the surrounding skin, out of the spot’s border
  • Itching, pain, tenderness in a specific area on your skin

Each type of skin cancer can appear differently. Talk with your doctor when you notice a change in your skin. WhatsDoc has a Skin Forum dedicated to your skin questions, as well as verified dermatologists that can assist in your skin changes and enquiries.

References:

https://www.cancer.org/latest-news/how-to-spot-skin-cancer.html#:~:text=Redness%20or%20new%20swelling%20beyond,of%20a%20lump%20or%20bump

https://www.curemelanoma.org/about-melanoma/melanoma-staging/stage-1/

https://www.mayoclinic.org/diseases-conditions/skin-cancer/symptoms-causes/syc-20377605

https://www.cancer.net/cancer-types/skin-cancer-non-melanoma/symptoms-and-signs

https://www.skcin.org/sunSafetyAndPrevention/howToSpotSkinCancer.htm

https://www.medicalnewstoday.com/articles/323486

https://my.clevelandclinic.org/health/diseases/15818-skin-cancer

https://www.healthline.com/health/managing-skin-cancer/warning-signs

https://www.cancerresearchuk.org/about-cancer/skin-cancer/symptoms/photos

https://www.cdc.gov/cancer/skin/basic_info/symptoms.htm

https://www.singhealth.com.sg/patient-care/conditions-treatments/skin-cancer#:~:text=According%20to%20the%20Trends%20in,in%20female%20cancers%20in%20Singapore.

https://www.ncis.com.sg/Cancer-Information/About-Cancer/Pages/Skin-Cancer.aspx

https://www.healthxchange.sg/cancer/skin-cancer/skin-cancer-types-symptoms