"Only Good Things Can Come From That"

This evening (December 10, 2014) I was fortunate enough to attend the 2014 GSK Melanoma Virtual Summit.  This was an online gathering of bloggers and melanoma advocates and organizations to discuss recent developments in the fight against melanoma.   I’ll admit, I wasn’t very good at keeping notes, so what I share here will be a very summarized and abbreviated account of the 90 minute session.

First of all, we all introduced ourselves.  I was thrilled to see the faces of familiar friends and “meet” those I’ve followed for a few years.  I’ll share respective blog and websites at the end of this piece.  There were also representatives from various melanoma advocacy groups (see the list at the end).

First on the agenda was a discussion of a patient’s perception during initial diagnosis.  GSK, as a drug manufacturer, interacts primarily with doctors and medical facilities and not so much actual patients.  They’ve been investigating the patient point of view more and presented some insights.  The most riveting part of this section of the summit was not GSK’s presentation, but the opportunity for melanoma warriors/survivors to tell their tale.  My friends Timna and Rich shared their reactions and experience with initial diagnosis.  It was encouraging to see a representative of the “Big Pharma” corporate healthcare world (GSK) listen to real human stories and emotions.

The next segment dealt with updates on recent policies related to melanoma.  July’s “Call to Action” by the Surgeon General emphasized.  This is not a federally funded venture, but a true call to action in local communities.  Organize the building of shaded areas in parks.  Increase awareness of UV dangers.  Promote sun-safe policies in schools and in the community.  Participate in fund-raising and awareness-raising activities.  Support legislation to ban the use of tanning beds for minors.  While it may have been the same message from July, it was an effort to recharge our efforts.

Others also presented updates on the recently signed Sunscreen Innovation Act.  Now, new formulations of sunscreen will be expedited for FDA approval.  This will introduce a slew of sunscreen formulas to the United States that already exist in other countries.  I asked if the increased options in sunscreen might help reduce the price of sunscreen…perhaps through increased competition.  Unfortunately, this could not be predicted or known at this time.

Additionally, there was discussion about the FDA Guidelines on sun lamps (warning stickers and reclassification of tanning beds), funding for various research, and details about research on genetic testing, specifically on those melanoma patients not fortunate enough to have the B-RAF gene (as there is no effective treatment for this 50% of the melanoma patient population).  This last effort is lead by the SU2C/MRA Melanoma Dream Team.  In addition, there was a report on the Brain Mets tissue bank to help research brain metastasis.  Over half of all melanoma deaths occur from brain metastasis.  Count my brother Jeff as one of those.

The summit closed with a brief impromptu discussion about pediatric melanoma and the apparent increase in such cases.  It was noted by one participant that 10 years ago, melanoma research concentrated on men in the 50’s.  Now, the research is heading to younger ages…20’s and now even to pediatric patients.  It’s a disturbing trend.

With the upcoming merger/acquisition/whatever of GSK with Novartis, there’s some concern that this summit will continue going forward.  The GSK group seemed confident that it will continue.  I certainly hope so.  Does this group of bloggers and advocates create new and innovative “legislation” against melanoma?  No.  But as my friend Rich commented, “The value of these things is to establish and build personal connections and relationships in the melanoma advocacy community.  Only good things can come from that.”

Thank you to the following organizations for your participation:

AIM at Melanoma – aimatmelanoma.org

Melanoma International Foundation – melanomainternational.org

Melanoma Research Alliance – curemelanoma.org

Melanoma Research Foundation – melamoma.org

Skin Cancer Foundation – skincancer.org

Skin of Steel – skinofsteel.org

The following is a list of attending bloggers as supplied by the GSK organizers.  My apologies for any that attended but were not on the provided list or that I simply forgot to type (it’s late at night…lol):

TJ Sharpe - http://www.philly.com/philly/blogs/patient1

Timna Understein - http://respecttherays.blogspot.com.es/

Steve and Jennifer “Who Dat” Martin - http://martinfamilyjourney.blogspot.com/

Martha Bishop - http://melanomas.bishless.com/

Alisa Linton - http://joshalisa.blogspot.com/

Julie Marzano - http://juliesmelanomajournal.blogspot.com/

Chelsea Price Dawson (and her little dog, too) - http://adventurewithmelanoma.blogspot.com/

Rich McDonald - http://hotelmelanoma.blogspot.com/

Some Time Away

Happy Thanksgiving!

I’ve taken some time off from blog writing.  While my responsibilities at work contributed to my reduced personal time and online absence, the truth is I decided to simply take a break.  Some of it was writer’s block but a lot of it was to get away from melanoma for a while.

This started at the first of the month when I spent an amazing birthday weekend with family.  My dad and his wife headed on their annual migration from West Virginia to Florida and decided to spend a few days with my sister-in-law Debbie.  She lives a few hours from my house, so my family and I decided to join the others at Debbie’s place for a reunion of sorts.  You see, this was the first time the three of us (Dad, Debbie and I) have been together since Jeff’s death.

I had visited dad a few times either in WV or Florida…and we’ve visited with Debbie as well.  But this was our first gathering of the three.  In my over-analyzing thoughts, I wasn’t sure how the weekend would go.  Our last such gathering…at Jeff’s funeral…was anything but enjoyable.  Certainly memorable, but not for any reasons we wanted to remember.  How would things be this time?

Gladly, it was spectacular.  We laughed, we ate (Debbie cooked…yum!), we laughed some more.  Debbie and I shared inside jokes that Jeff and I would have shared…Dad and I shared a few melancholy moments talking about my mom and brother…but none of the times spent together felt like any type of memorial.  It was simply family time.  It was great.  It was cleansing.

The trip offered a bit of unexpected closure.  Despite enjoyable visits with each since Jeff’s passing, there was always the pretense that Jeff was no longer around.  There was almost a “let’s don’t discuss it” feel in the air.  And as a result, there was always a presence of melanoma.  Somehow, the black cancer would invade our time together and remind us that it had taken our loved one away.

During this trip, we all talked and laughed about Jeff...about ourselves…about family.  There was no feeling of an uninvited guest.  There was no melanoma in our midst. 

Ironically, my dad had been diagnosed with melanoma in situ a couple months earlier and had it removed.  He showed off the scar (although very difficult to see) on his scalp where the cancer was removed.  Perhaps this is why melanoma wasn’t present at our gathering.  Yes, melanoma had invaded our family and taken one of us away.  The next time it came, it was detected early and pushed away.  While we respected it for the danger that it is, we were no longer afraid of it.  And thus, it was not with us.

I embraced that feeling after leaving and decided not to drag melanoma along.  I still followed and shared stories on Facebook and tried to keep up with the goings on of friends in the melanoma community, but otherwise, I remained silent and simply kept melanoma off my mind for awhile.

My work and the holidays will most likely keep me busy and possibly away from the keyboard for a few more weeks, but I’ve decided to renew my fight against melanoma.  There is so much to do.  Not just for the memory of Jeff, but to protect my children, who will become tenacious teenagers this coming year.  Tanning bed legislation…sun safety education…fundraising events…  Yes, so much to do.

And so much to be thankful for.

Note: The photo I share in this piece is actually a photo of a photo I spotted in Debbie's bedroom.  It was taken back in 2000 or possibly earlier.  That's me on the left, Jeff in the middle, and Dad on the right.  This was one of the last Thanksgivings that we all spent together as my mom passed away in 2005 after my kids were born in 2002.

The Wolf Reveals Itself

Back in May, I wrote a post about the proposed tanning ban bill in North Carolina and how the American Suntanning Association actually supported the bill.  (It has yet to pass).  I stated that I was suspicious of the ASA’s motives to back such legislation to ban minors from tanning salons.  I suspected that they wanted any discussion of the negative impact of tanning to be swept under the rug. 

“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.”

I went on to predict that while people would celebrate the passage of such a bill, the tanning industry would be licking their chops toward an older population.  After all, according to the ASA, those under 18 years of age account for only about 2% of the indoor tanning clientele.

“I predict the ASA 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.”

Today, I read where that sheep’s clothing has indeed been shed,  Here's one of many articles.

A study published in JAMA Dermatology (a journal of the American Medical Association) reports that 12% of the top 125 colleges across the US provide on-campus tanning facilities. Over 14% of colleges allow the use of campus cash cards to pay for tanning.   Also, more than 42% of the campuses have tanning facilities in off-campus housing that are pretty much part of the rent.  In other words, there is no limit on usage for the tenants!

The conclusion of the study: “Reducing the availability of indoor tanning on and around college campuses is an important public health target.”

What did the tanning industry have to say about this? Well, the Indoor Tanning Association stated “There is no consensus among researchers regarding the relationship between melanoma skin cancer and UV exposure either from the sun or a sunbed.”  No surprise there.  The wolf is back.

We need to take the study’s conclusion to heart…we need to make college-supported tanning a target for elimination.  We, as alumni, students and supporters need to contact our institutions of higher learning and demand that on-campus tanning be eliminated completely.  We need to demand that the schools not endorse off-campus housing that provides tanning beds as amenities.  We need to support and promote any campaigns that educate the student population on UV exposure and its true relationship to skin cancer and melanoma.  We need to contact our fraternity brothers and sorority sisters and encourage them to take positive action in this cause.  We need to make the university and college student population understand that the damage they do to their skin today will last a lifetime.

Please take action.  It’s the only way to defeat the wolf.  

The Staging Debate: An Analogy

Note: This post is not intended to reflect my views on gun control or gun owner rights…it is to merely serve as an analogy to make my point.

A gun was pointed right at you.  The eyes of the gunman were wild and stared into your soul.  You glanced at the gun and saw his trigger finger curl.  Then there was the deafening sound.  There was no way you could completely dodge the bullet. 

There are a few scenarios that could have played out from this scene.  Let’s count them down from worst to best.

4. The bullet inflicted a severe wound and you had an 85% chance of dying.  The internal damage was extensive and you likely suffered a painful death.

3. The bullet inflicted significant damage to a major organ and you were in intensive care and watched closely.  You still had a 60% chance of dying.  If you didn’t die, the recovery process was slow, painful and expensive. 

2. The bullet hit no vital organs but you were still hurt quite significantly.  You may have gone through rehabilitation and suffered permanent scarring.  Chances are that you lived, but you may have limitations later in life…not only physical, but mental and emotional.  The image of your experience will never go away.

1. The bullet hit your arm or leg, but didn’t cause major damage.  You required some minor surgery and ended up with scarring, but there was no danger at loss of life.  You will, however remain emotionally scarred.

0. The bullet barely grazed you.  You had no physical evidence of being hurt except for maybe a scratch, but you may wake up from your sleep with nightmares of your experience.

Of these five results, would you claim that any is not a victim of an armed assault?  My guess is no.  Whether you died or you were barely touched by the bullet, the morning headline would still most likely read, “One Person Shot.”  You would indeed be a victim.

So why is it that someone with Stage IV melanoma (who has only a 15% chance of surviving) is deemed as a melanoma warrior or survivor, but those diagnosed Stage 0 or Stage I are told they can’t be considered the same?

Sure, the higher stage diagnosis involves a LOT more heartache, pain, treatment and money spent.  No one would ever dispute that a Stage 4 warrior suffers far more than a Stage I patient.  But anyone…ANYONE…who is told “you have cancer” has seen that gun barrel pointed right at their chest.  They’ve seen the wild eyes of a killer face-to-face.  They’ve realized that they have a very real chance of something going very bad.  Perhaps hearing those words…”you have cancer”…is what defines a warrior.  It’s what defines a survivor.

There is one difference between the analogy comparing an armed assault victim to a melanoma patient.  The gun victim may never have to experience such an encounter again.  The melanoma warrior has a 1 in 3 chance of the melanoma coming back.  And in the case of my low-stage diagnosed brother, it came back to kill him 6 years later.

Pennies and a Tutu

Please accept my apologies for my absence from blogging.  Work is always a challenge, plus I went on a vacation, celebrated an anniversary, and enjoyed the height of softball season for my daughter (my first as a sport parent).  Oh, and there was this little thing called the 4th AnnualAmanda Wall – Corey Haddon Memorial Walk…also known as the Miles for Melanoma – Raleigh Walk.  (Whew…that’s a long name!)

This is the third year that I’ve been associated with this walk and it’s greatly rewarding every time.  Admittedly, those that founded this walk do a lot more than I, but I still try to pitch in when I can.  For me personally, this was the most successful walk yet!  Here’s why:

Over $22,000 raised!  This is lower than our goal, but considering that the committee cut back on some raffle items, we did pretty damn good!

One of our top fund-raising (nearly $3000) and entertaining teams...The Sun Block-ade 

Blue Lizard!  The awesome sunscreen company became a corporate partner with the walk this year and made their presence known with some samples at the walk.  It was nice to know that Blue Lizard is now available locally at Harris Teeter supermarkets (although…pssst…it’s cheaper to order online).

Blue Lizard...Corporate Sponsor!

Skin screening!  For the first time, we had a dermatologist (from Sanford Dermatology) performing free skin screenings.  The doc pointed out two spots that should be looked at more closely.  I have my annual appointment in about a month, so you can bet that my dermatologist will be made aware of these spots!

Family and friend support!  While I would promote the walk at my workplace in previous years, there seemed to be a greater interest this year.  This was partly due to the Amanda-Corey group’s presence at my company’s health fair in August.  Also, I decided to be a bit more aggressive in urging people to attend or donate.  And they did!  Plus, my family joined me at the walk for the first time.  There had always been some conflict in the past, but this year I got to have my wife and two kids walk along side…even though they seemed a little wary of my attire.

Co-workers Phung and Marcie, Marcie's kids Max and Connor, Me, my kids and my wife Kim  (missing from photo are co-worker spouse Jon Bailey and son Joshua)

Pennies!  I decided to start a campaign called #CARRYMYPENNY in which I would carry a penny for every dollar donated.  While my unofficial total was $860, I went ahead a carried an even 1,000 pennies just in case I missed a few.  That’s 6 ¼ pounds worth of pennies.  Admittedly, that’s not a lot, but I can tell you that it feels quite a bit heavier after 3 miles of walking.  Although as you can see in the next photo, I had a bit of help from one of my co-worker’s sons.

Connor toting my pennies!

Tutu!  I was very proud to wear the black tutu as the East Coast Division of Men in Black.  There was talk among the Amanda-Corey group that perhaps others would don the tutus next year for certain donation amounts.  I know this method works…I had a rush of donations once I announced I’d wear the tutu after I hit the $500 mark.  Perhaps next year I’ll offer other humiliating incentives for higher amounts.  I need to ponder that for a while.

Man in Black...East Coast Division

My friends at the Amanda-Corey Walk deserve a nice long rest and a celebration dinner.  I know they’ll start planning again in a couple months, and I have no doubt that next year’s event will be spectacular!

Labor Day...No Time to Put Away the Sunscreen!

It’s Labor Day.  Summer is unofficially over.  If you or your kids aren’t back in school already, they’ll more than likely start very soon.  It’s time to put away the beach towel, the boogie boards and the sunscreen, right?

Wrong!  Okay…the beach towel and boogie board can get stowed away, but that sunscreen needs to remain in your medicine cabinet or bathroom counter!  Even though the hot summer sun won’t be shining so high in the sky, it still emits those UV rays that damage your skin.

Many people associate heat with sun exposure.  If it’s not hot, the sun can’t be causing any harm…right?  The truth is sun exposure can be damaging even in the cold winter months.  While UVB rays, which cause burning, are weaker in the mornings and afternoons as well as the non-summer months, UVA rays are at their full intensity.  Yep…UVA rays are as strong in mid-winter as mid-summer, from sun-up to sun down.

UVA rays are more commonly associated with aging and wrinkling.  They also penetrate the skin more deeply than UVB rays (thus not associated with burning as much).  This deeper penetration causes significant and irreversible damage to your skin that may not be noticed for months or years down the road.  It’s important to protect yourself year round!

How?  Use sunscreen, but be well aware of what your sunscreen protects.  The SPF rating of a sunscreen indicates its ability to protect against UVB rays.  The SPF rating has no bearing on how well you’re protected against UVA rays!  It’s important to use a sunscreen that is “broad spectrum” or offers UVA/UVB protection.  Otherwise, you may not be protected from UVA rays at all!

Even if you have the right sunscreen, it doesn’t offer all the protection you need.  That low autumn or winter sun plays havoc on your eyes, especially when driving.  Most likely you’ll be wearing sunglasses, but again, it’s important to wear the right type.  Did you know that 70% of UVA rays penetrate glass?  Yes…even eye glasses and car window glass.  Don’t simply by glasses with a darker tint.  It’s important to select sunglasses rated with 100% UV protection…these will deflect the UVA rays as well as UVB rays.

As the air gets cooler, you’ll most like wear longer sleeves and slacks.  This should provide good sun protection, but don’t forget your exposed neck, face, ears and hands.  Apply sunscreen as mentioned before, but also wear a hat.  A wide-brimmed hat is preferred over a ball cap in order to protect your neck and ears.

I hope this past summer created great memories while you protected yourself against the sun.  But please don’t forget that sun protection is a year-round event.  Stay sun safe!

Kings Island Kicks Cancer

When I was a kid growing up in St. Albans, West Virginia (near Charleston), one of the best day-cations we would take every year was a trip to King’s Island just north of Cincinnati, Ohio.  My parents would wake my brother and me up well before sunrise and we’d hop in the car for the 3 ½ to 4 hour drive to Mason, Ohio…usually stopping for breakfast at the original Bob Evans farm near Gallipolis, Ohio.  Spotting the 333 feet Eiffel Tower from Interstate 71 set our hearts racing and we knew we’d soon be stopping in the Penelope Pitstop section of the massive parking lot and riding the shuttle to the main gate.  Carousels, rides, shows…this place had it all.  As little kids, we’d hold our parents’ hands and drag them to each attraction.  As teenagers, we’d venture out on our own and seek every thrill ride, and perhaps a cute girl we’d never meet again.  But the highlight of the day back then was challenging the longest wooden roller coaster in the world…”The Beast!”  Whipping through the woods at 65 MPH caused us to scream in delight and terror all at once.  It was the best.

It’s been years…no, decades since I’ve been to Kings Island, but the memories I have are still some of the best ever.  So it was with great interest and pride that I saw where the amusement park had launched a program called “Kings Island Kicks Cancer.”  From July 25 through August 24, park guests can purchase a soccer ball for $5 to kick into the park’s massive fountain.  

Each ball is an entry to win a 201 Honda Fit, plus net proceeds benefit three cancer charities: TheDragonfly Foundation, Pink Ribbon Girls, and Melanoma Know More!

Today, August 9, 2014, Kings Island and Melanoma Know More teamed up to organize a world record-setting event.  2,148 people applied sunscreen at one place at the same time!  

This beat the previous world record of 1,822 set in May by Ann’s Hope Foundation, another great organization raising funds for melanoma research and education.

Ever since melanoma entered my life after my brother’s diagnosis and eventual death, I have heard melanoma referred to as “The Beast.”  Every time I’ve heard those words, I was reminded of the good times at Kings Island, tackling a different Beast.  Today, these two parts of my life merged in a beautiful way…one beast fighting another.

Events like this are a fun way to educate people about melanoma, to encourage sun safety, and to answer the Surgeon General’s Call to Action against skin cancer.  Thank you Kings Island…and thank you friends at Melanoma Know More.

Psoriasis and Tanning Beds

Credit: Rich McDonald

I ran across a headline during a general Google search stating, “Kim Kardashian At Ulta – Promotes Kardashian Sun Kissed.”  This was immediately next to another headline touting, “Kim Kardashian  Flaunts Cleavage in Tight Pink Dress.”  The second headline itself was no more shocking to me than, “Scientists Determine that Water is Wet.”  However, the first headline grabbed my attention as I wanted to see whether or not Mrs. West was promoting “safe” tanning products or tanning enhancers.

When I clicked the link, there she was in her tight pink dress and plenty of cleavage.  In truth, all things Kardashian, or any name associated with tabloid headline pandering, simply turns me off.  To use an old cliché, I was reading this for the article.

Sure enough, Kim was appearing at a Los Angeles Ulta Beauty Store to promote the Kardashian Sun Kissed tanning line.  While her tanning product line does include self-tanning products, it also includes a “tanning extender” which is used after tanning to lengthen the life of one’s tan.  This didn't surprise me at all as I had little faith that any Kardashian would promote sun safety, despite having had episodes of skin cancer in the family.  While there was no surprise in the article, there was one major face-palm quote from Kim.

When I travel, the one thing that makes me feel alive whether or not I have makeup on is a tan, especially in my face. When you travel, you can’t just go lay out. I do like regular tanning because I have psoriasis, and the tanning beds are particularly good for that.

Tanning beds are good for that…that being good for the treatment of psoriasis?  I've heard that before.  I’ve addressed it before.  But I’ll address it again.

If you search the internet for “Psoriasis and tanning beds,” you’ll find a variety of information on both sides of the argument.  The fact is that Phototherapy is indeed a legitimate way to treat psoriasis.  Ultraviolet B rays (UVB) penetrates the skin and slows the growth of the affected cells.  Treatment is recommended to be administered on a set schedule by a medical professional, although there are home-based systems available by prescription only.  Sometimes, the UVB therapy is combined with a topical agent or other medication to make the treatments more efficient.  UVA rays are also used in other forms of light therapy, but only in conjunction with a medication psoralen which makes the skin more sensitive and much be monitored VERY closely.  All therapies described above, in fact are monitored closely by a health care specialist.  

So tanning beds should be a good alternative…right?  Wrong!  The majority of tanning beds emit primarily UVA rays which are mostly ineffective against psoriasis, unless combined with psoralen as mentioned above.  But again, this medication causes the skin to be much more light-sensitive and severe burning will occur.  There are tanning beds that emit UVB rays, but they are hardly regulated for intensity and not properly adjusted for specific treatment of psoriasis.

The National Psoriasis Foundation (NPF) has this to say about tanning beds:

Phototherapy (light therapy), performed under medical supervision is safe, effective, and cost-effective. The National Psoriasis Foundation does not support the use of indoor tanning beds as a substitute for phototherapy performed with a prescription and under the supervision of a physician. Only medical professionals should provide and advertise light therapy for the treatment of psoriasis.

The NPF goes on to say that the “spectra of light in tanning beds vary greatly and often include wavelengths of light that are carcinogenic and photo-damaging.” The NPF’s full statement on tanning beds can be found here.

There are plenty of accounts online from people that claim that tanning beds DID help with their psoriasis, and I don’t doubt that they believe that.  Many people don’t consider other influences that may have simultaneously impacted their improved condition.  Did they change their medication?  Were there other changes?  Or did their condition improve simply from the placebo effect?  I don’t often doubt that when something works, it works.  But at the same time, I feel it’s best to take the advice of medical professionals devoted to the treatment of this skin condition rather than trust the declaration of a tabloid celebrity.

Disclaimer reminder…I’m not a medical professional.  I’m just a guy that’s expressing his opinion based on what I've read in articles from various organizations and individuals representing various views related to melanoma and skin cancer.  My opinions are mine and I’m not paid by anyone to express them.  And trust me, I wish I were getting paid just to be me.  But then again, if I was, I’d probably be a Kardashian.

Pampering Ignorance

Groupon recently revealed the country’s most pampered cities, based upon total spending on the company’s pampering coupon deals.   These deals included haircuts and coloring, nails, facials, teeth whitening and, yes, tanning.  Overall, Green Bay, Wisconsin was ranked as the most pampered city, based mostly on their ranking in facials (#1) and hair care (#2).  No doubt, cheesehead hats combined with green and yellow face paint wrecks havoc on one’s face and hair.  White Plains, NY and Cleveland, OH were the next two on the list.

Groupon also listed each winning city by category.  The “winning” city for cashing in on the most tanning coupons is Shreveport, LA.  The Louisiana city will very likely lose that distinction soon as Louisiana has banned minors from tanning salons as of this past week (August 1).. 

Sadly, this bit of trivial news supports that tanning is still considered a pampering luxury…at least by Groupon.  One would hope that perhaps the recent Call to Action would encourage Groupon and other such services to refuse to offer coupons for tanning salons.  Based on the number of tanning discounts I found on a quick search, it’s highly unlikely. 

Perhaps the fight against artificial tanning will follow the same path as cigarettes.  It was 1965 when cigarette packages were required to contain the Surgeon General’s warning that tobacco use can be hazardous to your health.  In 1971, cigarette advertisements on television and radio were discontinued.  Smoking was banned on interstate busses and domestic airline flights of less than 6 hours in 1990.  Joe Camel and other advertising deemed aiming at minors was sent packing in 1995.  Nowadays, smoking is not allowed in many public places, including the old staple of smoke-filled rooms, the bar.  Even in tobacco-rich North Carolina, there are significant restrictions on smoking. 

People still smoke, but I would be willing to bet that nearly every one of them knows that it’s bad for them.  How often have you seen or heard a smoker state, “yeah, I know these things will kill me…” before lighting up?  How many times have smokers referred to cigarettes as cancer sticks?  Tobacco use is down, but it’s not out, and I doubt we can ever expect it to be.  We need to have the same expectations for tanning.

If the current trend continues and the Surgeon General’s warnings are heeded, tanning will be banned for minors across the country within the next few years.  It’s not a matter of if, but when.  Yet, people will tan.  I’m hoping the difference then versus now will be a lack of ignorance.  I would guess that most tanners today are ignorant.  Yes, many are stupid and stubborn, but some are just plain ignorant because they simply don’t realize that tanning dangerous for one’s health.

The FDA now requires that tanning beds contain a warning that such devices should not be used by individuals under 18.  I would like to see required signs at the front door of each establishment that offers UV tanning that states the same thing.  Or better yet, the sign should state that UV tanning is hazardous to one’s health and have a nice photo of a severe skin cancer excision.  From that point forward, tanners of the future will no longer be ignorant because they would be reminded every time they walked through the door.  They will be idiots, but they will not be ignorant.

The battle against tanning is one fight within a huge war against melanoma, but it’s our most public and controversial battle.  Our mission is to eradicate the disease, but one of our more subtle goals should be not just to increase melanoma awareness, but to eliminate melanoma ignorance among those who wish to continue tanning.  Getting skin cancer of any type is not a form of pampering.   

A Call to Action

What exactly is a “Call to Action?”  In the sales world, a Call to Action (or CTA…sales people have to use acronyms) is a word or phrase that urges others to take immediate action, as in “Write now!” “Call now!” or “Click Here!”  It’s the punch line after the sale pitch.

I use CTA phrases all the time in my blogs.  “Wear sunscreen!”  “Get checked!  “Be sun safe!”  Of course, my calls to action do not necessarily result in a prize or reward, but they do attempt to inspire some type of action on the reader’s part with regard to melanoma awareness and sun safety.

The Surgeon General issued a Call to Action today.  His website states that a call to action is “a science-based document to stimulate action nationwide to solve a major public health problem.”  When the Surgeon General issues a CTA, it’s serious.  This is only the 10th^th CTA that the Surgeon General’s office has issued in the 21^st century!  Previous calls to action include preventing suicide, obesity and underage drinking and supporting breast feeding.

Today’s Call to Action is to Prevent Skin Cancer.  I know you’ve read about it.  Its big news in melanoma nation and is being covered by all major news organizations.  (In case you missed it, here's the Executive Summary)  I was fortunate to learn last night about the web broadcast of the Surgeon General’s announcement this morning.  The atmosphere I witnessed was nothing short of electric and optimistic.  I’d never seen nor heard of Rear Admiral Boris Lushniak before, but he made quite an impression.  I expected the acting Surgeon General to be staunch and serious, but he was light-hearted, energetic, and passionate.  He’s the type of person you’d want to be your doctor (he’s a dermatologist).  He’s the type of person for whom you would take action.

All the statistics that I and other melanoma advocates have been spouting for years were presented.  But in this case, it was the Surgeon General conveying that melanoma is on the rise while other cancers are declining.  It was the Surgeon General stating that one person dies from melanoma every hour and 6,000 cases of melanoma a year are attributed to tanning beds.  It was the friggin’ Surgeon General who repeatedly stated that “tan skin is damaged skin.”  And while people have listened to the grass-roots efforts of bloggers and Facebookers, ears were definitely perked today.  News organizations acted like this was breaking news.  The true breaking news is that they are finally listening!

The Surgeon General’s office also had a conference call with “stakeholders” in the afternoon.  I admit that I snuck into this one on a “borrowed” pass.  When I called, I gave my name, and when asked for my “affiliation,” I stated that I am a skin cancer awareness blogger.  I thought for sure I’d be kindly told this was invitation only, but to my surprise, I was in for the listening.  There was no news different than the morning’s announcement, but it was just as exciting.  Rear Admiral Lushniak addressed that many were afraid that the Call to Action would get lost in the pile of hot news stories today.  Ebola virus.  The Gaza Strip.  Ukraine.  However, he was happy to report that his time between the morning’s announcement and the afternoon conference call was packed with requests and interviews.  “We are breaking news and people are hearing our call to action!”

Going back to the Call to Action…what does it mean for me and you?  It means we need to take action.  We have done our part by making people aware of melanoma.  While we should never stop that campaign, it’s now time to take action against melanoma.  Attend a fundraiser.  Write your government representative, whether national or your neighborhood home owner’s association and petition for more umbrellas at the pool.  Encourage the PTA to install shade structures on the playgrounds.  Ask the school board to reconsider their policy on sunscreen use for kids.  Demand local coupon flyers refuse to post tanning salon discounts.  Organize a church or civic event to buy sunscreen for financially-strapped families.  TEACH YOUR CHILDREN! 

Answer the Surgeon General’s Call to Action to Prevent Skin Cancer!

Is the App "iTanSmart" a smart choice?

I ran across a review for a suntan app called “iTanSmart.”  Let me share the information about this product first, and then I’ll share my thoughts at the end (you know I have something to say...)

The basic features for this app are available for free from the Apple Store.  For $1.99, the app will block advertisements, provide a list of medical conditions and related drugs that may increase one’s sun sensitivity, track user’s total daily sun exposure and vitamin D production, and offer specialized settings for children.

The app requires that the user enter the following criteria:

•         Whether you are managing for sunburn or for tanning.
•         Your skin type (very fair to dark)
•         Your level of sun protection.
•         Your location (environment and directness of sunlight, such as Beach or Mountains, Sunny or Cloudy)

The video for this product claims the app takes the guesswork out of sun tanning by alerting users when to get out of the sun or when to reapply sunscreen.   The app uses “real time UV data from space satellites to measure the current and maximum UV index in your location.”  The video goes on to say that the four day UV forecast is perfect for vacationers and avid sunbathers.  They can even see the forecast in vacationing towns so they can pack the “appropriate SPF and outer wear.”

iTanSmart will alert you with audible chimes when it’s time to leave the sun or reapply sunscreen.  Oh…and when maximum vitamin D production has occurred (emphasizing that all this occurs before over exposure).

The developer of iTanSmart and president of UV Technologies, LLC has been recently diagnosed with basal cell carcinoma and had it removed surgically.  He’s now reportedly more determined to get this valuable tool out to the public. 

The video concludes with a testimonial from an attractive, fair-skinned red haired woman:  “I have a very fair complexion, and in the past when I've laid out in the sun I either got no color or burned badly.  Since downloading this app a month ago, and using it often, I haven’t burned once!  I even have tan lines, which I typically only get after a burn subsides.  I am SO glad I downloaded this app!”

At first glance, the intent of this product seems to be towards sun protection, but there are some serious flags and flaws with the product information.  First of all, let’s look at the product name:  “I tan smart?”  Really?  I know and I hope that you know that there is no such thing as a smart tan.  Tanned skin is damaged skin.  Period.

The next flag for me is that the first criterion one enters is whether or not to manage your exposure for sunburn or for tanning.  Again, tanning is bad.  There should be no choice on what to manage.

Admittedly, I like the other input.  Let’s say for instance that I typically wear SPF 30 and I go to the neighborhood pool.  I notice that I somehow packed SPF 15 instead.  I could enter this value into the app and hopefully find out if there is a different frequency to how often I should reapply.  Then again, I could simply know that SPF 30 is recommended always…and I should always reapply every 2 hours.  My phone and tablet have a timer, so no app needed.  If I happen to pack SPF 15 by mistake, simply apply more often.

I also like the list of medical conditions and medications that could increase sun sensitivity.  I have taken medication for my cholesterol for so long that I haven’t read the medical information about the drugs in years.  I honestly couldn’t tell you whether or not my sensitivity is affected.

However, I’m leery of the emphasis on Vitamin D production.  Yes, I know that the sun is a source for Vitamin D and that the tanning industry screams of its health benefits.  I also know that almost every breathing dermatologist will recommend Vitamin D intake through diet and/or supplements.  It personally takes me seconds in the morning to digest a supplement that costs pennies each.

Lastly, the lady who shares her testimonial does nothing to tout the app as a tool for sun protection.  She states enthusiastically that she has tan lines without burning!  I’ll say again…tanned skin is damaged skin!  I really don’t think the developer of this app understands this, despite having had a basal cell carcinoma removed from his arm!

I’m sure I could input settings into iTanSmart that would do exactly as I would request in such an app…to inform me of the local UV index, to remind me to reapply sunscreen every 2 hours or get out of the sun and to aid in sun protection.  But unfortunately, there seems to be far too much flexibility and product attitude to encourage users to get a tan, and therefore increase their risk of sun damage and skin cancer.  Tan management is not sun protection.

Please understand that this personal opinion is based solely on the product video that I’ve watched and I have not tried this app for myself.  (This product is not available on Android yet).  You can watch the video here.  If you have downloaded and tried iTanSmart, please feel free to share your thoughts with me.  If you find it to be a good tool for sun protection (and not tan management) I will be more than happy to share such thoughts right here.

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.

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!

Here’s the video.

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.

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