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Queens Chronicle

Tanning: Smart or not? A look at melanoma through the eyes of an expert

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Posted: Thursday, May 16, 2013 10:30 am | Updated: 12:51 pm, Thu May 16, 2013.

Dermatologists and skin cancer experts, especially before and during the summer months, write articles and give speeches on the harmful effects of sun exposure on the skin: the risk for melanoma and other skin cancers and premature aging of the skin. Despite all efforts, beaches are filled with people tanning in the midday sun, streets are filled with people with a pink-red burnt or bronze skin and tanning salons are filled with clients. Why can’t we deliver our message? Tanning is harmful to our skin just like smoking is harmful to our lungs.

Melanoma is the deadliest form of skin cancer. One person dies every hour from melanoma in the U.S. There are more than 76,250 estimated new cases of invasive melanoma in the U.S. annually resulting in over 9,180 deaths per year. It is the fifth and sixth most common cancer in men and women, respectively. If melanoma is diagnosed early, it is typically cured with surgery. However, advanced disease has a poor outcome and can lead to death.

Warning signs of melanoma. Melanomas often resemble moles; some develop from moles. The majority of melanomas are black or brown, but they can also be skin-colored, pink, red, purple, blue or white. The ABCDE rule of melanoma indicates that melanomas are typically asymmetric, have irregular borders, irregular color, a diameter greater than 6 mm, and evolve. However, not all melanomas follow this rule and have all of these characteristics.

What are the risk factors for melanoma? Everyone is at some risk for melanoma. However, increased risk depends on several factors: fair skin, increased sun exposure, increased number of moles, dysplastic or atypical moles (benign moles with special features), large moles from birth, having had melanoma and other persons in the family with melanoma.

Melanoma as a genetic disease. Cancer results from an accumulation of genetic changes in the DNA that leads to uncontrolled growth of cells. Thus, melanoma is a genetic disorder. Even though melanomas can look similar on the skin (usually brown or black and irregular), recent studies show that genetic changes in one melanoma can be quite different than the other. These findings imply that there are many different types of melanomas. The future requires genetic characterization of a person’s melanoma and treating the patient based on these findings.

The link between melanoma and sun exposure. The majority of melanomas develop on the skin (~95 percent). Rare forms are present such as those that develop in the eye, mouth, gut and the genitalia. Clinical studies that were carried out in the past decades suggested sun exposure (ultraviolet radiation) as a critical factor in promoting melanoma development of the skin. Recent genetic studies examining changes in the DNA now provide evidence that melanoma of the skin is closely related to ultraviolet-related damage. One exception, however, is the sun-protected sites of the skin, such as palms and soles, for which the reason of their development is beyond sun exposure. These recent scientific studies confirm sun exposure as a critical element in the majority of melanomas of the skin.

Tanning and indoor tanning (tanning booths or beds) increase one’s risk for melanoma. Indoor tanners are 74 percent more likely to develop melanoma than those who have never tanned indoors. Those who tan indoors only four times a year increase their risk of developing melanoma by 11 percent. There is an alarming increase of melanoma among young women possibly due to increased use of indoor tanning in this age group.

These studies provide further evidence linking sun exposure to melanoma. One can avoid harmful sun exposure by avoiding the midday sun (11 a.m.-4 p.m.), using protective clothing and by frequent sun block (SPF>30) application. Indoor tanning should never be used. More importantly, one can enjoy the summer months without being subjected to significant levels of ultraviolet radiation by using these measures.

As in other cancers, prevention strategies are of utmost importance. Routine skin cancer screenings and close surveillance of individuals at high risk for melanoma lead to early recognition, treatment and cure. May is Skin Cancer Awareness Month. In May, free skin cancer screenings are offered by dermatologists throughout the U.S. The Mount Sinai Department of Dermatology will be conducting a free Melanoma Cancer Screening on Thursday, May 23. We are encouraging everyone to take this potentially lifesaving step by coming in to obtain a total body skin examination. This free screening will be held between 3-5 p.m. We will be accepting all walk-ins. No appointment is necessary. Have skin cancer screenings and save your life.

Tanning not only predisposes individuals for melanoma, but for other skin cancers and for premature skin aging: wrinkles, sagging of the skin, brown and red spots. Do you still want to tan? Do you still want to ignore skin cancer screenings? Wake up America!

Julide Tok Celebi, M.D.
Professor and Vice Chair, Dermatology
Professor of Pathology
Director, East Side Dermatology Practice
The Icahn School of Medicine at Mount Sinai
5 East 98th St., 5th floor
New York, NY 10029-6189
For Appointment:
Tel: (212) 241-9728

Welcome to the discussion.

3 comments:

  • sasha posted at 12:58 am on Wed, Jun 19, 2013.

    sasha Posts: 0

    Wow good to hear that there will be free skin cancer screening in the month of May. But still why are people not taking advantage of this. As you said ever hour a person dies of melanoma. Some say that using more cosmetics will also lead to skin cancer but you haven't mentioned anything about that.
    Check out: http://www.empowereddoctor.com/cancer-treatment

     
  • Shelly 75ngml posted at 12:44 am on Fri, May 17, 2013.

    Shelly 75ngml Posts: 0

    Ah, but you ARE delivering your message. So much so that we are currently at epidemic rates of Vitamin D deficiency. Your message is completely unbalanced. That is where your problem lies. Moderate, responsible UV exposure is the way to go. I know, I listened to your message most of my life and what did it get me? Vitamin D blood level of 11ng/ml. That is low enough to cause osteoporosis and was why my muscles ached so much I couldn't exercise. My doctor recommended UV exposure to bring my dangerously low Vitamin D level up. I worked with a professional salon and they helped me gradually and conservatively build my levels in a sunbed based on my skin type. I was able to increase my level to 75ng/ml, I no longer have muscle aches and I have lost over 25 pounds. I tan for 6 minutes every 7-10 days and after a year, I have maintained my Vitamin D level and was just tested last month with the result of 63ng/ml. To completely discredit the need for sunshine and UV is very dangerous. Vitamin D deficiency is linked to over 100 diseases and health risks including many forms of cancer. It is time to admit that the "wear sunscreen every minute of every day" and "avoid any and all UV exposure" is the wrong message. The balanced, correct message is that UV in moderation can be beneficial.

     
  • Healthy Tanner posted at 1:52 pm on Thu, May 16, 2013.

    Healthy Tanner Posts: 0

    Even the most professional "expert" dermatologist must excise 10-15 benign skin-lesions in order catch one real malign melanoma. The worst dermatologists make 93 unnecessary incisions for every necessary. (Data from a huge multinational study presented in 2012).
    The problem is that also the incisions of initially suspected melanoma (biopsies not included) land in the cancer-registers as melanoma and thus contributes to the steep increase of people diagnosed with skin-cancer.
    The mantra repeated in this article has been used for 30 years without any positive results except for in the bank-accounts of the sponsors to the melanoma awareness early screening campaigns. These sponsors are producing either sun-protection cosmetics or remedies for the millions of new "skin cancer victims" created in the campaigns. In any case, they are direct and indirect beneficiaries of the scare created.
    The 74% increased risk for those who "ever" used a tanning bed, is of course a ridiculous and relative number. In reality, the research in question showed a statistically manipulated increase from 0.2% to 0.3%. The use of relative statistics is both unethical and unserious (but effective for public relation).
    The reason for the propaganda against UV-exposure is simple. The sponsors of the established illness-maintenance system know that regular and moderate exposure to UV-light will make you naturally healthier and in less need of their products and services. Follow the money and you will find the cause.
    http://www.thetanningguru.com/melanoma-day-its-scary-but-not-in-the-way-you-might-think/