Kangri is a firepot kept beneath the traditional Kashmiri pheran. If a person is wearing a jacket, it may be used as a hand warmer. It is approximately 6 inches in diameter and reaches a temperature of approximately 150°F. Kangri cancer is a squamous cell carcinoma induced on the inner surface of the thigh or on the abdominal wall in areas of recurrent thermal skin injury in people who warm themselves by Kangri that contains live coals held under their clothing. This type of cancer is found only in Kashmir.
Kangri cancer is more often associated with the abdomen, thigh, and leg regions due to the usage and positioning of kangri pots. Over time, the use of kangri to keep warm results in erythema , a precancerous keratotic growth that takes the shape of superficial reticular blackish brown coloured lesions. Eventually, the cells at the lesion site become more irregular in shape and form. The lesions ulcerate and may become itchy and bloody. The resulting irregular growth is the manifestation of kangri cancer.
Use of the kangri pot is the principal cause of kangri cancer. Elements that are believed to contribute to the development of kangri cancer are heat, burning wood particles, smoke and burnt chinar leaves. In one study, researchers found that kangri cancer patients had a history of using a kangri for 5-6 hours a day, 3-4 months in a year. This study highlighted that gastric cancer is the leading cancer encountered in our hospitals (18.8%) and is the leading cancer site among men (25.2%) and third most common cancer among females (10.4%). Gastric cancer is one of the most common cancers in Kashmir along with oesophageal cancer.
SIGNS AND SYMPTOMS
In majority of the cases, skin squamous cell carcinomas are asymptomatic and do not present any signs or symptoms (during the initial period). However,
1) The appearance of a slow-growing lesion may be noted.
2) Skin lesions may be noticed on the abdomen or upper thigh.
3) The skin lesions may appear as crusted ulcer and nodules. They may ulcerate and bleed.
4) In some cases, the affected skin may appear more/less pigmented than the surrounding skin.
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
The first case of kangri cancer was reportedly recognized in 1819. The incidence of kangri cancer is higher for those over the age of 50.There is no definitive predominance of kangri cancer in either males or females.
Radiotherapy: External beam radiotherapy has been used to prevent the relapse and growth of tumour metastases to the head and neck regions. The prophylactic applications of radiation have been noted as “encouraging” in reducing some tumours and eliminating others.
Surgery: In the treatment of kangri cancer, surgery is most often the first-line course of action to remove the primary tumour.
1) Kangri cancer may be prevented by avoiding the use of Kangri pots close to the body skin. Individuals may instead use adequate thermal protective clothing and other heat sources appropriately.
2) Education and awareness of this particular cancer type among the local Kashmiri community can help reduce the incidence rates.
3) Regular medical screening at periodic intervals with blood tests, scans, and physical examinations are important due to its high metastasising potential and possibility of recurrence.
Do not pick or pop the blisters. Doing so can affect the healing process and may result in secondary infections.
Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition.
The presence of dirt on the body is not a causative factor for the condition. However, it helps to be clean and hygienic, which may prevent the condition from getting worse.
Health is wealth and prevention is better than cure. Wish you all a safe winter. Take care.
—The writer is a student of BSc Nursing at Pacific Institute of Medical Sciences, Udaipur. [email protected]