Patients may no longer have to undergo a biopsy to test for skin cancer, as doctors at the National Skin Centre (NSC) in Singapore are now able to make a diagnosis simply by looking at the patient’s skin through a special machine.

The new machine will save patients from the need to come in for a consultation, followed by an appointment for a painful biopsy which involves cutting off a piece of skin for microscopic examination according to Associate Professor Thng.

"Most of all, it saves (them) the stress of waiting for the results,” said Prof Thng.

New advances translate to better treatment and care for patients

The new equipment utilises confocal imaging technology which allows doctors to see whether a patient has skin cancer in up to 95% of cases, thus allowing some to even have surgical removal of the cancer on the spot.

According to Prof Thng, the new technology saves patients from scarring and the cost of a biopsy, which can add up to about S$300. At present, research funding has allowed the use of the new machine for free, and a charge fee has yet to be determined.

The NSC began testing out the machine in December 2014, and started offering services six months after.

Skin cancer among top 10 cancers in Singapore

Skin cancer is one of the top 10 malignancies for both men and women in Singapore, and is approximately three times higher among the fairer-skinned Chinese population, compared to Malays and Indians, where skin cancer barely makes it to the list of common cancers.

The most common subtype of skin cancer in Singapore is the basal cell carcinoma, followed by squamous cell carcinoma, whereas the more aggressive melanoma, though common in the West, is rare in the country.

Between 2010 and 2014, there were 3,089 new cases of skin cancer reported in the country, which is a huge jump from 1,813 cases between 2003 and 2007 according to Dr Eileen Tan, a dermatologist from Mount Elizabeth Novena Hospital.

While the rise in rates may be due to the ageing population, as skin cancer can take years to develop and surface, Dr Tan posited that excessive exposure to the sun may also be a cause.

"The hypothesis is mainly excessive exposure to harmful UV rays from the sun, increased indoor tanning, and lack of regular sun protection," she said.

This is in addition to the recent discovery by local scientists of mutations in the gene NLRP1 that causes defect in patients’ immune systems, which in turn causes misdirected immune response in the skin and increases their risks of developing skin cancer.

According to the researchers, the discover provides pathways for advancements in the treatment of skin cancer that is resistant to surgery, as well as other chronic skin conditions related to the immune system as well, such as eczema and psoriasis.

"This is a significant illustration of how studying rare diseases can benefit the research on common ailments afflicting the general population," said lead researcher Dr Bruno Reversade of A*Star's Institute of Medical Biology. MIMS

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