In Part 2 of an interview on skin cancer with Dr Angeline Yong from Angeline Yong Dermatology, we learn more about symptoms and treatment options for the disease.
Q: How can we spot a potential skin cancer? What are its symptoms?
There are a lot of things to look out for:
- New moles.
- Moles that increase in size.
- Moles with borders that appear notched or ragged.
- A spot that is changing in colour, or is varied and pearlescent.
- A spot that becomes raised or develops a lump within it.
- The surface of a mole becoming rough, scaly or ulcerated.
- Moles that itch or tingle.
- Moles or spots that bleed or ooze.
- Spots that look different from the others.
- Lesions or sores that never complete heal.
Q: What should we do if we think we have skin cancer, have an unusual mole, or lesions we are concerned about?
The number rule is: if in doubt, get it checked out! See a dermatologist for a professional opinion as early as possible because the earlier we catch the cancer, the easier it is to deal with.
Q: What are the treatment options for skin cancer?
The treatment options will depend on the type of cancer and stage it has reached.
Cryosurgery: The medical term for freezing, this treatment option is often used for pre-cancerous actinic kerastoses and some small, early-stage cancers. Liquid nitrogen is used to freeze and kill the cancer. The dead tissue then sloughs off when it thaws.
Excisional surgery: This is one of my specialties. Mohs procedures are good for dealing with larger, recurring or difficult-to-treat skin cancers, which may include basal and squamous cell carcinomas. I often use this technique on the face to conserve as much skin as possible and reduce scarring. Mohs surgery involves removing the skin growth layer by layer, examining each layer under the microscope, until no abnormal cells remain. This procedure allows cancerous cells to be removed while preserving as much of the surrounding healthy skin as possible.
Curettage and electrodesication: This involves excising most of a growth by scraping away layers of cancer cells using a device with a circular blade called a curette and then using an electric needle to destroy any remaining cancer cells.
Photodynamic therapy: A treatment that destroys skin cancer cells with a drug that is very sensitive to a special kind of light. When exposed to that special light, the drug produces a chemical reaction that kills the cancer cells.
Radiotherapy: Uses high-powered beams, such as X-rays, to kill cancer cells. Radiation therapy is an option when the cancer cannot be completely removed with one of the aforementioned surgical procedures, or if the patient may not be suitable for surgery.
Chemotherapy: In chemotherapy, chemicals or drugs are used to kill cancer cells. For cancer cell limited to the top layer of skin, topical creams or lotions containing anti-cancer agents may be applied directly to skin. Systemic chemotherapy involves administering drugs orally or intravenously to treat cancers that have spread to other parts of the body such as the lymph nodes.
Biological therapy: Also known as immunology, this therapy is also used when the cancer has spread. It involves training the body’s immune system to kill cancer cells. Cancer cells often disguise themselves to hide from the body’s immune system and immunology treatments expose the cells or destroy their disguises, leaving them vulnerable.
Q: What can we do to reduce our chances of developing skin cancer?
Limit your exposure to sunlight and ultraviolet radiation by applying a high factor sunscreen, wearing hats and long-sleeved clothes, staying in the shade, etc. Never, ever use tanning beds and don’t smoke; quit if you do. If you have moles, keep a close eye on them and get a family member or friend to help you check them on a regular basis. Lastly, if you have a close family member who has had skin cancer, it could mean you at higher risk of developing skin cancer too, so do all of the above if you have any potential risk factors. If you have a fair skin type, it would be prudent to have a check-up with a dermatologist every year or two just to be extra safe.
Dr Yong from Angeline Yong Dermatology is an experienced and accomplished Singapore-based dermatologist accredited by the Ministry of Health. Prior to starting her own practice, Dr Angeline Yong was the founding consultant and lead of the hair transplant service of the National Skin Centre. She has in-depth experience and all-round expertise in dermatological surgery – from laser and follicular restoration, Mohs Micrographic Surgery, to other cold steel, scalpel techniques – and was the only dermatologist dual-accredited to perform both Mohs Micrographic Surgery and hair transplantation in the National Skin Centre.