Skin Cancer: Types, Symptoms, Diagnosis, Treatment

Skin cancer develops from the rapid growth and division of skin cells. The risk of skin cancer is greatest for skin that are exposed to the sun. However, it may also develop in areas of skin that are rarely exposed to the sun.

What are the types of skin cancer?

The skin - the largest organ in the body - consists of three essential layers. They are the epidermis, dermis, and hypodermis. The epidermis (upper or outer layer) and dermis (lower or inner layer) are the main layers.

There are three main types of skin cancer:

Basal cell carcinoma (BCC): BCC is the most common form of skin cancer, which typically begins in the cells that line the base of the epidermis.
Squamous cell carcinoma (SCC): SCC, which is the second most common form of skin cancer typically develops in areas of the body that are regularly exposed to the sun, such as the face, neck and arms. It begins in the cells that form the epidermis’ outermost layer.
Melanoma (malignant melanoma): Due to its propensity to spread, melanoma is considered to be the most severe type of skin cancer. It originates in the melanocytes that are responsible for producing the pigment melanin. It may develop within an already present mole or quickly manifest as a dark spot on the skin.

What are the risk factors for developing skin cancer?

Here are some of the risk factors for skin cancer:

Overexposure to UV radiation
Moles or freckles
Blonde hair, freckled skin, or light-coloured eyes
Family history of skin cancer
Personal history of skin cancer
Weak immune system
An underlying disease that weakens your immune system
Male above the age of 50 years

What are the signs and symptoms of skin cancer?

Skin changes are the most common indicator of skin cancer. This may be new growth, a non-healing wound, or a change in a mole.

The symptoms of skin cancer differ according to the type of skin cancer.

Squamous cell carcinoma (SCC)
- This cancer is characterised by a firm and pink lump with a rough or crusty exterior. The lump may bleed and be painful, leading to the development of an ulcer.
Basal cell carcinoma (BCC)
- This cancer typically manifests as a tiny, pink, or pearly-white, transparent, or waxy nodule. It may also manifest as a scaly and red patch. There is occasionally brown or black pigment within the spot. The growth may bleed, become crusty, or develop into a painless ulcer.
Melanoma
- Melanoma can form anywhere on the skin, although they tend to begin on the legs in women and the chest and back in men. The neck and cheeks are also prominent locations.
- The warning signs for melanoma include:
  - Asymmetry - The spots on the skin are not identical
  - Border - The edges are irregular, jagged, blurred or notched
  - Colour - The colour is inconsistent
  - Diameter - The diameter of the spot is more than 6 mm
  - Evolving - The spot is changing colour, size, or shape

Consult your doctor if you observe any warning signs of melanoma, a new growth, an unhealed sore, or a change in an existing growth.

How do doctors diagnose skin cancer?

A diagnosis is made based on various investigations. Your doctor will first evaluate your medical history and symptoms prior to conducting a physical examination.

A biopsy may be conducted to confirm skin cancer. A dermatologist will numb the skin, before removing of a sample of abnormal cells for laboratory testing.

Learn more about the different types of screening and diagnostic procedures performed to diagnose skin cancer.

How is skin cancer treated?

The treatment of choice for skin cancer depends on the type of cancer and the stage of cancer. The key treatment options are surgery, chemotherapy, and radiotherapy.

Surgery may be the only treatment needed if the cancer is caught early.
- Wide excision is conducted by numbing the affected area using a local anaesthetic, before removing a tumorous portion along with an area of normal-looking skin. Then, the remaining skin is stitched together, leaving a scar.
- Mohs surgery removes thin layers of skin slowly with the tumours, and each layer is examined under the microscope, until signs of cancer are not seen. This method is often used for cancer that develops on the face, neck, or hands, where the skin layers are thinner.
- Curettage and electrodesiccation involve removal of the cancerous portion carefully with a curette, followed by with electrodes to destroy any remaining cancer cells.
Immunotherapy uses medications given through a vein in your chest or arm to stimulate the immune system to target and destroy cancer cells. It can be used alone or in conjunction with chemotherapy.
Targeted therapy are medications aimed at inhibiting the progression of advanced skin cancer. It is used to treat skin cancer with specific genetic mutations.
Chemotherapy employs potent cancer-killing medications. This treatment can help slow cancer spread and relieve symptoms or shrink tumours.
Radiotherapy uses high-energy radiation to shrink tumours and destroy cancer cells. It is used to relieve symptoms associated with advanced cancer, or sometimes used in the early stages of melanoma when surgery is not possible.

Learn more about the different types of treatment technologies to treat skin cancer.

What can I do to reduce the risk of developing skin cancer?

To reduce the risk of skin cancer, you must avoid exposure to sunlight or any harmful sources of ultraviolet (UV) radiation for an extended period.

Some of the effective ways by which you could reduce the risk of skin cancer are:

Avoid using sunlamps and tanning beds
Avoid being directly exposed to the sun during the day (from 9 AM to 3 PM)
Apply lip balm and a broad-spectrum sunscreen with SPF 30 or higher half an hour before going outside
Wear a hat with a wide brim when participating in outdoor activities
Refrain from sunbathing
Wear clothing that covers your arms and legs

Do I need to get screened for skin cancer?

Skin cancers are most easily treated when they are detected early. It is advised to self-check your skin every month. Check all regions of your skin, including the palms, soles, scalp, nails, ears and back, in a well-lit space using a mirror. Inform your doctor if you notice any spots on your skin that are new or that have changed in shape, size, or colour.

Make an appointment at Pantai Hospitals

Early detection of skin cancer makes it easier to treat the disease with effective and appropriate treatment. A dedicated multidisciplinary team of specialists and oncologists at Pantai Hospitals is available for consultation to provide the best care and assistance to patients through screening, diagnosis, and treatment.

Get in touch with us to book an appointment today if you have any concerns or questions about skin cancer treatment options.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.