Bandra resident Anu Singh's confidence levels kept dipping in proportion to the size of the mole on her left eyelid. "As it grew, I felt people were looking at it instead of listening to me," said the teacher, who was 24 when she first got the mole removed.
It came back with a vengeance four years later. "The first doctor who removed the mole said it was extra skin growth and no cause to worry," said Singh (name changed). When it reappeared, she went to a plastic surgeon who insisted on a skin biopsy as well. The answer shocked Singh. "I have basal skin cancer-a disease I never thought existed in India," she said.
The popular belief is that Indians are not prone to skin cancer because of the higher concentration of melanin or pigmentation. While one in every five Americans could develop skin cancer sometime in his/her lifetime, the probability for Indians is not so high.
But a new multi-centric research of over 2,500 patients claims that skin cancer is more common than previously thought. "Over 20% of the excised lesions in our study were skin cancer," said Dr Debraj Shomewho treated Singh and led the study. Of the patients with cancer in the study, the most common type was basal skin cancer with an incidence of 12.1%. Basal skin cancer never kills or spreads to other organs but can cause significant disfigurement if not treated. "Almost 5% had squamous skin cancer that occurs on the sun-exposed parts of the body," said Dr Shome. It can spread, in rare cases, to the lymph nodes.
The worst type of skin cancer called melanoma was detected in only 1.5% of the patients, said the study, which has been submitted for publication in a medical journal.
The most worrying finding, said Dr Shome, was that most doctors don't send excised skin or mole for pathology. "Around 30% of the patients had previous presentation of the disease and underwent surgery. In more than half of these patients, no samples were sent for pathology to detect cancer," said Dr Shome, who heads the facial plastic surgery department at Nova Specialty Surgery in Chembur.
Most patients who are detected with skin cancer come for treatment late. "Delayed presentation to a doctor leads to advanced lesions and needs more extensive surgery" Shome said.
Dr Shripad Banavali, who heads the medical oncology department of Tata Memorial Hospital, said skin cancer is still low in incidence in Indians for it to be considered a big worry. An article in the Indian Journal of Dermatology in October 2010 said non-melanoma skin cancer may be on the rise in India. Dr Shome said sunlight is an established human carcinogen. "Other factors are use of unapproved skin lotions, inks used for tattoos, etc.''