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Skin Cancer

About the Department

An uncontrollable and abnormal expansion of skin cells that most frequently develops on the skin being exposed to sunlight may lead to skin cancer. However, skin cancer can also develop in areas of the skin that have not been exposed to the sun. The majority of skin cancers are malignant growth of cells that are locally destructive on the skin. The cancerous cells primarily originate from the epidermis cells that lies in the surface stratum of the skin. Most types of skin cancer do not penetrate other parts of the body except for cutaneous malignant melanoma. Therefore, fatalities in case of skin cancer are mitigated to a large extent. 

The primary areas where skin cancer develops includes the face, scalp, lips, ears, neck, chest, arms, hands and legs, especially when the skin is exposed to the sun. However, the palms of your hands, the area beneath the fingernails and toenails and even the genital area can also be prone to skin cancer in spite of limited sunlight exposure.  

Skin cancer can occur in both people of light and dark skin complexions. For those with darker skin tones, melanoma usually attacks the person’s palms, soles of the feet and areas that are normally not exposed to the sun. 

It is universally accepted that skin cancer occurs due to exposure to ultraviolet rays of the sun and therefore, the disease is not usually passed on genetically within the family. However, genetics is an important aspect of skin cancer as the skin tone and poor pigmentation are usually hereditary. 

1 in 27 white men and 1 in 42 white women have an increased risk of developing skin cancer in their lifetimes. Women less than 49 years of age are more prone towards skin cancer than men of a similar age group. However, post the age of 50, men are more at risk of skin cancer in comparison to women. Skin cancer does not discriminate by age. Younger men between the ages of 15 and 39 have a 55% more chance of developing skin cancer than women of a similar age group. 

At Fortis Hospitals, Bannerghatta Road, skin cancer patients are treated by an expert team of physicians and health care professionals who are adept at tackling even the most complex cases of skin cancer and other skin related conditions. Within the care team, the patient will have access to specialists from allied medical disciplines including medical and surgical oncologists along with expert nurses who will collaborate and work towards detecting and treating skin cancer with the most modern and updated therapies available. Tailoring the treatment plan that best suits the patient is a part of our multidisciplinary approach to patient care. 

To optimise the treatment to be successful, Fortis concentrates on offering our skin cancer patients access to state-of-the-art facilities, top class diagnostic screenings and treatment by specialists who are some of the leading oncologists in the city. The objective is to fight skin cancer by working together in coordination and continuous reviews of the patient’s heath condition and delivering appropriate treatment as the situation demands. Fortis Hospitals also has support groups who will constantly counsel the patient and their loved ones to take on this difficult journey with a positive frame of mind. 

Areas of Care

The Department of Skin Cancer at Fortis Hospitals is dedicated to be the best healthcare partner for our patients battling all types of skin cancer. There are two main classifications of skin cancers, namely, keratinocyte carcinoma and melanoma. But, a number of other skin lesions may also be taken under the broader skin cancer umbrella. Whereas all these skin lesions may not be cancer, in due course of time, there is the possibility of them turning malignant. 

Here are the types of skin cancers:

- Actinic keratosis
- Basal cell carcinoma
- Squamous cell carcinoma
- Melanoma

  • superficial spreading melanoma:
  • lentigo maligna melanoma
  • nodular melanoma
  • acral lentiginous melanoma

- Kaposi sarcoma

The best preventive measure to protect against skin cancer is limiting the exposure to the sun and always wearing sun block when going out during day time. However, if you do suspect any skin abnormalities, you should immediately seek medical help from a dermatologist. Earlier detection of the skin cancer type has more chances of the treatment being successful. 

Symptoms & Diagnosis

Signs and Symptoms of Skin Cancer

Most people tend to either overlook the symptoms of skin cancer or easily confuse them with non-malignant moles, freckles, or growths. Most types of skin cancers do not cause symptoms and even if they do, it varies from individual to individual. 

Skin cancer symptoms include:

- If you observe skin lesions including moles, abnormal growths, swelling, sores, scaly patches or dark spots that are persistent for a long period of time
- If notice that the two halves of the mole or the lesion are asymmetrical 
- If you find that the lesions have borders that are ragged with uneven edges
- If you observe that the spot on the skin has an unusual colour, for example, pink, black, blue, red or white
- If you see that the spot is greater than one-quarter inch in diameter
- If you notice that the size, shape or colour of the mole is changing

Watch out for unusual changes on your skin as that can be a warning sign for skin cancer. Check for any additional symptoms of skin cancer if you think it is a possibility. Being aware of the evolving transformations on your skin can lead to an early diagnosis of the disease. Consult a dermatologist, if you see that one of many of the above symptoms have been persisting for some time. 

Our Diagnostic Services

It is difficult to differentiate between skin cancer and any other non-malignant skin diseases. As an early check, your specialist may apply some oil on the skin and make use of a magnifying glass like instrument known an a dermatoscope to examine the region closely. The following tests may be recommended to confirm the skin cancer diagnosis:

- Skin Examination:
Your skin will be examined by the specialist doctor to check for skin transformations that are likely to be an indicator for skin cancer.

- Skin Biopsy:
This is the main diagnostic test for skin cancer. However, there are multiple types of skin biopsies available including:

- Incisional biopsy involves taking a tiny sample of the tissue from the abnormal area through a surgical knife. The entire thickness of the skin is collected during the procedure. Local anaesthesia is applied and the area where the incision is made, is then closed up with dissolvable stitches.

- Excisional biopsy is a procedure where the doctor uses a surgical knife to remove the entire abnormal region. A part of the healthy tissue surrounding the suspected cancerous area is also collected to be later examined if the cancer has spread to nearby regions in the body. Stitches are required to close the area. 

- Punch biopsy uses a special tool wherein a tiny circle with the full thickness of abnormal skin is collected. You will again need stitches to close the area unless the cut is really small. Eventually, it may heal on its own.

- Shave biopsy makes uses of a specialised instrument that helps to shave off the surface layer of the skin. The area that has been scrapped usually forms a scab and heals on its own. Stitches are not required in this case. 

The results of the biopsy will assist the specialist to arrive at a diagnosis and subsequently determine the route of treatment to be followed. It will additionally provide information on the size of the growth and how far the condition has metastasised beneath the skin’s surface layer. 

The next step will be to check if the skin cancer has started spreading. In order to do that, the following diagnostic tests will be prescribed by the consulting specialist. 

- Lymphatic mapping with sentinel lymph node biopsy
- Fine needle aspiration biopsy
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI) scan
- Positron emission tomography (PET) scan
- Blood tests
- Chest X-ray
- Nuclear imaging bone scan

It is absolutely normal to be worried when you are told that your diagnosis has returned with a confirmation of skin cancer. Your care team at Fortis Hospitals is always there to support and hand-hold you through this difficult phase of your life. Discuss your concerns with your consulting specialist and learn more about your current condition. Let your preferences in terms of treatment be known to your care team, so that the treatment plan takes them into consideration.

Treatment Options

The treatment plans are usually variable for both skin cancer and actinic keratoses which are precancerous skin lesions. A lot will depend on the type, size, location and depth of the skin cancer and the lesions. One or more of the following treatments may be required:

- Freezing is a process where the doctor is able to kill actinic keratoses and some forms of early skin cancers with the help of extreme cold and liquid nitrogen. This procedure is also referred to as cryosurgery. The dead tissue on the skin is sloughed off when it defrosts.

- Surgical therapy includes three main procedures.

- Excisional surgery involves treatment for all types of skin cancer. Generally, the specialist will make an excision and cut out the malignant tissue along with a portion of the healthy skin during the procedure. In some cases, the doctor may recommend making a larger excision to remover a greater portion of the surrounding normal skin.

- Mohs surgery is a process that is used to treat recurring and larger, hard to treat skin cancers. This surgical therapy can also be used for basal and squamous cell carcinomas. The process is typically used in cases where the skin has to be conserved as much as possible, for example, the nose area. During the procedure, the skin growth is removed layer by layer. The layers are later examined under microscopic conditions until such time that no abnormal cells remain. 
- Curettage and electrodesiccation or cryotherapy is a procedure where the growth is removed wholly or partly. The doctor using an instrument called the circular blade or a curet, shaves away the cancerous layers of cells. Additionally, an electric needle is used to kill the remaining malignant cells. The method may be customised to include cryotherapy where extreme cold or liquid nitrogen is used to freeze the base and edges of the area that has been treated.

- Radiation therapy is a treatment process that used high dose of energy beams, for example, x-rays, to destroy the malignant cells. This can be used in combination with surgical therapy.

- Chemotherapy uses medication to destroy the cancer cells that is administered through an IV line. If the cancer is limited to the surface layer of the skin, then chemotherapy may be performed by applying creams or lotions containing anti-cancer agents directly on the skin.

- Photodynamic therapy involves destroying the cancer cells by combining medications and laser light. This process makes the malignant cells sensitive to light. 

- Biological therapy treats skin cancer by using the immune system of the patient’s body that helps to destroy the cancer cells. 

At Fortis Hospitals, Bannerghatta Road, your cancer care team will include multiple experts like dermatologists, pathologists, surgeons, plastic surgeons, medical oncologists and radiation oncologists who will work together and provide 360-degree patient care. Amassing several years of experience in treating complicated cases of skin cancer, the team of specialists will discuss, confer and review each stage of your treatment meticulously. We aim to meet the highest standards of comprehensive cancer care, recognising scientific excellence and combining it with a multi-disciplinary approach. 

Our Team That Cares

Little conveniences go a long way when it comes to maintaining high levels of skin cancer treatment at Fortis Hospitals. That’s why, we offer vital resources and services that helps to detect skin cancer at its early stages. With on-going supervision and constant monitoring, the department of skin cancer cohesively works as a team to beat the disease. 

Fortis receives several complex cases of skin cancer in the city of Bengaluru. Our goal is to cure every skin cancer patient that partners with us. We consider that an accurate, detailed and thoughtful style of patient care works best in terms of keeping the patient happy and positive. We believe that listening to our patients and their families is a critical part of treating the condition. We encourage our skin cancer patients to participate and drive the decision-making process. With access to specialist support groups, we carefully balance our approach with innovative therapies and integrated clinical research focussed on improving the patient’s overall health and quality of life.