The reality of skin cancer in Singapore
Early detection of skin cancer is key to successful treatment. Know the causes and treatment options
According to the Singapore Cancer Society, skin cancer ranks as the sixth most common cancer for men and the seventh for women in the nation. The skin is the largest organ in the body, yet people often do not consider the risk of skin cancer seriously enough. This underscores the importance of awareness and prevention, even in a country with a generally lower overall cancer rate. Early detection is crucial, as skin cancer is highly treatable and often reversible in its early stages. However, if left untreated, it can become life-threatening.
What causes skin cancer?
The primary cause of skin cancer in Singapore, as well as globally, is exposure to ultraviolet (UV) radiation from the sun. However, certain factors can increase susceptibility to cancerous mutations. It's reassuring to know that skin cancer is more about lifestyle than genetics and is preventable in most cases, so it's important to be proactive and stay aware. Here’s an overview of these key factors:
- Fair or light skin tone
- History of sunburn
- Proneness to developing moles
- Family history of skin cancer
- Long-term use of immunosuppressive medications
- Occupational exposure to ionising radiation (e.g., radiology personnel, airline crews)
- Prolonged exposure to toxic substances such as pesticides and tar
- Exposure to UV radiation from commercial tanning beds and sunlamps
Understanding these factors is crucial for proactive skin protection and early detection, ensuring optimal skin health.
Why is early detection important?
Ignoring suspicious moles or lesions can have severe consequences. If left untreated, skin cancer can progress through stages, becoming increasingly difficult to manage. In advanced stages, it can spread to other parts of the body, significantly impacting survival rates. Early detection is key to successful treatment and a positive prognosis.
Stages of skin cancer:
- Stage 0 (also known as Carcinoma In Situ or CIS): Cancer is confined to the outermost layer of the skin and hasn't invaded deeper layers. Early detection at this stage typically results in a very high cure rate.
- Stage I: Cancer is still small (usually less than 2 cm in diameter) and confined to the skin. Treatment is generally effective, and the prognosis is excellent.
- Stage II: The tumour is larger than 2 cm but hasn't spread to lymph nodes or other organs. Surgery and other treatments remain very effective.
- Stage III: Cancer has spread to nearby lymph nodes but not to distant organs. Treatment becomes more complex and may involve surgery, radiation, and systemic therapies.
- Stage IV: Cancer has metastasized to distant parts of the body, such as the lungs, liver, brain. Treatment focuses on managing symptoms and prolonging life, and the prognosis is less favourable.
Understanding these stages underscores the critical importance of early detection and proactive monitoring of skin changes.
What are the available treatment options?
The good news is that skin cancer, when detected early, has a high chance of successful treatment. Here are some common approaches:
| Type of treatment | What it does |
| Excision Surgery | This is the most common treatment for skin cancer. A skin graft may be required after a wide excision of skin. |
| Curettage and Electrocautery | The tumour is scraped off the healthy skin and the area is heated to destroy remaining cancer cells. |
| Cryotherapy | The cancer cells are frozen off with liquid nitrogen. |
| Lasers | An intense beam of light is used to destroy the cancerous growth with little damage to surrounding skin. |
| Radiation | This is used in areas difficult to treat with surgery. |
| Topical Chemotherapy | A cream or liquid is applied directly to the tumour to kill the cancer cells. |
| Topical Immunotherapy | Creams are applied directly on the affected area of the skin to stimulate the immune system to attack the cancer cells. |
| Photodynamic Therapy | This is a new form of treatment that combines oxygen, light energy and a photosensitizer to generate oxygen radicals that eliminate cancer cells. |
| Moh’s Micrographic Surgery | The cancerous tissue is excised, mapped and examined under the microscope until a clear margin is obtained. |
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Why is prevention the best cure?
Prevention is the best approach to skin cancer because it significantly reduces the risk of developing the disease in the first place. Early preventive measures can save lives and reduce the need for extensive treatments later. Here are some proactive steps you can take:
- Manage Sun exposure: Moderate early morning sun can be beneficial. Sunlight before 10 am provides vitamin D without the intense UV radiation that peaks later in the day. Aim to get out before the UV becomes too harsh but find shade during peak hours (10 am to 4 pm) to reduce your risk of UV radiation exposure.
- Apply sunscreen: Singapore is perpetually sunny all year long, making daily application of broad-spectrum sunscreen with SPF 30 or higher essential, even on cloudy days. Studies show that regular sunscreen use can reduce the risk of melanoma by 50% and squamous cell carcinoma by 40%.
- Dress to protect: Wear long sleeves, pants, hats, and sunglasses to shield your skin. Aim for clothes with fabrics that have a UPF (Ultraviolet Protection Factor) of 30 or higher. According to the Skin Cancer Foundation, clothing can provide substantial protection, blocking up to 98% of UV radiation.
- Inspect your skin: Regularly examine your skin for any changes in moles or lesions. People having more than 50 moles is unusual and should be checked by a doctor as this increases the risk of cancer. Early detection is crucial, as the 5-year survival rate for melanoma when detected early is approximately 99%.
By adopting these habits and staying vigilant, you can greatly reduce your risk of skin cancer.
Remember, early detection is crucial for effective treatment. Schedule regular check-ups with your dermatologist and seek professional advice if you notice any changes in your skin.
Additionally, ensure you have adequate health insurance coverage to protect against the costs associated with cancer treatment. Taking control of your sun exposure, making regular skin checks a priority, and having comprehensive insurance empowers you to protect against skin cancer and safeguard your well-being.
Sources:
- https://www.healthxchange.sg/cancer/skin-cancer/skin-cancer-types-symptoms
- https://archive.is/https://www.straitstimes.com/life/doc-talk-fighting-skin-cancer-with-an-arrayof- tools
- https://www.straitstimes.com/singapore/extra-protection-against-sunburn-needed-as-uv-indexin-s-pore-hits-extreme-levels-on-wed-afternoon
- https://www.uchealth.org/today/am-i-at-a-greater-risk-for-skin-cancer-if-i-have-a-lot-of-moles
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