Wednesday, August 1, 2012
Our latest carcinogen- tanning beds
Recently a cousin of mine died of malignant melanoma. He lived in Israel and had a lot of exposure to the sun particularly as a youngster and of course, with little protection. I wrote about his problem and the failure of one of the new molecular inhibitors of melanoma ($10,000/month) to help much. Indeed the literature is being filled with papers on drugs that can block the growth of melanoma cells, equally expensive and generally helping for no more than a few months. Melanoma numbers are on the rise. Since 1975 the rate of this skin cancer has quadrupled in men and doubled in women. And now, the outlook is even worse because of tanning beds. Manufacturers of these devices claim they do not increase skin cancer rates. They are wrong. A recent article published in the British Medical Journal summarized all the studies done on the relation of tanning beds to melanoma. They found that using a tanning bed increased a person’s risk of melanoma by 25%. Of course using it less lowered the risk and frequent use raised it. But the big news was that if you started using tanning beds before you were 35 years old, your risk of melanoma is nearly doubled. Melanoma will kill over 9000 people in 2012. But this may be the low point as more tanning bed victims develop this cancer. There is hope. Detected early, melanoma is curable. There are two systems for increasing your suspicion that a dark lesion is a melanoma. The first, the American system uses ABCDE. A stands for asymmetry – the lesion is not symmetrical, B stands for irregular Borders, C for uneven Color, D for Diameter over one-fourth inch and E for Elevation – raised or Evolution – meaning changing. A British system is similar but allows for a slightly bigger lesion, and includes redness and crusting, oozing or bleeding. Having any of the ABCDE changes or 3 of the British system changes is worth a biopsy. Interestingly, although the number of melanomas has gone up in recent years, the death rate hasn’t. This means that people and their doctors are much more aware of melanoma and more likely to refer for a biopsy if any of these changes are seen. Still, why take the risk?