Smoking histories were assessed and compared between patients diagnosed with BCC and/or SCC, and a group of controls comprised of patients who were screened for skin cancers, but who were not diagnosed with and had no history of skin cancer. The study’s 698 participants were recruited through Moffitt’s Lifetime Screening and Prevention Center and the University of South Florida’s Dermatology and Family Medicine Clinics. Participants were asked about their smoking behaviors in terms of years smoked, how many cigarettes per day they smoked, and when those who once smoked quit smoking. The results were stratified by sex.

The study revealed that there was a definite link between smoking and non-melanoma skin cancers for women with squamous cell carcinoma being more common than basal cell carcinoma. The risk increased with the amount of cigarettes smoked per day as well as with the amount of years a person smoked for.

The researchers concluded that:

• Cigarette smoking was associated with non-melanoma skin cancer, and the risk increased with increasing dose (cigarettes per day) and number of years smoked.
• Among men, smoking was modestly associated with BCC and SCC.
• Among women, smoking was strongly associated with SCC, but not BCC.

The research was conducted by the American Association for Cancer Research in Boston. Researchers looked at:

…coffee consumption and the risk of three forms of skin cancer — basal cell carcinoma, squamous cell carcinoma and the rarer and more deadly melanoma — among about 113,000 participants in two long-term health surveys. The data came out of the Nurses’ Health Study out of Brigham and Women’s Hospital and the Health Professionals’ Follow-Up Study at the Harvard School of Public Health. They found 25,480 incidences of skin cancer, 22,786 of the basal cell carcinoma, 1,953 squamous cell carcinoma and 741 melanoma.

Woman who drank three cups or more of caffinated coffee had their risk of developing basal cell carcinoma lowered by 20 percent. Men had their risk lowered by 9 percent. But as the article points out, “…those percentages add up, given that about 1 million new cases of basal cell carcinoma are diagnosed each year”.

Unfortunately, the consumption of coffee did not seem to affect those with the other two types of skin cancer, squamous cell carcinoma and melanoma. These two are the more dangerous cancers of the three. The study also did not find a correlation with patients who drank decaffeinated coffee.

What is important to remember however, is that those who have had basal cell carcinoma have an increased risk for squamous cell carcinoma and melanoma. So, here at MoleSafe we say drink up!

A New Reason To Love Coffee

Now, there’s more news to be hopeful about on the pharma front with potentially greater results: The FDA has also given the go-ahead to a drug called ZELBORAF (vemurafenib, pronounced vem-yoo-RAF-en-ib).   A comprehensive overview by ABC News offers a clear explanation of how Zelboraf attacks a genetic mutation (known as BRAF V600E) which is found in about half of melanoma patients, inhibiting the disease’s ability to spread.

We now have the capability to analyze a patient’s melanoma tumor for the genetic mutation BRAF and use the targeted treatment Zelboraf to attack the tumor, shrink it and stop the progression of this deadly disease,” said Dr. Anna Pavlick, director of the NYU Melanoma Program at the NYU Cancer Institute, who has been involved in clinical trials for Zelboraf. …Zelboraf shuts down the abnormal signals of the tumor cells that are caused by the genetic mutation and stops the cells from dividing, without affecting healthy cells.

At the same time, the FDA approved a genetic test to determine if patients carry the mutation since only those with the abnormal “BRAF” gene can take Zelboraf.  Interestingly, since the same genetic mutation is found in those with other forms of cancer, there may be future help from this drug beyond skin cancer and is now, for example, being tested on thyroid cancer patients.

This is the fastest the FDA has ever approved a drug to come to market – in just five years.  And even better: Zelboraf, which is a first-in-class drug, is anticipated to be available in the next two weeks.

There are differences between Yervoy and Zelboraf.   As described in the coverage by the SF Chronicle,

Yervoy was found to extend patients’ lives, an improvement over many current treatments. However, the drug works for less than 20 percent of patients, and doctors say they can’t predict which patients will find it most effective.

Zelboraf was clinically effective in 50 percent of patients [with the] specific genetic mutation … Most of the therapies for melanoma work for less than 20 percent of patients, and some fall into single digits.

Neither Zelboraf nor Yervoy cure melanoma.  And as a patient who had great success in a clinical trial for the new drug said, “there’s nothing that says this medication will help you forever.”  But these drugs bring hope for a longer life, and as new therapies come along the melanoma pipeline, there is reason to be optimistic.

Here’s how it may work, as described by MSNBC.com:

When UV rays hit your skin, they activate “reactive oxygen species,” or ROS, which then oxidize big molecules like lipids and DNA. This activates particular enzymes that kill skin cells. But grapes’ flavonoids work to decrease the formation of the ROS’s in skin cells that were exposed to UVA and UVB rays.

Basically, the thinking is that the flavonoids in grapes help halt the chemical reaction that kills skin cells leading to skin cancers and melanoma, and causes sun damage.

The catch? Consume as you will, but the researchers will be applying their findings to the development of new photoprotection skin products, sun-shielding drugs and cosmetics.

Cheers.

You may have also read on our wall, or on Twitter, that we’re going to be accepting appointments at our MOBILE clinic, arriving in San Francisco the week of October 10th. Please share this with all your friends and loved ones in the Bay Area as we bring the most advanced detection services to the West coast.  Call 1-877-MOLESAFE (1-877-665-3723) to schedule an appointment there…or at any of our permanent clinics in six locations around the country.

If you can’t make it to one of our clinics, do continue to practice self-exams and book your annual examinations with your dermatologist.

MelApp from Health Discovery on iTunes

If you’ll be attending the AAD next weekend (American Academy of Dermatology) we hope to meet you.  Please look for me, Dr. Richard Bezozo as well as Dennis Favazza – MoleSafe’s Director of Business Development, and Maddie Pallamary, RN.  We’ll be at the conference, taking place Aug 4-6 at the Hilton Hotel in NYC — Booth # 330.  Please come by and let’s talk in person about MoleSafe and our leading edge diagnostic tools.

Finally, in other news, there’s another way to remember your ABCDEs! Similar to the app we reported on a couple of months ago you can use your iPhone now in the meantime with MelApp to share images of your moles with your doctor, along with a helpful reminder of exactly what to look for on your skin — and the skin of a loved one.

Bikers –

Cycling news site, Nouvelles à Vélo du Monde — Bike World News –  has some practical reminders:

People who bicycle a lot have several strikes against them when it comes to skin cancer… Because many cyclists ride near their homes, they think they’re not at risk if they don’t put on sunblock — even for a short ride. The problem is that cyclists tend to expose more skin than other athletes because of the clothes they wear (shorts and short-sleeve shirts). In addition, many cyclists may not realize that water, sand, and asphalt streets reflect dangerous UV rays.

In addition to the expected recommendations such as sunscreen, including face, nose, neck and ears, less obvious suggestions include moving your cycling time to when the sun is less severe, such as early morning, wearing riding gloves and also a thin cycling hat under a helmet. 

Another interesting suggestion?:

Don’t forget to stay hydrated while cycling by drinking plenty of non-alcoholic beverages before  and during a ride. When your skin dries out or is not hydrated properly, it’s more susceptible to sunburn and long-term skin damage.

Beach and Pool:

Be sure to reapply sunscreen every two hours when you’re in the sun and every 40 minutes if you are in the water.  And don’t forget your feet.  Believe it or not, some say flip-flops are causing increased skin cancer!  Well, not the sandals themselves, but the increased popularity of that sun-exposing style vs. covered shoes.  But as described on Fort Bragg Patch.com,

“Being protected from the sun doesn’t mean you have to throw all the fun out the window. Find the coolest pair of shades you can come by, get a ridiculously big hat (like Carrie from Sex and the City), park it under a tree or umbrella and sip on something fruity to keep you cool.”

That said, sometimes a burn will still happen.  USAToday.com has good and practical treatment advice in that worst case scenario.  I encourage you to read it, but some high points are:

After a cool shower or bath, slather on a moisturizing cream or lotion to soothe the skin. …And consider a product containing vitamin C and vitamin E: It might help limit skin damage (though studies have not proved that)… It’s also OK to use a hydrocortisone cream for a day or two to relieve discomfort.

…Drink extra water, juice and sports drinks for a couple of days and watch for signs of dehydration… Children are especially vulnerable, so check with a doctor if they appear ill.

Consider medicating with ibuprofen which not only alleviates the pain and some swelling, but might prevent some long-term skin damage.  While they remind us most sunburns can be treated at home, “if a blistering burn covers 20% or more of the body (a child’s whole back), [or if symptoms such as fever or chills occur] seek medical attention”

First, as stated by MedPage Today,

“If you have to have malignant melanoma, be a woman – your chances are better.”

While it’s considered preliminary data, the article share that “women exhibited a consistent independent advantage in melanoma progression, metastasis, and survival across all stages which was independent of hormonal status.”

That means the results were the same, regardless of age.  The challenge is that we still don’t know WHY women survive melanoma or it progresses less quickly than in men. Even the speculation that it was behavioral was ruled out — such as men avoiding the doctor more than women — and is seen as something biological.  But what?:

It’s…not an obvious effect of changes in hormone levels driven by menopause. Women 45 or younger had similar rates of progression-free survival as women 64 and older. But there could be other hormonal factors, differences in vitamin D metabolism, or variation by sex in how people handle reactive oxygen species and oxidative stress, [Arjen Joosse, MD, of Erasmus University Medical center in Rotterdam, the Netherlands] speculated.

Even such a factor as obesity might play a role, since adipose tissue releases hormones, he said.

Indeed, the key question is no longer if the observation is true, but what’s causing it,

Vitamin D supplementation at a relatively low dose plus calcium did not reduce the overall incidence of NMSC or melanoma. However, in women with history of NMSC, CaD supplementation reduced melanoma risk, suggesting a potential role for calcium and vitamin D supplements in this high-risk group. Results from this post hoc subgroup analysis should be interpreted with caution but warrant additional investigation.

That leads us to the next report that just came out, and as reported by MedScape Today:

Calcium plus vitamin D supplementation did not reduce the overall incidence of nonmelanoma skin cancer (NMSC) or melanoma in postmenopausal women in the Women’s Health Initiative (WHI), researchers say.

However, the placebo-controlled study found that, in women with history of NMSC, calcium plus vitamin D supplementation reduced subsequent melanoma risk, suggesting a potential role for the supplements in this high-risk subgroup, said the authors, led by Jean Tang, MD, PhD, from Stanford University in California.

So, while we don’t know why women do better in battling melanoma, and we know that Calcium and Vitamin D seem to be ruled out as a factor in preventing the disease, there DOES seem to be some evidence that the supplements may hold melanoma at bay a bit in women who have had NON-melanoma skin cancers before.

The takeaway continues to be, as with our other posts on studies and treatment news, that we are continuing to gain ground and promising results are coming in.  But, we must continue the research and continue down the path a ways to reach a cure.

*Please remember, we share information on Melanoma Updates that we found interesting, inspirational, or thought-provoking.   Any science or clinical study news you read here or elsewhere should be reviewed with your doctor.

“A child’s skin has structural quality that makes it more vulnerable to the effects of UV radiation, and this can result in an increased risk of later skin cancer,” said Roya Samuels, MD, a pediatrician at the Steven and Alexandra Cohen Children’s Medical Center of New York in New Hyde Park.

New York City dermatologist Doris Day, MD, says that “newborns, infants, and toddlers have skin that is continuing to develop…and it is really important to protect it,” she says.

However,  it’s not easy to find sunscreen for infants and toddlers: “Sunscreens for infants must be non-irritating to the skin and eyes…” For both these reasons, for the first six months, infants should be covered from direct sun via clothing, hats, etc., This is also important since harmful rays can penetrate car and home windows. (Consider clear protective window coatings.)

Then, in selecting a sunscreen, with a minimum SPF of 15, many parents “may prefer that infant sunscreen leave a temporary film so they can be sure all exposed body parts are well covered. In addition, water-resistance is an important quality for infant and toddler sunscreens….” as is the need to ensure a sunscreen blocks against both UVA and UVB rays.  The thicker zinc- or titanium-based products are more opaque and sit on skin more than getting absorbed.  “…And zinc and titanium don’t irritate the eyes as much because they tend to stay in place.” 

We shared the Environmental Working Guide’s new rating of more than 1,000 sun products in our last post.  And The Daily Green culled through that list to post their selections from that list of the 13 most affordable natural kid and baby sunscreens with mineral sunblocks.

As mentioned in WebMD:

Ravinder Khaira, MD, a pediatrician with Sutter Independent Physicians in Sacramento, Calif., says that applying sunscreen — and reapplying it according to the directions — is the No. 1 way to prevent sunburn and sun damage that can lead to skin cancers when children grow up.

Take special care to cover their ears, nose, and scalp, he says.

Young children do have highly sensitive skin, so it’s a good idea to do a small patch test before slathering on a new sunscreen. “Test it on the forearm and wait about 30 to 40 minutes to see if any hives, swelling, redness, or itchiness occur,” Khaira says.

If children get sunscreen in their eyes, flush their eyes and face with cold water to minimize any irritation, he says.

It’s not always easy being a dad…or a mom.  But once the kids are slathered up, you can sit back and rest.  For a second.

And area readers may have seen a profile of yours truly, which ran on NJ.com on Sunday.  I share this because it enabled me to explain the reason I’m passionate about MoleSafe, and how it came about.

More importantly, it hopefully brought a little more awareness about this important screening technique to more people.

There’s been more exciting news in the area of Melanoma research and treatment.  I’ll share that later this week….

In the meantime, please remember to review your choices, and keep applying that sunscreen!

The Environmental Working Group’s guide to effective and less-toxic or non-toxic sunscreens is out again with additional options on this 2011 version. This comprehensive list, and associated articles, does an excellent job of explaining the challenges with both the FDA’s progress in setting standards for sun-protection products…and consumers’ understanding of the elements that go into that sunscreen — good or bad.

Even since we shared their 2010 list last May, more outcry has been heard about a common ingredient in many mainstream sunscreens, that is a derivative of Vitamin A: Retinyl palmitate.  In fact, in June of last year, Senator Chuck Schumer called on the FDA to investigate it, as mentioned in this release from his office:

Retinyl palmitate is an ingredient found in most of the 500 most popular sunscreen products. Scientists at both the NCTR and the NTP have been working diligently over the last decade at the FDA’s request in order to determine whether this Vitamin A derivative, retinyl palmitate, is safe to use in sunscreen products. In one study, tumors and lesions developed up to 21 percent faster in lab animals coated in retinyl palmitate-laced cream than animals treated with a cream that did not contain RP. While these studies have been completed for almost a year now, the FDA has not issued an assessment of ruling on either of them….

Schumer added, “Millions of Americans use sunscreen to keep themselves and their families protected from the dangers of too much sun. If the product they are using is doing more harm than good, they have a right to know.”

Of course, there is NO safe way to TRY to tan, just as the American Academy of Dermatology says. But in tan PREVENTION, there are things to consider.  Here’s something from a section on their Website about sunscreen, that you might not have known:

Q: When should sunscreen be used?
A: Sunscreen should be applied every day to exposed skin, and not just if you are going to be in the sun. UVB rays cannot penetrate glass windows, but UVA rays can, leaving you prone to these damaging effects if unprotected.

For days when you are going to be indoors, apply sunscreen on the areas not covered by clothing, such as the face and hands. Sunscreens can be applied under makeup, or alternatively, there are many cosmetic products available that contain sunscreens for daily use. Sun protection is the principal means of preventing premature aging and skin cancer. It’s never too late to protect yourself from the sun and minimize your future risk of skin cancer.

Don’t reserve the use of sunscreen only for sunny days. Even on a cloudy day, up to 80 percent of the sun’s ultraviolet rays can pass through the clouds. In addition, sand reflects 25 percent of the sun’s rays and snow reflects 80 percent of the sun’s rays.

So, as the inquiry continues, we, again, are of the belief that smart skin cancer prevention tactics start with covering up and include generous use of sunscreen. Of those, perhaps making a more natural choice of mineral (titanium dioxide, for example) vs non-mineral protection is a better option.  The  introductory paragraph to the Environmental Working Group’s guide says it all:

The best sunscreen is a hat and a shirt. No chemicals to absorb through the skin, no questions about whether they work. But when you can’t get away from exposing your skin to the sun, use EWG’s top-rated sunscreens to provide broad-spectrum (UVA and UVB-sunburn) protection with fewer hazardous chemicals that penetrate the skin. Sunscreen and sunblock makers are awaiting FDA approval for a wider selection of UVA-blocking chemicals. In the meantime, all [the Guide's] top-rated products contain either zinc or titanium minerals to help cut UVA exposures for sunscreen users.

PS: And now, yes, “there’s an app for that.”  The EWG Sunscreen guide reviews some 1700 products, so keeping them straight at the point of purchase will be easier for iPhone owners now.  Check it out in iTunes app store, for free.