Petticoat cancer: Know the risks and how to prevent it

As Indian women, we all love wearing sarees. The saree has long been an essential piece of traditional Indian clothes, adored by women of all ages and cultures throughout the country. It is a staple garment in all households. However, did you know that your favourite garment, the saree, can give you cancer? Yes, under the bright sarees lies a secret risk to Indian women: petticoat cancer. A recent study published in the British Medical Journal has raised serious concerns for women who wear sarees daily. This unique condition typically affects the abdomen or waistline and is caused by prolonged irritation caused by a tightly tied petticoat string (or nada) that holds the saree in place.

What is petticoat cancer?

Petticoat cancer, also known as Marjolin’s ulcer, is a rare type of skin cancer that appears around the waist in people who wear tightly knotted saree underskirts (petticoats) or dhotis. The persistent friction and pressure from tightly tied waist cords can cause chronic skin irritation, discolouration, and ulceration, eventually leading to squamous cell cancer, as found in a study published in the British Medical Journal Report.

Symptoms of petticoat cancer

Marjolin’s ulcer or petticoat cancer, is a rare and aggressive type of skin cancer that develops in pre-existing chronic wounds or scars. Here are some common symptoms, as found in a study published by StatPearls:

• The most prominent symptom is a wound that fails to heal despite appropriate treatment.
• The appearance of the wound may change, such as the wound may suddenly start to grow larger or deeper, the edges of the wound may become raised, rolled, or thickened, the wound may bleed easily, even with minor contact, it may also produce a foul-smelling discharge or pus and it may become increasingly painful.

What are the causes of petticoat cancer?

Petticoat cancer or Marjolin’s ulcer is not directly caused by wearing a petticoat, but rather by the chronic irritation and inflammation that can occur at the waistline due to the tight fit of the garment. Here’s how:

1. Chronic irritation or inflammation

A petticoat’s tight cord or waistband can cause constant friction and pressure on the skin at the waistline, leading to chronic irritation and inflammation. This can result in skin breakdown and the development of chronic wounds or ulcers. Over time, these chronic wounds can become susceptible to malignant transformation, ultimately leading to the development of Marjolin’s ulcer or petticoat cancer, as found in a study published in the Journal of Clinical and Diagnostic Research.

2. Weakens skin barrier

A tightly fitting petticoat’s constant friction and pressure can significantly weaken the skin barrier at the waistline. This weakened barrier disrupts the skin’s natural defense mechanisms, making it more susceptible to various forms of damage, as found in a study published in the Journal of Clinical and Diagnostic Research. The compromised barrier becomes less effective in protecting the underlying tissues from external irritants, pathogens, and mechanical stress. As a result, the skin becomes more vulnerable to injury, leading to the development of abrasions, cuts, and ultimately, chronic wounds. These chronic wounds can then serve as a potential site for the development of petticoat cancer.

3. Genetic predisposition

While not a direct cause, genetic predisposition to skin cancer may contribute to the development of petticoat cancer. People with a family history of skin cancer, such as melanoma or basal cell carcinoma, may be more susceptible to this rare type of skin cancer, as found in a study published in the journal Current Opinions in Oncology. However, it is important to note that the presence of chronic wounds or scars, caused due to a prior cancer, has a key role in the development of Marjolin’s ulcer. The genetic predisposition is most certainly a contributing component, increasing the risk in people with pre-existing skin damage.

How to prevent petticoat cancer?

Here are some prevention tips you can follow to prevent petticoat cancer as found in a study published in the Journal of Clinical and Diagnostic Research.

• Opt for loose-fitting, breathable fabrics that minimise friction and allow for proper airflow. Avoid excessively tight waistbands, belts, or cords. Or give some break in wearing petticoat.
• “Perform regular self-exams of your skin, paying close attention to any pre-existing wounds, scars, or areas of irritation,” says oncologist Dr Reshma Puranik.
• Seek medical attention for any non-healing wounds or sores. Proper wound care can help prevent complications and reduce the risk of malignant transformation, a process by which cells become cancerous.
• Maintain a healthy lifestyle, including a balanced diet, regular exercise, and no smoking, as these factors can contribute to overall skin health.

How to treat petticoat cancer?

Depending on the stage and extent of the cancer, petticoat cancer is often treated using a multidisciplinary approach. “The primary treatment is surgical excision, which aims to remove the diseased tumour while leaving a margin of healthy tissue,” says the expert. In some situations, additional treatments, such as radiation therapy or chemotherapy, may be required to eradicate any remaining cancer cells and lower the chance of recurrence. Early detection and treatment are critical to boosting your chances of effective treatment and recovery. Consult a qualified healthcare professional for diagnosis and treatment of any medical conditions.