Skin cancer is the uncontrolled growth of abnormal skin cells to form malignant tumours and in Singapore, it is the sixth and seventh most common cancer among men and women respectively.
More skin cancer patients are being diagnosed at a younger age here, with the National Cancer Centre Singapore (NCCS) seeing a 60 per cent increase in the number of new skin cancer patients under the age of 50 between 2013 and 2017.
While the spike in numbers could be due to increasing health-seeking behaviour and easy access to healthcare, other factors like lifestyle and low awareness of safe sun habits may play a part too. For instance, younger adults can get skin cancer if they lead a lifestyle of excessive sun exposure without adequate protection, for example, by partaking in outdoor or water sports, or travel to high altitude areas, according to Dr Natascha Ekawati Putri, who is an associate consultant at the Division of Surgical Oncology, NCCS and a NUS Medicine clinical lecturer.
“Based on my experience, Singaporeans tend to have low sun protection awareness or do not usually treat sun protection as a high priority,” said Dr Natascha.
Studies suggest that getting a sunburn, which is a clear sign that the DNA in skin cells has been damaged by excessive ultraviolet (UV) radiation, just once every two years may triple the risk of skin cancer. Therefore, people of all ages, including children should protect their skin from excessive exposure to UV rays, which is also the only preventable risk factor for skin cancer. Infants under the age of six months should be kept out of the sun as they do not have sufficient melanin to protect them from the damaging effects of UV rays, and parents are advised to use a broad-spectrum sunscreen for babies that are older than six months. Sun protection is also needed for those who rarely head outdoors, on cloudy days or during wintertime travel.
Apart from excessive sun exposure, many other risk factors of skin cancer exist, such as age, family history and history of atypical moles. Individuals with a first-degree relative diagnosed with melanoma, a type of skin cancer, have a 50 per cent higher risk of developing the disease than those without a family history, according to Dr Grace Tan, a consultant from the Division of Surgical Oncology, NCCS and a clinical lecturer at NUS Medicine.
More moles on the body also represent a greater risk of melanoma, particularly atypical moles, which are also known as dysplastic nevi and are usually larger in size, irregular-shaped and tend to have an uneven colour.
Early detection and treatment of skin cancer can cure most non-melanoma skin cancers. Skin cancer treatments vary, from the surgical removal of the skin cancer to curettage or electrocautery, whereby the tumour is scrapped off healthy skin and the area is desiccated to destroy remaining cancer cells. A newer therapy called photodynamic therapy can also be used, which combines oxygen, light energy and a photosensitiser to generate oxygen radicals to eliminate cancer cells.
“At an early stage, surgery is usually all that is needed for treatment,” said Dr Tan. When skin cancer advances to other parts of the body, simply removing the affected mole will not suffice, and will require more extensive surgery or additional treatment like chemotherapy, radiation and immunotherapy to achieve control.