Highest mortality rates are in older Caucasian men
Skin Cancer Statistics
Over half of all new cancers are skin cancers
More than 1.5 million new cases of skin cancer will be diagnosed in the US this year
79% new skin cancers are Basal Cell Carcinoma (BCC)
15% are Squamous Cell Carcinoma (SCC)
5% are Invasive Melanoma
1% are rare types of skin cancer
Skin Cancer Statistics
Both BCC and SCC have better than a 95% cure rate if detected early
10, 590 died of skin cancer in 2005: 7,770 from melanoma and 2,820 from other skin cancers
The incidence of melanoma tripled among Caucasians between 1980 and 2003
More than 73% of skin cancer deaths are from melanoma
Skin Cancer Statistics
Melanoma and thyroid cancer are the most commonly diagnosed cancers in women between the ages of 25 and 29 years
Invasive melanoma is the fifth most common cancer in men and the sixth most common cancer in women.
Skin cancer is now as common as all other cancer combined
The increasing incidence of nonmelanoma skin cancer among both men and women below age 40 demonstrates the great need for both detection and prevention strategies
Skin Cancer Incidence
Increasing affluence of many Americans
More time and money to devote to outdoor activities
More vacation
Thinning ozone
Global warming
Nonmelanoma Skin Cancer
Two Types
Basal cell Carcinoma (BCC)
Squamous cell carcinoma (SCC)
Rarely metastasize
Basal Cell Carcinoma (BCC)
Three out of four skin cancers are BCC’s
Usually seen on sun exposed areas, like the head and neck
Grows slowly
Can grow into nearby areas and invade bone or other tissue
Basal Cell Carcinoma (BCC)
BCC’s can recur in the same place on the skin after treatment
Many patients with one BCC will develop new skin cancer within the next five years after initial diagnosis
Represents 35% to 50% new skin cancer cases
Squamous Cell Carcinoma (SCC)
Accounts for two out of ten skin cancers
Usually appears on the face, ears, neck and other sun exposed areas
Can begin within scars, skin ulcers or burns
More likely to invade fatty tissues beneath the skin
Slightly more likely to spread to lymph nodes or distant body parts
Malignant Melanoma (MM)
Begins in melanocytes
Often are brown or black in color not always the case
Most often seen on trunk (back) of fair-skinned men
Seen on the lower legs of fair-skinned women
Malignant Melanoma (MM)
Having dark skin lowers the risk of melanoma, but it does not mean that a person with dark skin will never develop melanoma
Almost always curable in its early stages
Likely to spread to other parts of the body
Much less common than BCC or SCC but far more serious as it can metastasize throughout the body and kill
Risk Factors for Malignant Melanoma (MM)
Sunlight is a source of UV radiation
Tanning booths and sunlamps
People with large amounts of large moles
People with fair skin, freckling, red or blond hair
Family history
Immunosuppressed people (transplant patients, HIV patients)
Past history of melanoma
The Total Body Examination
Recommended once a year for everyone
Important to check your own skin monthly
Self-exam best done in front of a full length mirror
A mark or mole not healing may also be a new skin cancer
Recommendations to Decrease Skin Cancer
Avoid the sunlight, especially between 10AM and 4PM
Protect your skin with clothing, Solumbra and Coolibar have an SPF 30
Use a hat with a broad brim
Use sunblock and lip balm with at least an SPF 15
Use the proper amount of sunblock even on hazy or rainy days
Recommendations to Decrease Skin Cancer
Wear sunglasses that decrease UVA/UVB absorption
Teach your children to protect themselves from the sun, and keep newborns out of the sun
Avoid other sources of UV light such as tanning beds and sunlamps
Check suspicious moles with your dermatologist
Every race and every age should use broad spectrum protection
General Skin Cancer Facts
One in 5 Americans and one in 3 Caucasians will develop skin cancer in the course of a lifetime
Nationally, there are more new cases of skin cancer each year than the combined incidence of cancers of the breast, prostate, lung and colon
More than 90 percent of all skin cancers are caused by sun exposure, yet fewer than 33 percent of adults, adolescents, and children routinely use sun protection
Melanoma Facts
Melanoma costs Medicare over $495 million dollars annually
The incidence of melanoma, the deadliest form of skin cancer, is rising faster than that of any other cancer
By 2010, melanoma is projected to rise to one in 50 Americans
While Melanoma is uncommon in African –Americans, Latinos, and Asians, it is most deadly for these populations
Men/Women Facts
Eighty percent of sun damage happens before age 18, however sunburn and use of tanning salons at any age may promote an early diagnosis of melanoma
Skin cancer is the #1 cancer in men over age 50, ahead of prostate, lung and colon cancer
Middle-aged and older men have the poorest track record for performing monthly skin self-exams or regularly visiting a dermatologist. They are the least likely individuals to detect melanoma in its early stages.
Men over age 40 spend the most time outdoors and have the highest annual exposure to ultraviolet radiation
In the past thirty years, skin cancer has tripled in women under age 40
Teens/Children Facts
One blistering sunburn in childhood more than doubles a person’s chances of developing melanoma later in life
It is estimated that 2.3 million teens visit a tanning salon at least once a year
In the past 20 years there has been more than a 100% increase in the cases of pediatric melanoma
Less than half of all teenagers use sunscreen
The effects of photoaging (skin aging caused by the sun or tanning machines) can be seen as early as in one’s 20’s
Cancers in children often go undiagnosed because doctors do not think to look for skin cancer in youngsters. Unlike for adults, there are currently no set guidelines for skin examinations in children.
The CDC reported that less than one-third of American children practice effective sun protection
Children are especially vulnerable to ocular sun damage, because the lens is clear until 10 years of age. And unlike skin damage, which varies with skin type, sun-induced eye damage occurs in children irrespective of iris color.
New research shows that even a mild to moderate increase in sun exposure over an extended period, with or without sunburn, may significantly spur the growth of pigmented moles in children, thereby greatly increasing their risk of melanoma and other skin cancers
One out of three teenagers sat they tan because it looks healthy. In fact, in an AAD survey, more than 80 percent of people aged 25 and younger said they looked better with a tan
The skin of teens is thought to be more vulnerable than adults. Teen may be especially susceptible to skin cancer because their cells are dividing and changing more rapidly than those of adults.
New research shows that parents carefully protect toddlers against sun exposure in their first year, but begin slipping in the child’s second year. Thus, 54 percent of children received sunburns in their second year compared to only 22 percent in their first year.
Vitamin D “Deficiency” Issue
Controversial media topic
Minimal laboratory blood level lower limit of vitamin D has been increased by the FDA
Body stores can be replaced with a prescription vitamin D dose of 50,000 IU for two weeks, followed by daily supplementation of 800IU
Oral vitamin D supplementation and use of sunblock is a better way to maintain bone health than unprotected frequent sun exposure
Solaplex™
Ocean Potion has a UV stabilizer that provides photostability to avobenzone (Parsol 1789)
Solaplex will therefore boost the longevity of broad spectrum protection
This trademarked ingredient will be introduced this year as a UVA stabilizer
Helioplex™
Also a UVA stabilizer for avobenzone
Found in Johnson & Johnson’s Neutrogena Helioplex line
Found in Aveeno Continuous Sun Protection Line known as Active Photobarrier Complex
UVA Stabilizers
This new development in UVA stabilizers is exciting because avobenzone blocks UVA light and is easily broken down over time
Solaplex™ and Helioplex™ promise to revolutionize suncare as sunblock will better protect our skin from burning and wrinkling
They will also ultimately better protect from skin cancer as well
Skin Cancer Foundation SPF Statistics
SPF 15 = 93.5% protection from the sun’s rays
SPF 30 = 96.5% protection from the sun’s rays
SPF 45 = 97% protection from the sun’s rays
Water Resistant vs. Waterproof
Water resistant - sunblock should remain effective for at least 90 minutes when a person is involved in moderate outdoor exercise
Waterproof – sunblock should remain effective when in the water for at least 60 minutes when not active in the water
California Class Action Lawsuit
9 previous lawsuits filed by individuals have been consolidated into a single class action lawsuit
Lawsuit alleges that manufacturers are making systematically fraudulent and misleading claims on their labels and websites about their sunblocks
Lawsuit seeks an injunction against the manufacturers
Seeks compensation for consumers and other educational remedies paid for by the industry
What next?
We all need to continue our efforts to educate the public so they do not stop using sunscreen
People still need to wear and reapply 1 or 2 ounces of sunblock every two hours (a shotglass full)
FDA needs to finalize its monograph governing sunscreen use and marketing
There needs to be accepted UVA standards and water immersion efficacy measurements for UVA and UVB
The Morning After Lotion
Dimercine is an oily lotion that contains repair proteins
These repair proteins can remove some damaged DNA and induce the body to repair itself
In preliminary studies after a patient sustains a bad sunburn this lotion may reduce the risk of the most common types of skin cancer by 30% and precancerous lesions by 70%
Currently in FDA trials for treatment of xeroderma pigmentosum
But…
Dimercine is not FDA approved yet as a “chemopreventive” agent
Potential for abuse and misuse within the tanning salon industry
Not a panacea
Does not reverse topical damage from too much sun so this IS NOT an anti-wrinkle cream
Complete Sun Protection Regimen
Seek the shade between 10AM and 4PM
Do not burn
Wear a sunscreen SPF 15 or higher daily
Apply 1-2 ounces (4 tablespoons) of sunscreen to your entire body 20-30 minutes before going outside
Reapply every two hours
Cover up with a broad-brimmed hat and UV blocking sunglasses
New Technology
Sunsignals are self-adhesive patches that gradually change color to a bright orange when exposed to UV rays
Electronic UV monitors can be programmed with your skin type, your SPF level and the day’s UV rays
Sunguard (RIT) is a laundry additive that costs $2.00, will give an ordinary T-shirt an SPF of 30 and lasts about 20 washings
Sunpill (Pure Pharmaceuticals) and Heliocare (IVAX) are both dietary supplements that claim to be sun protectants for one dollar a day, but critics disagree
Goals
Increase the public awareness and therefore public use of sunblock for everyone
To get public to understand that sunblock must be reapplied at least every two hours
To decrease the rate of skin cancer despite increased leisure time
Conclusions
The public must evaluate their own moles once a month
Seek shade between 10AM and 4PM
Wear broad spectrum protection with avobenzone to cover UVA rays and oxybenzone to cover UVB rays with at least an SPF of 15 to 30
Reapply to sun-exposed areas every two hours, especially the face, neck, ears, back of hands, and feet.
Daily use of is important every day rain or shine from January through December, regardless of race or skin color
