Thursday, July 24, 2014

Lefty

In the spirit of another blogger’s confession, I’ll admit that I haven’t always been so diligent about applying sunscreen every day.  On weekends, I’m the poster boy for sunscreen application as I apply it before walking out the door, especially when I’m working in the yard or just spending time outdoors.  But on the week days, I have convinced myself that my exposure to the sun is very limited and that sunscreen might not be needed.

I have a 25 minute commute which starts at 7:30 each morning.  I drive north, which means the morning sun is mostly blocked as it shines dimly through the passenger-side window.  I work in a cubicle farm with absolutely no windows in the office or on the manufacturing floor.  Most of my work days last well past 5:00, so if the sun is still shining at all when I leave, it sets in the western sky through my passenger window again as I commute home.  I really get very little sun if at all.

Or so I thought.

One of the first things I do every work day morning is jump in the shower.  While this wakes me up a little, the sight of me in the full length mirror as I step out of the shower stall scares me fully awake.  After the shock, I take advantage of the mirror and take a quick look at my skin, looking for anything different.  Yes, I check my skin daily…perhaps a tad more than the recommended monthly check, but I figure if I’m exposed in the morning, why not?  I have a few larger moles that my dermatologist and general practitioner have deemed healthy, but I watch closely anyhow.  In fact, my skin check is usually quite close up using a hand mirror.  But what I noticed the other day was during the initial step out of the shower…a “wider picture” if you will.

I noticed that I have basically no tan lines, except along my left tricep.  My left arm is at least a subtle shade darker than my right.  When I wear a polo shirt (my typical work attire), the difference is not noticeable, but when I’m in shower mode, the darker arm is clear as day.

There are a couple reasons for this.  First of all, while a window will block most UVB rays (the ones that cause burning), a majority of the UVA rays (the ones responsible for skin aging and used in most tanning beds) penetrate and shine right on your skin.  Despite being on the side opposite of the sun as I drive, my left side is still more exposed to the sun than my right.  Remember this guy?


He’s the trucker that made the news a couple years ago because of the sun damage to the left side of his face.  Dermatoheliosis, or photoaging, is due to chronic exposure to UVA and UVB rays. The result is a gradual thickening and wrinkling of the skin.  Twenty-eight years of driving his truck led to this excessive exposure.

Of course, my commute offers me far less exposure than did this trucker, so my condition is nowhere near as drastic.  But there is one other factor to my darkened left arm.  The air conditioner has been busted in my car for well over a year.  Yes, I drive mostly with the window down and therefore rest my arm upon the door.  It’s still on the opposite side of the car from the rising or setting sun as I drive and it’s well outside of the peak sun hours of 10AM to 2PM, but it still rests unprotected as I drive.  Despite the apparent safer conditions, my left arm has a slight bit of sun damage.

In a slight bit of irony, just as I noticed my arm, the following ad from Banana Boat came to my attention.


Yep, that’s me.  Except now, I've learned my lesson.  Every morning as I get out of the shower (eeek!), I check my skin and then apply sunscreen to my arms and neck.  I also now keep a small bottle of sunscreen in my briefcase and apply it to my arms before heading home.

Please realize that sun exposure is constant from morning ‘til night.  While the early morning sunlight may seem safer, there are still UVA and UVB rays hitting your skin.  When you sit in your car (hopefully with air conditioning), the sun that shines through your wind shield still carries along UVA rays.  The same holds true of windows in your home or office…make sure to draw the shades or wear sunscreen!  Please be diligent and wear your sunscreen even when you’re convinced it’s not necessary.

Thursday, July 10, 2014

Melanoma Advocacy and the Return of Dr. Oz

The melanoma advocacy community has really spoken up lately.  In May, we did our part in increasing melanoma awareness in the general population.  I’ve never seen or read so many corporate-sponsored ads and Twitter chats regarding sun safety and skin cancer.  From L’Oreal Paris and Neutrogena to Glaxo Smith Kline and the Melanoma Research Foundation, it was difficult to venture into social media without seeing some hint of melanoma awareness advocacy.

After the dust settled, well, it didn’t.  Someone spotted a contest on Ellen DeGeneres’ website soliciting “funny sunburn photos.”  This is apparently an annual event on Ellen’s website, but this year we got wind of it and expressed our concern.  In some cases, outrage was expressed!  Melanoma warriors and survivors sent in photos of their scars and excisions rather than “funny” sunburns.  Emails were sent and Ellen’s Facebook page was flooded with concerned comments.  Within 48 hours (or less?) the request for sunburn photos disappeared.  Perhaps this was merely a coincidence or maybe it was a direct result of our efforts.  Whichever, it seems we were heard.

Before the last virtual champagne bottle was opened, another fly in the ointment appeared.  The infamous article from RealFarmacy.com (and posted in other sites) was posted, offering alleged proof from a “major study” that sunscreen causes skin cancer.  The only problem was, the data was cherry-picked, extremely misleading, based on decade old research (long since obsolete) and just down-right full of incorrect information.  In this case, the melanoma advocates didn’t address the source, but chose to share opposing views via their Facebook pages, blogs and articles.  Not only did simple bloggers like me address the issue, major websites such as IFLScience, Snopes and the Melanoma Research Foundation issued statements including supporting evidence of the original articles falsehoods.  As this event is recent, I’m sure there will be even more comments in support of sun safety.

It finally looked like things were going to quiet down, but then I saw another small article today.  It’s not as blatantly anti-sunscreen as the RealFarmacy article or as blissfully ignorant as the Ellen contest, but in my mind, it can be just as damaging to efforts in melanoma and sun-safety advocacy.  And it originates from our old friend Dr. Oz.

Dr. Mehmet Oz may have been the first to create a true outcry from the melanoma advocacy community.  You may recall that back in 2012, Dr. Oz hosted Dr. Joe Mercola, an FDA-cited, tanning bed selling “medical expert” who talked about the benefits of UVB tanning beds (which again…he sells) and how mainstream media was skewing the true melanoma statistics and that the cancer was not indeed increasing in society.  At the end of the interview, Dr. Oz stated that he would “rethink” the use of tanning beds.  Immediately, Dr. Oz became melanoma advocacy public enemy number one!  In my view, Dr. Mercola was the true “evil” in our midst.  Dr. Oz offered up a statement after the show to convey his strong stance against tanning beds, so I personally gave him a little bit of a break.  A little.  (Here’s my assessment of the two doctors).

That” break” has finally dissolved with the airing of his television show on July 7. 

During this episode, Dr. Oz addressed summer health myths, such as “Are mosquitoes attracted to sweet blood?” “Do you have to wait 20 minutes after eating before swimming?,” “ and “Does peeing on a jellyfish sting reduce the pain?”  The first myth addressed was “Does a sunburn fade into a tan?”  When I saw this introduction, I hoped that this would be a great opportunity for the good doctor to share good sun safety tips.  I figured he’d address the myth, and then mention that both sun burns and sun tans are signs of skin damage…just as is stated by the Skin Cancer Foundation and so many other fine medical organizations.

As anticipated, he addressed the myth first.  In short, no, a sun burn does not fade into a tan.  He states, “When the sun hits your skin, it doesn’t just tan – it destroys.”  He and an audience member (who he leads creepily around by the hand) perform a demonstration on how UV rays kill skin cells and tans the few remaining cells.  (This demonstration involved shattering glass for which each wore safety glasses, and scolding hot water, for which no protective gear was worn.  I could swear the audience member may have been burned by spattering hot water).  After the demonstration, Dr. Oz explains the mechanics, and then states, “that’s why burning is never a good idea if you want to get a tan.”  At this point, the audience member smartly states, “Just stay out of the sun unless you’re wearing sunscreen.  End of story.”  Okay…this is the perfect segue for the doctor to explain the damaging effects of burning as well as tanning.

How does Dr. Oz respond?  He replies, “…or get it gently.”   He explains that best way to get a tan is in small doses over time so that the skin cells that survive the burn will have the opportunity to darken and new cells will grow back to further darken through gentle tanning.  He doesn’t discourage tanning at all!  In fact, he’s trying to convince his audience that there’s a safe way to tan.

Let me repeat .  He is explaining a safe way to get a tan.  He never mentions that no tan is a safe tan, and he completely ignores his audience member’s comment that it’s best to wear sunscreen!


This entire discussion takes place in less than two minutes and it doesn’t have the wide distribution of the aforementioned RealFarmacy article, so I doubt there will be the same outrage.  But what upsets me is that Dr. Oz has millions of viewers.  As I stated in my earlier blog in 2012, when Dr. Oz talks, many impressionable viewers who trust his medical expertise will listen.  They now potentially believe that there is a safe way to tan, and are ignorant of the true facts of which Dr. Oz had the perfect opportunity to share.

We melanoma awareness advocates have our victories, but we have new and challenging battles every day.  Don't give up...and don't stop believing.  One day, people will know because they need to know.

Tuesday, July 8, 2014

The Big Bang Theory

Doctors at Johns Hopkins University noticed an interesting thing when examining teenagers with bangs.  The skin covered by the bangs was more pale and freckle-free while the rest of the face would exhibit more freckles.  Whiles freckles are not considered dangerous, they are a marker of increased sun exposure and potential skin damage.  Dubbed the “Big Bang Theory,” the experts at Johns Hopkins feel that this discovery would make a great teaching mechanism with which teenagers could relate, especially since teen idol Justin Bieber made the hairstyle popular.  Dr. Bernard Cohen was quoted (1) as saying that it’s “a gimmicky way to make them smile and engage them in conversation about sun protection.”

I appreciate the effort and intent of this teaching method, but I see two major flaws.  First, Justin Bieber no longer has bangs.
 
Source: music-mix.ew.com
Secondly, from what I understand in my own kids’ conversations, one mention of Justin Bieber would send most teens running away screaming or, worse yet, result in the dreaded eye roll!

Perhaps a couple of the lads from One Direction would be a more accepted comparison.

Source: musictimes.com
Or, if I may, you might consider my own son.

Source: Proud Dad
My 12 year-old son has bangs, as you can see.  His favorite move is the head swoosh where he shakes his head to one side hard enough for his bangs to lie at just the right angle.  He’s perfected the move to the point that he seems to be in a habitual seizure of head shaking.  But hey, that’s how he rolls.

He likes his bangs and it makes me long for the day when I had bangs. <sigh>

Source: The 1980's
Whether the example is Justin Bieber, One Direction, or my son Nathan, any gimmick that works is worth it.  Any talk with teenagers about skin cancer usually falls on deaf ears.  Teens consider themselves invincible and seldom worry about getting skin cancer that could be years or decades down the road.  Many experts suggest focusing on wrinkles and sun spots to get the point of sun safety across.  After all, while teens want to act older, they also want to continue looking younger.  The threat of looking like some old dude can be serious motivation to take care of the skin.  And showing the difference between covered and uncovered skin, even on the same head, might help get the point across.

Goodness knows there are many talks we need to have with our teens.  (Oh boy do I know that!)  But don't forget to add one more talk...the one about sun safety and wearing sunscreen.  It's as important as any other talk you may have!

(1) https://uk.news.yahoo.com/justin-biebers-bangs-could-save-teens-skin-234403230.html#KHxQVmo

Monday, June 30, 2014

Wrong Message Ellen

In case you missed it, the Ellen DeGeneres Show has asked the public to “Send us your bad sunburn photos!”  This is the photo they used as an example:


As a colleague of mine would say, from 50,000 feet, this seems funny.  I would equate the humor to someone writing “Dork” on a sleeping frat brother’s forehead.  Sure, it’s sophomoric humor, but it can be funny.

But in all honesty, this isn’t funny.  You and I both know that there is nothing funny about a sunburn.  One bad sunburn can significantly increase one’s chance of being diagnosed with skin cancer or melanoma.  Repeated sun exposure is even worse.  Of the top seven cancers, incidents of melanoma are rising while all others are declining.  Most skin cancer and melanoma can be attributed to UV radiation from the sun or tanning beds.  In short, sunburns are bad.  Very bad.

You might call me a hypocrite.  After all, I posted a blog a three years ago (almost to the day!) that made fun of “funny” sunburns.  Well, in all honesty, I was trying to showcase how improper sun screen application can result in sunburns.  Still, I used the words “every now and then I have to lighten things up” meaning that I thought the pictures in the blog were indeed funny.  In retrospect, they weren’t (although they still emphasize proper use of sunscreen). 

I do have a sense of humor.  Some would say I have a sick sense of humor that defies political correctness.  As I said before, from a distance, Ellen’s request seems funny…until you realize that some people may purposely subject themselves to “funny sunburns” so as to have their photo appear on TV.  This is what makes this so offensive to me.

If any sunburns are to be posted, let them be of sunburns that make attractive people look ridiculous. 


Make a statement that sunburns are not to be laughed at, but to be admonished with mutterings of “when will they ever learn?”  I would love to see a segment on Ellen start with such photos to cause the audience to laugh…and then show a picture such as one of these:



Imagine how the audience would grow silent.  Imagine how they would stop to think.  Imagine the message that could follow with important and substantial discussion about sun safety and melanoma.

Now THAT would put a smile on my face.

Thursday, June 26, 2014

Teaching Hope


In 2012, a teacher of Healthy Living at Lufkin Road Middle School in Apex, NC was battling melanoma.  Marti Capaforte wanted to keep her illness private, but a few of her colleagues approached her with an idea about a school-wide cancer awareness event.  Her co-workers wore purple t-shirts with the word “Hope” on the front, and Capaforte’s favorite saying on the back: “Have a great day on purpose!”  Students began participating in activities which inspired cancer awareness.  Posters on the facts and dangers of tanning beds and tobacco use adorned the hallways. 


Toward the end of the year, the students enjoyed field day, one of Capaforte’s favorite student activities that the staff chose to bring back.  This became the first “Hope Games.” 

Melanoma eventually claimed Capaforte’s life, but her message and inspiration live on.  A memorial garden sits in the front lawn of Lufkin Road Middle school and each year, students plant more trees in her memory. 


Sara DeMarco was one of Capaforte's friends/colleagues that first formed the Hope games.  Herself a melanoma and cervical cancer survivor, DeMarco continues to teach cancer awareness to her students (including my own children).  Due to an unusual amount of inclement weather and lost instructional time in the winter of 2014, the Hope Games had to be cancelled this past year with the hope of it returning in 2015.  However, DeMarco organized one week this past semester in her Healthy Living class that was still devoted to cancer awareness, including breast cancer, lung cancer (where all students signed a no smoking pledge), leukemia and melanoma.  Each day, my kids came home with new information to share with me.  Yes, even on melanoma day, my daughter (clad in her “Black is the New Pink” t-shirt) was excited to tell me about slip-slop-slap! 


The students also had the opportunity to give back and donate to the American Cancer Society.  Total donations added up to $1,467.84.  I’m proud to report that my kids’ track/pod donated the most per kid with a track donation of $208.


The fact that Marti Capaforte was stricken with melanoma is tragic.  However, her story has inspired one middle school in North Carolina to teach its students cancer awareness (including sun safety) and the joy of giving to help others.  Thanks to Ms. DeMarco and the rest of the staff for teaching my children (and many others) a very important lesson for life.


Saturday, May 31, 2014

Journey of a Tanning Ban Bill and the Role of the American Suntanning Association - A Wolf in Sheep's Clothing?

The Youth Skin Cancer Protection Act was introduced to the North Carolina House of Representatives in 2013.  The bill (HB18), similar to legislation across the country, would disallow persons under 18 to use tanning equipment if passed as a law.  Nearly every medical association supported passage of this bill.  Former tanning bed users who later developed skin cancer or melanoma spoke before the committees.  The Director of the Duke University Melanoma Center also spoke about the dangers of tanning equipment.  However, there was one very influential group that spoke against such a law…the American Suntanning Association.

When asked, Joe Levy who at the time represented the indoor tanning salon trade group called “Smart Tan Network, Inc.” stated that melanoma “does not have direct relationship with sunlight.  It is a complex relationship if at all.”  The ASA had also touted the supposed health benefits of UV rays such as vitamin D absorption, treatment for psoriasis, and treatment seasonal affective disorder.  Despite fact-based statements to the contrary by represented medical professionals, the legislators listened to the ASA with great interest. 

There was also more political-based discussion.  Tanning supporters claimed that parental rights would be violated by this law.  “Every parent has a right to decide what’s best for their children…not the government!”  (Of course, let’s ignore the age restrictions on cigarettes, alcohol, voting, driving, pornography…all imposed by government regulation).    

The bill passed by a House vote of 94 to 22, meaning that 22 bought into the ASA’s claims.  It was passed along to the Senate and subsequently entered committee purgatory within the Senate’s Committee on Rules and Operations.  This is the committee where bills go on hiatus waiting to be used as a bargaining chip to slide into controversial legislation or simply left to be forgotten.  Bill HB18 was introduced to this committee on March 21, 2013 and still sits there today as of May 30, 2014.  The American Suntanning Association may have lost the vote, but they seemed to have won the battle.

When I asked sponsors of the bill if they felt the battle had indeed been lost, they responded quite the opposite.  They stated that before the bill was introduced, they really didn’t know who would support or oppose the legislation.  Now that the initial debate had begun, the line had been more clearly established between supporters and detractors.  Even though the Senate had yet to discuss the bill, clear alliances existed between Senate and House members, so it was pretty easy to determine how a Senate vote might go.  With this knowledge, the sponsors now know who they need to convince to vote in favor of the bill.  This was fascinating insight into the political process, but I sadly felt that the bill had seen its last day…at least for a few years. 

But then the American Suntanning Association made a surprise move.  They dropped their opposition!

This opened the door to start campaigning anew.  The election-year “short session” has begun and the bill sponsors and other organizations have been pushing hard to the Committee Chair (Sen. Tom Apodaca…someone who opposed the bill in favor of “parental rights”) to forward the bill onto the Senate floor.  Senator Apodaca has stated that the Senate’s focus is on the state’s budget and doubted that this bill would be forwarded on.  However, the ASA’s retraction and recent tanning bed regulatory changes by the FDA have shown that this bill should pass with minimal resistance.  Let’s hope this is the case.

The American Suntanning Association’s reversal from HB18 opposition begs one question.  “Why?”
Joe Levy, now Scientific Advisor to the ASA, has stated that they want to have “high-level discussion on the risks and benefits of any UV exposure and for heightened responsibility both in the tanning market and in those who oppose UV exposure.”  Translation: they want real debate about the dangers of tanning swept under the rug.

According to Levy, people under 18 years old account for about 2 percent of the total tanning business.  To continue to fight legislation which is sweeping the country would cost the tanning industry thousands if not millions of dollars, far more than they would most likely lose in lost business to teenagers.  But I think there’s another reason.

When HB18 was introduced last year, it was not the top headlining piece of legislation, but it received its fair share of news coverage.  Any debated topic means better ratings for news broadcasts.  As a result, there was increased debate over the air and in online forums.  Awareness of tanning danger, skin cancer and melanoma was on the rise.  The more these dangers were expressed, the more people over the age of 18 started to listen.  The more they listened, the more they reconsidered the safety of tanning salons.  These were the people on whom the tanning industry relied for their business.  If adults started to shun the tanning beds, the industry would be in serious trouble.  So they changed their strategy.

The ASA is now supporting legislation to ban minors from tanning.  According to Mr. Levy, the ASA has helped pass such legislation in 7 states thus far in 2014.  They hope that North Carolina will be the next. 
Think about it.  Having no opposition to this bill means there will be no heated debate.  There will be no online forums.  There will be minimal media coverage at best.  It will have the much public interest and notice as a fictional bill to add additional brake lights to school buses.  It will simply…pass.

Passing this legislation is a good thing!  It is a very good thing!  The sponsors of this bill need to do exactly what they are doing and wave the ASA’s endorsement in the legislators’ faces in hope to get HB18 passed.  After that, some lives will be saved.  Skin cancer and melanoma rates will decrease.  There will be a positive impact on the cost of healthcare in that fewer dollars will be needed to fight these cancers.  But what will happen to the angelic and enlightened American Suntanning Association?

I predict the ANA will refocus their monies from fighting legislation to pushing the tanning industry on the over 18 crowd.  College towns will have an increase in tanning salons.  Specials on lotions and tanning sessions will be promoted on campus.  University girls will be reminded that having no tan before Spring Break is a fashion faux pas.  The wolf will shed its sheep’s clothing and the tanning industry will evoke a full frontal assault on the 20-somethings.  Sadly, many will buy into it all.


As I said, passing the Youth Skin Cancer Protection Act into law is important.  Middle school and high school students will be banned from tanning salons.  But this is not the end of the battle for those opposed to the tanning industry.  There is still need for parental responsibility.  Parents, schools and people like us need to explain to these kids why there is such a tanning ban.  We need to teach kids about sun safety and melanoma awareness.  We need to educate the children BEFORE the tanning industry gets their fangs into them after high school.  

Friday, May 16, 2014

Ticking Bomb?

Let me preface this post by stating again that I do not have melanoma.  Thank goodness that I have no clue as to how it feels to have melanoma or any skin cancer.  I did have a prostate cancer scare a few years ago (false alarm…twice), but that’s not really the same.  I cannot relate to what it feels like to live with cancer.  I can only surmise how it feels from the experiences that my brother scarcely shared and from what I read from others…and there have been so many who have shared.  Regardless of so much “data,” I still will never know until I get it.  And that’s what I fear…”getting it.”

I have lived “high risk” for various conditions for several years now.  I have an extensive family history of cardiovascular conditions, plus I take medication to keep my triglycerides and cholesterol from going through the roof.  I love my pizza, cheeseburgers and burritos.  I’m a heart attack waiting to happen.  When I saw a photo that my daughter recently took, I got scared.  I am not in shape…unless you call round or pear a shape.  I need to make some changes to make sure that heart attack never happens.  The truth is I CAN make such changes.  Other conditions may not be so easy.

As I mentioned above, I had a prostate cancer scare several years ago.  The doctor felt a lump during the good ol’ “digital exam,” so she referred me to the even longer-fingered urologist who agreed that indeed there was a lump where there shouldn't be.  A painful biopsy followed with an inconclusive diagnosis.  There was “something” in there and they needed another look.  So I had a second biopsy performed with more pain but better results.  The conclusion was that I didn't have cancer.  “But,” as the doctor told me, “you are high risk to get prostate cancer…probably in your 50’s.”  I’m 51 now.  Unlike my weight and general shape for better heart health, there’s not a lot I can do to make me lower risk regarding prostate cancer.  I take supplements (saw palmetto and licopene) that have statistical links to improved prostate health, but truly there is nothing more I can do except, well, get in better shape.  (See love of pizza above)

And then a few years ago, my brother Jeff was diagnosed with melanoma.  At the time, he told me that melanoma was “carried” between siblings because we grew up in the same environment, and probably the same type of sun exposure.  Yep, baby oil, iodine and Solarcaine for the after burn…that was our method.  You know Jeff’s story.  Mine has a happier continuation with no end written…yet.  I have moles aplenty and remain high risk due to my blonde hair and blue eyes.  I wrote a blog once about uncontrollable risk factors.  One statistic that caught my eye was that having two immediate family members with melanoma creates a near 100% chance of being diagnosed with melanoma.  That seemed unreal to me and I actually contacted the source from where I obtained this data.  Sure enough…100%!  Thank goodness I had only one family member who had been diagnosed with melanoma.

Until now.

I called my dad the other day and he gave me the rundown of his week.  A gathering with some friends one day, a check up with his cardiologist another day and an appointment with his dermatologist to get some spots removed.  Obviously, I asked him about the latter first.  He responded, “It’s just a couple pre-cancerous spots that I always have taken off.  Oh, and he wants to remove a melanoma off my back.”

“A what?  Do mean ‘carcinoma’?”

“Nope, it’s a melanoma.  The doctor said it was no big deal.” (My dad would tell me that a tornado was no big deal to keep me from worrying)

So my mind thinks of all the times I've written how early detection of melanoma results in 97% survival rate.  Many articles state that early detection leads to it being cut out and being “cured” of melanoma.  My mind focused on this as I logically agreed that it indeed was probably no big deal…especially if it was indeed caught early as my dad implied.  My heart admitted that I'm a little worried.  My gut screamed one other thing…”That’s the second family member…dammit!”

Obviously I’ll be talking to my dad soon.  Logically I’m not worried because he DOES visit the dermatologist often and if melanoma was detected, I’m confident it was caught early enough.  As for me, I know I take all the precautions I can against melanoma…now.  In my earlier years…not so much. 

Once again, I have another “high risk” tag placed upon me.  I've been here before.  This time however, it got my attention a little more than usual.