It’s easy to assume that skin cancer is something we’d notice straight away, like a strange mole, a new bump, or something visibly wrong. But not all skin cancers announce their presence so clearly. In fact, some forms can remain hidden for years, slowly developing beneath the surface or masquerading as harmless skin conditions. This silent progression can lead to delays in detection and treatment, which may increase the risk of complications.
People often overlook early signs, especially if the affected area isn’t visible or seems insignificant. Yet, for certain types of skin cancer, these subtle features are exactly what we need to watch for. While some types grow rapidly and are easier to spot, others are incredibly slow-moving and subtle. Basal cell carcinoma (BCC), for example, is the most common type and often grows so slowly that it may not cause concern until it becomes quite large. It might present as a shiny bump, a pink growth, or a sore that doesn’t heal, which are all things that can be misinterpreted as eczema, acne, or even insect bites.
Melanoma, although less common, is the most dangerous form of skin cancer. It can spread quickly if not caught early, but even melanoma may not show obvious symptoms at first. In some cases, it may appear as a flat mole that changes so gradually over the years that no one notices. Because of their deceptive appearance and varied symptoms, certain skin cancers manage to fly under the radar for months, even years.
This is why awareness, coupled with routine skin checks, plays a key role in early detection and better outcomes.
Skin cancer originates from the uncontrolled growth of skin cells, primarily due to DNA damage from ultraviolet (UV) radiation. There are three main types:
1. Basal cell carcinoma: BCCs typically grow slowly and rarely spread to other parts of the body. They are often ignored or taken to be something benign, due to the lack of symptoms in the initial stages. In our experience, patients only start to notice BCCs after they have grown to a certain size and started to form an ulcer on the surface of the bump, resulting in bleeding after minor trauma such as wiping on a towel.
2. Squamous cell carcinoma: SCCs are also usually slow-growing, though rare subtypes such as keratoacanthomas can grow at an alarming rate. Compared to BCCs, SCCs are more likely to spread to lymph nodes or other organs, and may present as scaly patches, open sores, or wart-like growths.
3. Melanoma: This is one of the most aggressive types of skin cancers. Melanomas may appear in previously normal-looking skin or arise within an existing mole. An early melanoma may masquerade as a benign mole. Giveaways may include features such as asymmetry in its appearance, jagged or irregular borders, a chaotic, uneven mix of colours, or other changes in the “mole”’s appearance over time. These signs often go unnoticed, especially in people with many moles. Early detection is vital, as melanoma can spread to lymph nodes and internal organs within months.
Several factors contribute to skin cancer remaining hidden:
1. Location in less visible areas: Spots on the scalp, back, buttocks and under the feet are often not examined by patients or their doctors, and hard to monitor regularly.
2. Subtle appearance: Early lesions may be flat, small, or resemble harmless freckles.
3. Absence of pain: Unlike many diseases, skin cancer often doesn’t cause discomfort in its initial stages.
4. Slow growth: Some cancers can take years to evolve noticeable characteristics.
Because of these factors, periodic skin examinations at a reputable skin clinic in Singapore become invaluable for early discovery of skin cancers. A targeted skin cancer screening plan devised by a dermatologist proficient in the use of dermoscopy (a specialised hand-held tool that can pick up early features of skin cancers) can address these risks.
Letting skin cancer go unchecked can lead to serious consequences. Even slow-growing cancers like BCC can become disfiguring if they penetrate deeper layers of the skin or invade nearby tissues such as bone or nerves. SCC has the potential to spread to lymph nodes, while melanoma, if not caught early, can rapidly metastasise to other internal organs and become life-threatening.
Delayed diagnosis also limits treatment options. Smaller lesions may be treated with minor surgery, topical creams, or cryotherapy. But more advanced cases often require more extensive treatment, such as radiation, chemotherapy, or Mohs surgery in Singapore (a precise surgical technique that removes cancer layer by layer while preserving healthy tissue). Mohs micrographic surgery is especially useful for skin cancers on the face or other sensitive areas such as the hands and feet, where tissue conservation is crucial.
It’s worth noting that most skin cancer is curable if detected early. This fact alone makes the case for staying vigilant and seeking professional advice if you notice anything unusual on your skin.
Total skin examinations are essential in identifying skin cancers in their earliest stages. Regular self-checks at home, under good lighting and with the help of a mirror or partner, allow you to track any changes. Look out for the ABCDEs of melanoma:
Annual or bi-annual checks with a dermatologist are recommended, and offer a more thorough evaluation. Dermatologists are trained to spot suspicious lesions that may escape the untrained eye. If anything unusual is detected, they may perform a biopsy to confirm the diagnosis and recommend appropriate treatment.
Some dermatology clinics in Singapore also offer targeted options like Mohs micrographic surgery, especially for skin cancers in cosmetically or functionally critical areas. Mohs surgery allows surgeons to remove the cancer with extreme precision, reducing the chance of recurrence while preserving as much healthy tissue as possible.
Skin cancer can be a silent intruder that goes unnoticed, progressing without pain, or is often mistaken for something benign. But staying one step ahead is possible. Knowing what to look for, checking your skin regularly, and seeing a dermatologist for professional evaluations can dramatically increase the chances of early detection and successful treatment.
If you’re concerned about a suspicious spot or just want peace of mind, TSN Dermatology Skin Specialist Clinic offers comprehensive skin cancer screening and treatment, including advanced options like Mohs micrographic surgery. Schedule your visit today and take the first step towards safeguarding your skin health.
Ellis, R. R. (2024, March 13). Skin cancer: Melanoma, basal cell, and squamous cell carcinoma. WebMD. https://www.webmd.com/melanoma-skin-cancer/skin-cancer
What are basal and squamous cell skin cancers?: Types of skin cancer. American Cancer Society. (n.d.). https://www.cancer.org/cancer/types/basal-and-squamous-cell-skin-cancer/about/what-is-basal-and-squamous-cell.html
Skin cancer – diagnosis & treatment. Parkway Shenton. (n.d.). https://www.parkwayshenton.com.sg/conditions-diseases/skin-cancer/diagnosis-treatment
What to look for: Abcdes of melanoma. American Academy of Dermatology. (n.d.). https://www.aad.org/public/diseases/skin-cancer/find/at-risk/abcdes
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