Common skin cancers in Singapore
Skin cancer is a significant health concern in our tropical climate. According to the Singapore Cancer Registry Annual Report, non-melanoma skin cancer (NMSC) is the sixth most common cancer in males and the seventh most common in females.
While it is more prevalent in the elderly, there is an increasing trend among those under the age of 50 due to cumulative UV exposure.
Types of skin cancer in Singapore
Basal cell carcinoma (BCC)
- Appearance: Often appears as a “pearly” or waxy bump with visible tiny blood vessels, or a non-healing sore that bleeds and crusts.
- Location: Primarily found on sun-exposed areas like the face, scalp, and ears.
- Prognosis: It grows slowly and rarely spreads (metastasizes), but is locally invasive if left untreated.
Squamous cell carcinoma (SCC)
The second most common type, SCC is more aggressive than BCC.
- Appearance: Presents as a firm, red nodule or a flat, scaly, crusted growth. It may also look like an ulcer with a raised border.
- Location: Commonly on the face, neck, and hands.
- Prognosis: High cure rate if caught early, but has a higher risk of spreading to lymph nodes compared to BCC.
Malignant melanoma
- Appearance: Usually looks like a new, dark mole or a change in an existing mole.
- Note: For Asians, acral lentiginous melanoma is more common. It appears on the palms, soles of the feet, or under the nails, areas often overlooked during self-checks.
- Prognosis: Can spread rapidly to other organs; early detection is critical for survival.
The ABCDE rule: Monitoring your moles
Since early detection is life-saving, use this guide to check your skin once a month:
| Guide | What to look out for |
|---|---|
| A – Asymmetry | One half of the mole does not match the other. |
| B – Border | The edges are irregular, ragged, or blurred. |
| C – Colour | The colour is not uniform, with shades such as black, brown, pink, or blue. |
| D – Diameter | The mole is larger than 6mm, about the size of a pencil eraser. |
| E – Evolving | Any change in size, shape, colour, or symptoms such as itching or bleeding should be professionally reviewed. |
Treatment options in Singapore
- Surgical excision: Removal of the tumour with a safety margin of healthy skin.
- Mohs micrographic surgery: A precise technique used for facial cancers to ensure all cancer is removed while preserving maximum healthy tissue.
- Cryotherapy: Freezing early-stage or precancerous lesions (actinic keratosis) with liquid nitrogen.
- Advanced therapies: For metastatic melanoma, hospitals now offer immunotherapy and targeted therapy to significantly improve outcomes.
Prevention in our tropical climate
In Singapore, the UV Index often reaches “Extreme” levels between 11am and 3am.
- Broad-spectrum sunscreen: Use SPF 30 or higher (PA+++) and reapply every 2 hours if outdoors.
- Protective clothing: Wear wide-brimmed hats and UV-protected sunglasses.
- Seek shade: Avoid direct sun exposure during peak hours (10am to 4pm).
- Regular screenings: Consult a dermatologist if you have many moles or a family history of skin cancer.
Sources:
- Singapore Cancer Registry (SCR) Annual Report 2021 https://www.nrdo.gov.sg/publications/cancer
- Singapore Cancer Registry (SCR) Annual Report 2023 https://www.nrdo.gov.sg/publications/cancer
- HealthXchange (SingHealth) – Skin Cancer Statistics https://www.healthxchange.sg/how-to-prevent/skin-cancer/
- National Cancer Centre Singapore (NCCS) – Cancer Statistics https://www.nccs.com.sg/about-cancer/cancer-statistics
This article is reviewed by Dr Christopher Foo, Specialist in Dermatology and Senior Consultant, ">Raffles Skin & Aesthetics Centre
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