Skin Cancer Diagnosis and Management

Skin cancer can develop slowly and may be difficult to recognise in its earliest stages. However, if diagnosis and treatment are delayed, it can become serious and life-threatening. Most skin cancers, when diagnosed early, can be treated successfully.

When should you see a dermatologist about a skin spot?

It is easy to dismiss a new mole or skin change as something harmless, but waiting too long can delay important care. A mole does not need to be painful to be concerning. Warning signs are usually seen in the way it looks, not in how it feels.

You should see a dermatologist promptly if you:

• Develop a new mole that stands out from your other moles in size, shape or colour.
• Notice a mole changing over the course of weeks or months, whether it is growing, darkening or developing irregular edges.
• Notice any ulceration or bleeding, especially if it occurs without injury, as this may be a warning sign of skin cancer.
• Have multiple moles and find it difficult to keep track of them on your own, making professional monitoring important.
• Find a sore, lump or rough patch that fails to heal within a few weeks, especially in sun-exposed areas like the face, arms or scalp.

How is Skin Cancer diagnosed?

Diagnosis involves a series of careful steps carried out by an experienced dermatologist. The aim is to confirm whether a mole, spot or lesion is harmless or needs treatment. This includes:

• Clinical examination – The process begins with a full-body skin check. Our dermatologist will inspect the skin for unusual growths. They will pay close attention to the size, shape, colour and texture of the moles and patches. Meanwhile, spots that bleed, crust or do not heal are examined in greater detail.
• Dermoscopy – A dermatoscope is a magnifying device with a light source. It enables our dermatologist to examine beneath the surface of the skin, such as pigment patterns or blood vessels, for accurate diagnosis.
• Skin biopsy – A biopsy is often performed if a suspicious spot is found. This involves removing a small tissue sample under local anaesthetic. The sample is then analysed in the laboratory. A biopsy provides a definite diagnosis, distinguishing harmless growth from cancerous ones and guides our dermatologists to the next step in treatment.

What are the types of Skin Cancer that we treat?

There are several types of skin cancer and each behaves differently in the way it grows and spreads. Some forms develop slowly and rarely spread, while others can progress quickly and become life-threatening if they are not treated promptly.

Basal Cell Carcinoma (BCC)

Squamous Cell Carcinoma (SCC)

Melanoma

How is Skin Cancer Treated in Singapore?

The choice of treatment depends on several factors, including the type of skin cancer, how large it is, where it is located and your overall health. Some treatments are simple and curative, while others are designed for more advanced cases. Our dermatologist will carefully assess your condition and recommend the most suitable option for you, which may entail:

Surgical Removal

Surgical excision is the most common and effective treatment for many skin cancers. During this procedure, our dermatologist removes the cancer together with a small rim of healthy skin around it. This margin reduces the chance of any cancer cells being left behind. For early-stage cancers, this method is often curative. The wound is then closed carefully to promote healing and reduce scarring.

MOHS Micrographic Surgery

This is a highly specialised technique often used for high-risk BCC or SCC, located on delicate or visible areas such as the nose, eyelids, lips and ears. Unlike standard surgery, MOHS micrographic surgery removes the cancer in very thin layers. Each layer is immediately examined under the microscope. The process is repeated until no abnormal cells are found. This approach allows for the complete removal of cancer while preserving as much healthy skin as possible. It is especially useful for recurrent cancers or those with unclear edges.

Cryotherapy

The treatment is a simple and effective method for some small or superficial skin cancers. However, this treatment is preferred for non-surgical treatment candidates. It works by freezing the abnormal cells with liquid nitrogen, which causes them to blister and eventually fall away as the skin heals. The procedure is quick, usually performed in the clinic and does not require stitches. While cryotherapy is less invasive than surgery, it is only suitable for cancers that are confined to the surface of the skin.

Topical Treatments

Topical treatments involve applying medicated creams directly to the affected area. Some creams work by directly destroying cancer cells, while others stimulate the body’s own immune system to attack them. These treatments are usually prescribed for early, low-risk cancers or precancerous lesions like actinic keratosis. While convenient and non-invasive, topical therapy requires close medical supervision to ensure the cancer responds fully and does not recur.

Advanced Therapies (Immunotherapy and Targeted Therapy)

For cancers that have spread beyond the skin or are more aggressive, systemic treatments may be needed. Immunotherapy works by strengthening the body’s natural defences to recognise and attack cancer cells. Targeted therapy focuses on specific genetic changes within cancer cells, stopping their growth while sparing most normal cells. These treatments are most often used for melanoma. While not always curative, they can control the disease, extend survival and improve quality of life.