Skin Cancer And Surgery

BCC, also known as “Rodent ulcer”, is very common and makes up 80-85% of all skin cancers. It usually develops on the face, nose and around the mouth of fair-skinned individuals. It may just be a red patch or shiny bump or an open sore or ulcer that does not heal.

In Asians, it often presents as a pigmented bump, giving the misleading impression that it is a mole. This type of cancer can be cured easily if treated early with surgery.

Ulcerating BCC of the Upper Lip

Ulcerating BCC of the Right Ear

Ulcerating BCC of the Cheek

Pigmented Nodular BCC of the Forehead

SCC makes up 10% of all skin cancers and usually appears as a scaly patch or raised warty growth. It also has a high cure rate when found and treated early with surgery. In rare cases, if not treated, it can be deadly.

SCC in Situ on the Abdomen

SCC on the Forehead

SCC on the corner of the Mouth/Lip

SCC on the Left Shin

SCC on the Right Palm

Melanoma makes up only 5% of all skin cancers. However, it is the most dangerous form of skin cancer and the leading cause of death from all skin diseases combined. It usually looks like a dark brown or black mole-like lesion with irregular edges. This type of skin cancer can occur anywhere on the body and when found early, can be cured with surgery. If ignored, it spreads throughout the body and can be fatal.

Risk factors of Melanoma include:

• Fair complexion
• Excessive childhood sun exposure and blistering sunburns
• Increased number of atypical looking moles
• A family history of melanoma
• Presence of a changing mole on the skin

One thing worthy of note is that more than 50% of melanomas are believed to arise from the skin without any preexisting pigmented lesion. Early detection of melanoma is our only hope of reducing mortality and achieving a cure. Emphasizing to high-risk patients about the need for regular full body mole / skin cancer check is very important.

Melanoma on the Right Thigh

Advanced Melanoma on the Heel

The warning signs of early melanoma follow the ABCDE criteria for a changing mole:

• Asymmetry
• Border irregularity
• Colour changes
• Diameter greater than 6 mm
• Enlarging rapidly

Superficial spreading melanoma with asymmetry(A), irregular border (B), hyperpigmented colour (C) and diameter greater than 6mm(D). This melanoma below was picked up incidentally.

A “changing mole” is the most common symptom of melanoma. More than 80% of patients with melanoma have observed such warning signs at the time of diagnosis. Symptoms, such as bleeding, itching, ulceration and pain in a pigmented lesion, also warrant evaluation.

If you have a family history or other risk factors of melanoma, it is important for you to schedule regular check-ups with a dermatologist for early detection of melanoma.

In 1998–2000, Dr. Wong Soon Tee was conferred the Commonwealth Fellowship by the Association of Commonwealth Universities (UK) to research on skin cancers at the Imperial Cancer Research Fund, Skin Tumour Laboratory. This has honed his skills and sharpness in picking up early skin cancer and removing them.

Dr. Wong was trained in the UK for Dermatosurgery and Laser surgery and he has screened many patients for suspicious moles over 30 years as a dermatologist in NUH, Raffles Hospital and Assurance Skin Clinics. All his patients with skin cancer have been coming back to him yearly for skin cancer screening.