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New Findings: Indoor Tanning is to Skin Cancer as Smoking is to Lung Cancer

If you believe that indoor tanning isn’t dangerous, this finding from a study recently released by JAMA Dermatology might change that.

In likely the first summary of international indoor tanning exposure, researchers determined that the number of diagnosed skin cancer cases due to tanning is higher than the number of lung cancer cases due to smoking.

Can It Be True?   

Taken at face value, the study tells us what smoking is to lung cancer, indoor tanning is to skin cancer. And in fact JAMA Dermatology provides documented evidence gathered in the US, Australia and Northern and Western Europe. Researchers reported:

“Overall, we estimate 419,039 cases of basal and squamous cell carcinoma (NMSC) and 10,888 cases of melanoma each year attributable to indoor tanning. To put this in perspective, approximately 362,941 cases of lung cancer are attributable to smoking each year in these regions.”

However, the same study notes that the general risk for lung cancer is much higher (it assumes 90 percent of all lung cancer diagnoses are attributable to smoking) than for skin cancer (up to 22 percent among indoor tanners). And the World Health Organization (WHO) reported on February 4 that lung, breast and colon cancers are still the most diagnosed worldwide.

But the new figures suggest an even more alarming trend. While smoking is declining worldwide, indoor tanning may actually be increasing. And the Skin Cancer Foundation cites a study by the American Cancer Society which says that each year in the US there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon.

Work To Be Done

Several US states have banned or restricted indoor tanning, and many others are considering it. But, while the WHO considers indoor tanning a group 1 carcinogen, tanning beds in the US are still regulated by the FDA as Class 1 medical devices (the same as bandages and tongue depressors).

Perhaps the best context for the work that still needs to be done comes from the JAMA Dermatology researchers, who said: “Despite the mounting evidence of harms of indoor tanning, data on the scope of this problem, with which to guide public health efforts are missing.”

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SunAWARE

Study finds aspirin may help prevent melanoma

Reducing your risk for melanoma by 20 percent could be as easy as popping aspirin, at least if you’re a woman over age 50. A new study in the journal Cancer looked at melanoma in 60,000 post-menopausal Caucasian women. Over a 12-year period, women who took aspirin twice a week or more had a 20 percent lower risk of developing melanoma, the most progressive form of skin cancer.

The results applied to aspirin use only and not other non-steroidal anti-inflammatory drugs, such as ibuprofen.

Before aspirin can be prescribed to patients at risk for melanoma, clinical trial testing must be performed. Additionally, pain relievers increase a user’s risk of bleeding and pose other potentially serious side effects. The only proven method of skin cancer prevention is avoiding UV exposure and using sun protection (a wide brim hat, sunscreen and sun protective clothing).

Currently, researchers plan to do follow-up studies in younger women and men.

As always, talk with your doctor regarding your health concerns.

Disclaimer: The information provided by Coolibar and its contributors is general skin care information and should not be a substitute for obtaining medical advice from your physician and is not intended to diagnose or treat any specific medical problem.

Resources: CBS News; FOX News; NPR

Photo credit: Wikipedia

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Routinely Check Skin SunAWARE

A Valentine’s Day Gift That Shows You Care

If you share a close bond with your significant other, you may want to consider giving them a skin exam this Valentine’s Day and asking them to do the same for you.

Melanoma and non-melanomas can be tricky to spot on one’s own skin, especially on the scalp and back. For men in particular, one third of melanomas are found on the back. Men are also much less likely to examine their own skin, and studies have shown that when skin cancer is found at an early stage, it is most often detected by a spouse or partner. Studies have also shown that couples who check one another for skin cancer tend to do so more thoroughly than people who perform skin self-exams alone.

If you find a suspicious spot on your spouse, urge them to see a dermatologist right away for proper diagnosis. Melanoma, basal cell carcinoma and squamous cell carcinoma, the three most common types of skin cancer, are treatable when detected early. So help ensure you and your valentine are around for many Valentine’s Days to come.

Skin Cancer Warning Signs from the Skin Cancer Foundation

– A skin growth that increases in size and appears pearly, translucent, tan, brown, black, or multicolored.

– A mole, birthmark, beauty mark, or any brown spot that: changes color, increases in size or thickness, changes in texture, is irregular in outline, is bigger than 6mm or 1/4”, the size of a pencil eraser, appears after age 21

– A spot or sore that continues to itch, hurt, crust, scab, erode, or bleed.

– An open sore that does not heal within three weeks.

Look for any of the warning signs when you perform a self-exam. If you notice any change in an existing mole or discover a new one that looks suspicious, see a physician immediately.

To find out more about how to spot a skin cancer and for information on self-exams, visit www.skincancer.org/Self-Examination/.

Reference: The Skin Cancer Foundation. 

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Routinely Check Skin What's Hot

Are skin cancer apps harmful?

Earlier this month we discussed the growing role technology plays in the fight against skin cancer. In fact, we’ve created a pin board, highlighting some of our favorite apps.

Now, in light of a recent study published by researchers at the University of Pittsburgh Medical Center, there is a growing concern for the accuracy of the apps that are meant to detect skin cancer. Four smartphone apps were evaluated on their ability to determine whether moles have morphed into cancerous melanomas. The results ranged from 98.1% accuracy to only 6.8%. If consumers are relying on their smart phone alone to diagnose their health issues, this inaccuracy poses a big problem.

The Wall Street Journal reports, “Health-app makers include disclaimers warning patients that they don’t mean to diagnose anything. ‘We’re not saying this replaces a practitioner,’ said Avi Lasarow, co-founder of the Mole Detective app, which uses algorithms to gauge mole risk but plans to add a physician-referral feature. ‘We’re saying, this is a way you can look to determine whether you might have a problem,’ he said.”

Most consumer health apps haven’t yet been required to demonstrate their safety and efficacy through the Food and Drug Administration. The FDA said in a statement that the UPMC study results “reinforce the importance of consumers talking with a health care professional before making any medical decisions” because of the seriousness of melanoma, and that addressing mobile apps is a top priority at the agency.

What do you think, are skin cancer detecting apps helpful or harmful?

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Expert Rx

Mayo Clinic Study Provides More Reasons to Ditch Tanning

According to recent Mayo Clinic study, the incidence of melanoma has escalated, and young women are the hardest hit. Researchers speculate that the use of indoor tanning beds is a key culprit in the rising skin cancer rate in young women.

“We anticipated we’d find rising rates, as other studies are suggesting, but we found an even higher incidence than the National Cancer Institute had reported using the Surveillance, Epidemiology and End Result database, and in particular, a dramatic rise in women in their 20s and 30s,” says lead investigator Jerry Brewer, M.D., a Mayo Clinic dermatologist.

Researchers conducted a population-based study using records from the Rochester Epidemiology Project, a decades-long database of all patient care in Olmsted County, Minn. They looked for first-time diagnoses of melanoma in patients 18 to 39 from 1970 to 2009. The study found the incidence of melanoma increased eightfold among young women and fourfold among young men. The lifetime risk of melanoma is higher in males than females, but the opposite is true in young adults and adolescents, Dr. Brewer says.

“A recent study reported that people who use indoor tanning beds frequently are 74 percent more likely to develop melanoma, and we know young women are more likely to use them than young men,” Dr. Brewer says. Despite abundant information about the dangers of tanning beds, he adds, young women continue to use them.

Dr. Jessica Sparks Lilley, a pediatrician who has dedicated her life to helping children stay healthy, learned the hard way that the risks of getting melanoma from using a tanning bed are real! “The first time I went to a tanning bed, I was fifteen years old and trying to get a little ‘color’ to look good in a beauty pageant dress,” says Dr. Sparks Lilley.  “I heard nothing of the risks (which were largely unknown at the time) and never burned. I went about ten times a year after that for various reasons—prom, pageants, and even my wedding. I thought seriously about never going back was after my first pathology lecture dealing with melanoma and the strong emphasis on UV radiation as a cause of skin cancer. My last tanning visit was April 24, 2007, about a week before my wedding…and two years before the cancer diagnosis that changed my life.”

Three years later, Dr. Sparks Lilley is cancer-free and helping adolescents comprehend the risks of using tanning beds. “It’s humiliating to recount my story—I should have known better—but I hope to teach everyone who will listen three important take-home points,” she says.

Dr. Sparks Lilley’s points include:

1. Never indoor (or outdoor) tan.

2. Talk to your physician about health concerns.

3. Take time to take care of your health. 

Mayo Clinic release: http://www.mayoclinicproceedings.org/article/S0025-6196(12)00209-1/abstract

Dr. Jessica Lilley’s full story: http://blog.coolibar.com/doc-learns-hard-way-to-avoid-tanning

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Success Stories Wellness Warriors

Melanoma Survivor Stan

During Skin Cancer Awareness Month, Coolibar invites skin cancer survivors to share their stories with us in their own words. The ins and outs of treatment can be intense and not necessarily a fun thing to read; however hope, determination and drive to educate others play a major role in these individuals’ lives. Skin cancer doesn’t discriminate, it can happen to anyone. Prevention and early detection can be life saving! We hope you share these stories with your friends, family and colleagues. Be SunAWARE this month the all year round.

“My name is Stan Hankins, age 76, and I live in Albert Lea, Minnesota. I discovered a lump under my jaw in the fall of 2010. The tumor was surgically removed by a Mayo surgeon in Rochester, Minnesota, in December 2010. The pathology report showed metastatic melanoma that had spread from an unknown skin mole that was never found. I had never noticed a mole that looked suspicious nor had a doctor check any moles. In March of 2011 a new tumor was discovered in the same general area as the first one. It was removed along with 110 lymph nodes in my neck and cheek. The tumor and two of the lymph nodes in the tumor were again diagnosed as metastatic melanoma.

After healing of the surgical site, I underwent five radiation treatments. Each of the five treatments was equivalent to six regular radiation treatments, because melanoma is a beast. In June of 2011 a PET scan revealed tumors on the left lung. In July my doctor started me on Leukine where I self-injected the drug that has shown some success in melanoma patients. I did this until October when I had a CT scan that showed multiple tumors had developed in both lungs as well as on my liver and peritoneum. I had another surgery in October to obtain a biopsy of the lungs to determine that it was indeed metastatic melanoma. With melanoma in my vital organs, my prognosis was rather dire. I would probably live less than a year.

In November 2011 my doctor at Mayo suggested that I join a clinical trial that was just beginning. There are eleven patients on this clinical trial. The doctor had done a similar clinical trial six years ago, and two of the ten patients are alive and show no signs of melanoma. The trial is a 28-day cycle. I take a nausea pill and chemo pills before bedtime for 5 nights and then nothing for the next 23 days. The chemo drug boosts the immune system and does not destroy good body cells, and it does not make me sick at all.

After the second cycle in January 2012, I had a CT scan that showed many of the smaller tumors had disappeared, and the larger ones were reduced by 50 percent! After the fourth cycle in March, I had another CT scan that showed further reduction of the tumors, and my liver was clear of tumors. I have just completed six cycles, and I will have my next CT scan in May. My hope is that all of the tumors have disappeared. Six people of the eleven on this clinical trial have had positive results. My doctor is excited and I am. Our hope is that this is a breakthrough for melanoma treatment. I consider this a miracle. Throughout this journey, I have had prayer covering around the world. I have no symptoms, and I am feeling great.

I used to have no worries about the sun, and for many years I wore no shirt outside during the summer. Now I wear a hat and a long-sleeved shirt when I am outside. My advice would be to have moles checked out by a doctor on a regular basis, because I obviously had a mole that was the culprit and I never noticed it.”

Photo: The picture was taken in May 2011 when I finished radiation at Mayo.  They have patients ring the bell to celebrate the completion of treatment. I had five treatments that were equivalent to 30 treatments.

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Educate Others Parenting SunAWARE

Tanning Industry Investigation Confirms Need for Education

“Tanning is beneficial to your health,” claims tanning salon owners and employees when the House Committee on Energy and Commerce undercover investigators called 300 tanning salons nationwide.  This false claim may not fool many sun protection advocates, but the rest of the U.S. population could be easily led to believe that tanning is good for you. In actuality, nothing could be farther from the truth.

Tanning, whether outdoors or in a tanning bed, can have harmful effects on your health. In fact, the Skin Cancer Foundation states on their website that indoor ultraviolet tanners are 74 percent more likely to develop melanoma than those who have never tanned indoors.  Most people are not properly informed about the risks of using tanning beds and are putting their lives at risk without even knowing it.

During The Committee’s study, they had investigators pose as fair skinned teenage girls (over the phone) looking for information on tanning bed safety and policies. After contacting 300 salons, at least three in every state, they released these unsettling results:

1) Nearly all salons (90%) denied the known risks of indoor tanning.

2) Four out of five salons falsely claimed that indoor tanning is beneficial to a young person’s health.

3) Salons used many approaches to minimize the health risks of indoor tanning including saying, “it’s got to be safe, or else [the government] wouldn’t let us do it.”

4) Three quarters of tanning salons failed to follow FDA recommendations on tanning frequency.

The Skin Cancer Foundation, in an effort to help educate teenagers and save lives, is urging people to email letters of support urging the FDA to regulate tanning beds and ban those less than 18 year of age from using them. The SCF will then compile all emails and send them to FDA Commissioner Margaret Hamburg. You can email your letters to advocacy@skincancer.org.

The Skin Cancer Foundation’s report on Congressional Report Exposes Tanning Industry’s Misleading Messaging to Teens.

http://www.skincancer.org/news/tanning/tanningreport

Watch Chelsea’s Experience with Skin Cancer to see how misleading claims by tanning salons effect the people around us.

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Educate Others SunAWARE

A New Year’s Resolution with a Cause

While you may already have a personal goal in mind to accomplish in 2012, have you thought about creating a New Year’s Resolution that can have a profound impact on others as well? Over 58 thousand people in the United States were diagnosed with melanomas of the skin in 2007 (the most recent year statistics are available) and the number continues to rise (Center for Disease Control). You, just one person, can help lower the rate people are being diagnosed with melanoma, the most serious form of skin cancer, and save lives. This year, consider giving back by getting involved in a race for the cure, fundraise for melanoma research, or hold an event to help educate others about skin cancer and prevention. Our friends at Melanoma Research Foundation (MRF) have some suggestions to help you get started. Go ahead – set out to accomplish something BIG this year!

People often make cause related resolutions at the new year, particularly after the holidays when they feel the loss of a loved one more deeply. Often the individual will contact MRF directly with a statement along the lines of “I recently lost someone and I want to do something to help.

The MRF is uniquely available to fill that need for those who lost someone to melanoma or for those who are currently battling it. The MRF has several event based programs that allow people to join our community and raise funds for research. What is attractive to the individual is that they become part of a larger group who can make a bigger impact. As one it’s hard to feel like you’re making a difference, but when you join a group that ultimately has nearly 10,000 participants a year, and raises nearly $2 million a year, then you know you’ve made a difference.

Our participants take on challenges from the simple to the extreme. Many join us at our 5k Miles For Melanoma walks. Many of them will do some fundraising of their own, but most will join us to help with awareness and provide a sense of community. The more people we have at these events, the more we can make people aware of the need for sun safety and prevention.

Other participants might take on more daunting challenges – running a marathon, racing in a triathlon, riding their bike across the U.S. and more. These folks all become fundraisers and bring in an average of $1200 or more.

We also have supporters who focus on awareness and education activities – they often take their own time to reach out to school groups and businesses to educate them about the importance of getting a skin cancer screening, using sunscreen and promoting a better understanding of the seriousness of melanoma. It’s not “just” skin cancer. The MRF relies on our advocates and messengers to provide this valuable information to their communities.

Carolyn Edrington
Melanoma Research Foundation

Perseverance is key to reach your goal. You can achieve great things if you are focused and motivated.  Taking on a cause related resolution by yourself can be a daunting task, so create a plan to accomplish your goals and set milestones, track your progress and keep a positive ‘can do’ attitude. Make 2012 your greatest year yet!

Happy New Year!

Coolibar

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SunAWARE

While Melanoma Treatments Advance, Prevention Remains Key

Melanoma, the most serious form of skin cancer, isn’t going away. In fact, The National Cancer Institute previously estimated in 2011 that 70,230 people would be diagnosed with melanoma and 8,790 would die of melanoma of the skin. While two major melanoma treatment advancements have made headlines over the past year, it’s even more important to remember that the best way to fight this disease is prevention.

When caught early, melanoma can usually be cured with surgery alone, but once it metastasizes, treatment options become limited. According to the American Cancer Society, the 5-year survival rate for stage IV melanoma is about 15% to 20%. Yervoy™ (Ipilimumab) and Zelboraf™ (Vemurafenib) are two new late stage melanoma fighting drugs approved by the US Food and Drug Administration (FDA) in 2011. Yervoy is the first melanoma drug to receive FDA approval in 13 years. It’s also the first proven treatment to extend overall survival for late stage melanoma patients. “Yervoy may offer many patients a 2-year survival advantage, with a smaller percentage of patients being virtually cured,” claims the Skin Cancer Foundation’s (SCF) report the new drug.

B-RAF
Crystallographic structure of B-Raf (rainbow colored, N-terminus = blue, C-terminus = red) complexed with vemurafenib (spheres, carbon = white, oxygen = red, nitrogen = blue, chlorine = green, fluorine = cyan, sulfur = yellow). Source: http://en.wikipedia.org/wiki/File:3OG7.png

According to the SCF, Zelboraf, approved later in the year by the FDA, is the first targeted genetic therapy of its kind to treat advanced metastatic melanoma patients whose tumors have a specific mutation in the BRAF gene that’s present in 40-60 percent of melanomas. While both drugs represent a step towards a cure for melanoma, in most cases, these treatments only extend the life of advanced stage melanoma patients, and a cure for melanoma has yet to be discovered.

Even though melanoma, in particular late stage, is difficult to treat once it occurs, the good news is that skin cancer, including melanoma is preventable in many cases. Over exposure to UVA and UVB rays produced by the sun or artificial ultraviolet light (i.e. tanning beds) can form genetic mutations in the skin, which leaves those who have burned or tanned susceptible to all forms of skin cancer later in life. UV radiation is considered the main cause of nonmelanoma skin cancers (NMSCs), including basal cell carcinoma and squamous cell carcinoma. The SCF says NMSCs strike more than 250,000 Americans each year. Experts also believe UV radiation may also cause melanoma, the deadliest form of skin cancer.

By protecting yourself from UV rays (both artificial UV from tanning beds and naturally occurring UV from the sun) and performing routine skin checks, you’ll not only help reduce the incidence of skin cancers, but improve your overall skin appearance and health. Skin sun damage is cumulative, so there is still time to grab a bottle of SPF 30 broad-spectrum sunscreen, a wide brim hat, UV sunglasses and look into adding sun protective clothing to your wardrobe.

Photo credit: anolobb

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Educate Others SunAWARE

What is Skin Cancer?

Skin cancer is cancer that forms in the tissues of the skin, as defined by the Center for Disease Control (CDC). So when you hear about the most common types of skin cancer which include basal cell carcinoma, squamous cell carcinoma and melanoma, what does it really mean? What are the differences between these types of skin cancers?

Skin cancers occur if there’s uncontrollable growth of abnormal cells in the epidermis (outer layer of skin). The type of skin cancer, basal cell carcinoma, squamous cell carcinoma or melanoma depends on the types of cells the cancer forms in.

Basal Cell Carcinoma:
If skin cancer begins in the basal cells, which produce skin cells that continuously push older cells toward the surface, it’s known as basal cell carcinoma. Basal cells are found in the lower part of the epidermis. This is the most common form of skin cancer accounting for an estimated 1 million of the over 1.3 million cases of skin cancer diagnosed each year according to the CDC. This type of skin cancer is usually easy to treat.

Squamous Cell Carcinoma:
Cancer that forms in the squamous cells, the flat cells that form the surface of the skin, is called squamous cell carcinoma. According to the CDC, squamous cell carcinoma accounts for about 16 percent of diagnosed skin cancer cases each year. While this type of skin cancer can be treated in most cases, if untreated it can be fatal.

Melanoma:
Skin cancer that forms in pigment cells (melanocytes) is melanoma. Melanoma is the least common form of skin cancer, but it’s also the deadliest because it tends to metastasize or spread throughout the body when not detected early.  

Basal cell carcinoma and squamous cell carcinoma are also referred to as nonmelanoma skin cancers to differentiate them from melanoma. Anyone can get basal cell carcinoma and squamous cell carcinoma, regardless of skin color. Factors that may increase your risk are: age, cumulative ultraviolet radiation exposure, where you live and complexion.

When looking at melanoma specifically, the exact cause has yet to be determined; however, researchers argue that certain risk factors increase a person’s chance of developing melanoma including: abnormal moles, having more than 50 normal moles, fair skin, personal history of skin cancer, family history of melanoma, weakened immune system, severe sunburns and ultraviolet (UV) radiation exposure.

Take a personal quiz to see what your risk of developing skin cancer is and what you can do to help prevent it at the National Cancer Institute’s website: http://understandingrisk.cancer.gov/a_skin/02.cfm

Watch a video on the differnt types of skin cancer and how to help prevent them: http://video.about.com/dermatology/Skin-Cancer.htm

References:
Sun Protection for Life by Mary Mills Barrow and John F. Barrow (2005)
http://www.mayoclinic.com/health/medical/IM02400
http://www.cancer.gov/dictionary?cdrid=445084
http://www.cdc.gov/cancer/skin/basic_info/index.htm
http://www.healthonlinezine.info/what-is-skin-cancer-what-causes-skin-cancer.html

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