Skin cancerSkin cancer is not something one comes across commonly in India. But none-the-less the risk of developing this form of cancer is still a possibility. Here are the top 10 facts about the disease by Dr. J.B. Sharma, Senior Consultant, Medical Oncology, Action Cancer Hospital, Delhi.

Fact #1: Skin cancer is uncommon yet possible in India

It is not very common in India and constitutes approximately less than 1% of the total number of cancers cases. You can also read about how sun tanning is one of the leading causes of skin cancer.

Fact #2: The symptoms are easy to recognise yet difficult to discern

 Although the condition is uncommon, one should always be cautious about any abnormality in any area of the skin like:

  • Pink or black spots
  • Redness and swelling
  • Peeling
  • Bleeding or development of an open sore
  • Thickness

Skin changes may also occur due to damage caused by the sun. Some people — especially those with fair skin — can get crusty, coarse, or bumpy spots. These spots are called ‘actinic keratoses’, and are often found on the face, ears, arms or scalp, and can sometimes turn into skin cancer.

These symptoms are common missed out or thought to be due to some sort of skin ailment. This tends to delay treatment and diagnosis. 

Read about the common symptoms of cancer.

Fact # 3: The causes of the cancer are many, but moles are the most dangerous precipitative factor

There are both environmental and genetic risk factors:

Familial or hereditary factors: Roughly 10 percent of melanomas are familial i.e. they occur in the family members. There are multiple genes responsible for this. One of these is CDKN2A, cyclin-dependent kinase inhibitor 2A mutation.

People with Dysplastic Nevi:  Dysplastic nevi is a condition where a person has a mole-like growth on their skin that has irregular borders and varies in colour. It’s cause is yet unknown but individuals with dysplastic or atypical nevi carry a 20-fold more risk of developing malignant melanoma compared to the general population. Approximately 10 to 20 percent of diagnosed melanomas arise within atypical nevi.

People with high nevus count (large number of moles) - There is a strong connection between high nevus counts (more than 25) and melanoma. High nevus counts are more associated with melanoma developing on the legs or trunk, compared to other parts of the body.

Extreme ultraviolet exposure- Most of the skin cancers are caused due to exposure to the UV rays in sunlight. Both basal cell and squamous cell cancers tend to be found on sun-exposed parts of the body, and their occurrence is related to lifetime sun exposure. Clinical evidences demonstrate higher rates of melanoma risk in people with extensive or repeated intense exposure to sunlight.

Bodily appearance: Light skin pigmentation, hair color (red or blond), high-density freckling, and light eye color (green, hazel, blue) are associated with increased risk of developing skin cancer.

Other Causes:

  • Chronic immunosuppression like, HIV infection, or long-term glucocorticoid use, may increase the incidence of skin cancer.
  • Unrelieved inflamed skin resulting from scars, burns, chronic ulcers, sinus tracts, or inflammatory dermatoses can lead to an increased risk of cutaneous cancer.
  • Consumption of contaminated drinking water and occupational exposure are associated with skin cancer.
  • Human papillomavirus (HPV) infection can cause cutaneous cancer in genetically predisposed individuals and verrucous carcinoma of the penis.
  • Smoking and a diet high in meat and fat significantly increased the risk of skin cancer. Read about how smoking causes cancer. 

Fact #4: There are only two types of skin cancer that are likely to spread if not treated at the right time

There are 2 main types of skin cancer; melanoma and non-melanoma. While melanoma can originate in any part of the body that contains melanocytes (cells that produce melanin — the pigment that colours our skin) and is a less common form of skin cancer, non-melanoma skin cancer can occur anywhere on the skin, but is often on the head, face, neck, back of the hands, arms, and legs. This is because those body parts are most exposed to the sun’s rays.

The two most common types of non-melanoma skin cancer are called ‘basal cell carcinoma’ and ‘squamous cell carcinoma’. Most forms of non-melanoma skin cancer can be easily treated because they grow slowly. But if not treated, some non-melanoma skin cancers can become large or spread inside the body. Meanwhile, in case of a melanoma cancer, if caught early, it can be cured with relatively minor surgery.

Fact #5: A biopsy is the only way to diagnose the condition

When a patient visits a doctor, he/she will first do a physical examination of the skin and then suggest a biopsy based on his/her suspicions. The doctor takes a small sample of the abnormal area or removes the whole abnormal area. Then a pathologist examines the skin cells under a microscope to check for cancer.

Want to know what a biopsy is? Here are some cancer terms you should know about. 

Fact #6: Sunscreen may not be enough to keep skin cancer at bay

Sunscreen is just one precaution. There are various other measures that should also be taken to avoid sun exposure

  • Wear protective clothing that covers the exposed part of the skin such as a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses.
  • Seek shade whenever possible. Stay away from the sun rays especially between 10 AM and 4 PM.
  • Take extra precautions near the water, snow and sand as they reflect the damaging rays of the sun which can increase the chances of sunburn.
  • Less exposure to sun leads to vitamin deficiency as skin in presence of sun light makes vitamin D. Hence, a vitamin D enriched diet is necessary. Want to know about vitamin Dr ich foods? Here are all your queries answered. 

Read about how you should choose the best sunscreen for your skin type.

Fact #7: Once diagnosed there are a number of ways to treat the condition

A melanoma cancer can be treated by a surgery alone whereas people with non-melanoma skin cancer can have more form of treatments besides surgery.

  • Radiation therapy: Radiation therapy involves the use of X-rays to destroy cancer cells.
  • Skin creams: A strong cream is prescribed, which if put right, kills the cancer cells.
  • Photodynamic therapy: Photodynamic therapy kills cancer cells. For this therapy, a doctor uses a special cream and a special light to treat the skin cancer.

Fact #8: The sun alone is not a cause for skin cancer, there are many more

Apart from the sun there are other factors that can cause skin cancer. Things like an irregular diet, smoking, chronic infection and inflammation, arsenic exposure in a factory or contaminated drinking water can also contribute as risk factors.

Fact #9: The earlier the diagnosis the better the chances of survival

 The overall diagnosis for patients with primary skin cancer (cutaneous squamous cell carcinoma -SCC) is excellent. The patient’s chances of getting cured are greater than 90%. But, at times in stage IV, the chances of cure diminish to 10%.

Fact #10: Skin cancer can be prevented
Yes, skin cancer can be prevented by protecting your skin from the sun’s rays. However, to reduce the chance of acquiring the disease, one must:

  • Stay out of the sun in the middle of the day (from 10 a.m. to 4 p.m.)
  • Wear sunscreen and reapply it often
  • Wear a wide-brimmed hat, long-sleeved shirt, or long pants
  • Not use tanning beds
  • Avoid smoking and high fat meal

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  • saumya

    Hi, I have a rather asymetrical mole with irregular borders on my cheek. I am sort of fair complexioned, but have black hair and eyes. The region around the mole seems a little less sensitive to touch to me (very slight diffrence). Also that side of my face has been a little itchy scratchy since I think Nov 2013, but that might have been because of the cold. I saw a doctor and she said that cases of melanoma are very very rare in Indian people and I need not worry. I am not sure what to do now. This mole is diffrent from other moles on my face and it feels a little thicker and deeper inside the skin that other moles I have. Not to mention, this particular mole had a hair growing out of it. Some 2 years ago I tried plucking it out with a plucker (ans succeeded). Can that be a cause, my doctor was positive about that being a cause. I just want to stop worrying about this. Hope to get some reassurance.