Dr Dennis T H Lim
Head and Neck General SurgeonMBBS (Singapore), M.Med (Surgery), FRCS (Edinburgh), FRCS (Glasgow), FAMS (Surgery)
Melanoma is a type of skin cancer that often begins as a subtle change in the skin and develops quickly if not detected early. Recognising changes in your skin and seeking timely care can make a significant difference in treatment outcomes. Surgery is often the first step, and depending on the situation, other therapies may follow. Understanding your options can help you feel more informed and prepared as you explore the treatment process.
Melanoma is a form of skin cancer that begins in the cells that produce melanin, the pigment that gives skin and hair their colour. While defined as the most serious type of skin cancer, melanoma is easily curable when detected early, having a 5-year survival rate of up to 99%. Left untreated, the cancer can spread to the lymph nodes and nearby organs.
Melanoma can affect anyone, but certain characteristics and exposures may increase the likelihood of developing it. Risk factors include:
Repeated or prolonged exposure to ultraviolet (UV) radiation can damage skin cells and increase melanoma risk. A history of severe sunburn, particularly earlier in life, may also increase the risk.
Tanning beds and sun lamps expose the skin to artificial UV radiation and can increase the risk of melanoma.
Having many moles or certain unusual moles may be associated with an increased risk of melanoma. Changes in an existing mole should be assessed.
People with fair or lighter skin have less melanin protection against UV radiation and generally have a higher risk of melanoma. However, melanoma can occur in people of any skin tone.
Having a close family member with melanoma may increase the likelihood of developing the condition.
The risk of melanoma generally increases with age. A weakened immune system may also increase the risk of developing melanoma and other skin cancers.
Melanoma does not occur only in areas regularly exposed to the sun. It can also develop on areas such as the soles of the feet, palms and beneath the nails.
Melanoma is mainly characterised by the appearance of unusual growths and pigmentations, and significant changes in existing moles.
The ABCDE guide is a useful way to assess whether a mole may need further evaluation:
Other warning signs can include itchiness, swelling, oozing or bleeding, and sores that do not heal. Consulting a melanoma doctor in Singapore can provide a professional assessment and confirm whether a mole or pigmentation is cancerous.
While not all cases of melanoma can be prevented, adopting simple habits can help lower your risk:
Melanoma diagnosis today is more accurate and effective thanks to advanced techniques and careful evaluation. Key components include:
Treatment for melanoma depends on its stage, location and whether it has spread beyond the skin. Surgery is commonly used for localised melanoma, while non-surgical treatments may be considered depending on the extent and characteristics of the disease.
Surgery aims to remove the melanoma and, where appropriate, assess or treat nearby lymph nodes. Depending on the individual case, this may involve one or more of the following procedures:
For some melanomas, particularly more advanced disease, treatment may include immunotherapy, targeted therapy or radiation therapy. These treatments may be used alongside or instead of surgery depending on the stage and characteristics of the melanoma, under the care of the appropriate specialists.
The melanoma surgery procedure depends on the size, location and stage of the melanoma. While the exact approach varies, it generally involves the following steps:
Recovery after melanoma surgery depends on the type of procedure and the amount of tissue removed. For wide local excision, most patients recover within 1–2 weeks. During this time, the wound gradually heals. Following wound care instructions and activity guidance is essential for a smooth recovery.
Lymph node dissection typically requires a longer recovery, often 4–6 weeks or more. Because this procedure affects the lymphatic system, patients need closer monitoring and additional precautions to manage swelling and support proper healing.
When you choose Dr Dennis Lim for melanoma care, you can expect:
No. Most melanomas are detected early and can be effectively treated with surgery. Prompt assessment and treatment significantly improve outcomes and long-term prognosis.
Advanced melanoma requires a comprehensive approach. This often involves imaging, biopsies, and careful staging to determine the most appropriate treatment plan tailored to the patient’s condition.
If cancer cells are found in the sentinel lymph node, a more extensive procedure called nodal basin dissection may be recommended. This involves removing all the lymph nodes that drain the area of the primary melanoma. The surgery is both therapeutic and informative, helping guide whether additional treatments are needed.
SPECT (single photon emission computed tomography) combines a conventional gamma camera with CT imaging to produce detailed 3-dimensional images. It allows precise localisation of sentinel lymph nodes, which is crucial for surgical planning.
Not necessarily. A dermatologist can advise which lesions should be excised and which can be safely monitored with regular follow-ups. Decisions are made based on the appearance, size, and risk profile of each lesion.
Costs vary depending on the stage of the melanoma, the complexity of the surgery, and any additional treatments required. A consultation with a specialist can provide a personalised cost estimate and treatment plan.
Melanoma is a type of skin cancer, but not all skin cancers are melanoma. It develops from melanocytes, the cells that produce melanin, and differs from other skin cancers in how it develops and may spread.
The type of surgeon involved depends on the type, size and location of the skin cancer and the complexity of the procedure. Melanoma surgery may be performed by a surgeon with experience in surgical oncology and melanoma management, with other specialists involved where appropriate.
You should seek medical assessment if you notice a new or changing mole, an unusual skin growth, or changes such as irregular borders, uneven colour, bleeding or persistent itching. If melanoma is suspected or confirmed, you may be referred to an appropriate specialist for further assessment and treatment.
Melanoma can often be treated successfully when detected at an early stage and confined to the skin. Surgery is commonly the main treatment for localised melanoma. For melanoma that has spread, treatment may involve immunotherapy, targeted therapy, surgery or other treatments depending on the individual case.
Melanoma is less common in Singapore than some other types of skin cancer and is relatively uncommon compared with rates in many Western populations. However, it can affect people of any skin tone, and suspicious or changing skin lesions should still be medically assessed.
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