A Surprising Cause of Melanoma

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1/31/2012 10:39pm
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            A Surprising Cause of Melanoma

 
 
===================  The complete article is below  =======================
 
Rates of melanoma, the deadliest form of skin cancer, have been rising for at least the last three decades, and this increase has been largely blamed on exposure to ultraviolet (UV) light from the sun.

However, research published in the British Journal of Dermatology shows that the sun is likely nothing more than a scapegoat in the development of melanoma, and the sharp increase may actually be “an artifact caused by diagnostic drift.”

                                   Melanoma Increases Due to Benign Disease, Not Sunlight

Diagnostic drift, according to the study, refers to a hefty increase in disease that is being fueled by non-cancerous lesions.

In fact, during the study period from 1991 to 2004, there were nearly 4,000 cases of melanoma included in the report, with an annual increase of 9.39 to 13.91 cases per 100,000 per year.

The researchers revealed that, rather than being fueled by increasing exposure to sunlight as is commonly suggested, the increased incidence was almost entirely due to minimal, stage 1 disease.

They noted:

“There was no change in the combined incidence of the other stages of the disease, and the overall mortality only increased from 2.16 to 2.54 cases per 100,000 per year … We therefore conclude that the large increase in reported incidence is likely to be due to diagnostic drift, which classifies benign lesions as stage 1 melanoma.”

In other words, people are being diagnosed with melanoma skin cancer even when they have only a minimal, non-cancerous lesion, and these diagnoses appear to be skewing disease rates significantly. Further, adding even more credence to the growing body of evidence showing sun exposure is not the primary cause of melanoma, the researchers noted that the distribution of the lesions reported did not correspond to the sites of lesions caused by sun exposure.

They concluded:

“These findings should lead to a reconsideration of the treatment of ‘early’ lesions, a search for better diagnostic methods to distinguish them from truly malignant melanomas, re-evaluation of the role of ultraviolet radiation and recommendations for protection from it, as well as the need for a new direction in the search for the cause of melanoma.”

                                                   Is Lack of Sunlight a More Likely Culprit?

Despite all the bad press linking sun exposure to skin cancer, there’s almost no evidence at all to support it. There is, however, plenty of evidence to the contrary. Over the years, several studies have confirmed that appropriate sun exposure actually helps prevent skin cancer. In fact, melanoma occurrence has been found to decrease with greater sun exposure, and can be increased by sunscreens.

One of the most important facts you should know is that an epidemic of the disease has in fact broken out among indoor workers. These workers get three to nine times LESS solar UV exposure than outdoor workers get, yet only indoor workers have increasing rates of melanoma — and the rates have been increasing since before 1940.

There are two major factors that help explain this, and the first has to do with the type of UV exposure.

There are two primary types of UV rays from sunlight, the vitamin-D-producing UVB rays and the skin-damaging UVA light. Both UVA and UVB can cause tanning and burning, although UVB does so far more rapidly. UVA, however, penetrates your skin more deeply than UVB, and may be a much more important factor in photoaging, wrinkles and skin cancers.

A study in Medical Hypotheses suggested that indoor workers may have increased rates of melanoma because they’re exposed to sunlight through windows, and only UVA light, unlike UVB, can pass through window glass. At the same time, these indoor workers are missing out on exposure to the beneficial UVB rays, and have lower levels of vitamin D.

Researchers wrote:

“We hypothesize that one factor involves indoor exposures to UVA (321–400nm) passing through windows, which can cause mutations and can break down vitamin D3 formed after outdoor UVB (290–320nm) exposure, and the other factor involves low levels of cutaneous vitamin D3.

After vitamin D3 forms, melanoma cells can convert it to the hormone, 1,25-dihydroxyvitamin D3, or calcitriol, which causes growth inhibition and apoptotic cell death in vitro and in vivo. We agree that intense, intermittent outdoor UV overexposures and sunburns initiate CMM [cutaneous malignant melanoma]; we now propose that increased UVA exposures and inadequately maintained cutaneous levels of vitamin D3 promotes CMM.”

To put it simply, UVB appears to be protective against melanoma — or rather, the vitamin D your body produces in response to UVB radiation is protective.

As written in The Lancet:

“Paradoxically, outdoor workers have a decreased risk of melanoma compared with indoor workers, suggesting that chronic sunlight exposure can have a protective effect.”

                                             Vitamin D Helps Protect You Against Cancer

Vitamin D is a steroid hormone that influences virtually every cell in your body, and is easily one of nature’s most potent cancer fighters. So I want to stress again that if you are shunning all sun exposure, you are missing out on this natural cancer protection.

Your organs can convert the vitamin D in your bloodstream into calcitriol, which is the hormonal or activated version of vitamin D. Your organs then use it to repair damage, including damage from cancer cells and tumors. Vitamin D’s protective effect against cancer works in multiple ways, including:

  • Increasing the self-destruction of mutated cells (which, if allowed to replicate, could lead to cancer)
  • Reducing the spread and reproduction of cancer cells
  • Causing cells to become differentiated (cancer cells often lack differentiation)
  • Reducing the growth of new blood vessels from pre-existing ones, which is a step in the transition of dormant tumors turning cancerous

This applies not only to skin cancer but other types of cancer as well. Theories linking vitamin D to certain cancers have been tested and confirmed in more than 200 epidemiological studies, and understanding of its physiological basis stems from more than 2,500 laboratory studies, according to epidemiologist Cedric Garland, DrPH, professor of family and preventive medicine at the UC San Diego School of Medicine.

Here are just a few highlights into some of the most noteworthy findings:
  • Some 600,000 cases of breast and colorectal cancers could be prevented each year if vitamin D levels among populations worldwide were increased, according to previous research by Dr. Garland and colleagues.
  • Optimizing your vitamin D levels could help you to prevent at least 16 different types of cancer including pancreatic, lung, ovarian, prostate, and skin cancers.
  • A large-scale, randomized, placebo-controlled study on vitamin D and cancer showed that vitamin D can cut overall cancer risk by as much as 60 percent. This was such groundbreaking news that the Canadian Cancer Society has actually begun endorsing the vitamin as a cancer-prevention therapy.
  • Light-skinned women who had high amounts of long-term sun exposure had half the risk of developing advanced breast cancer (cancer that spreads beyond your breast) as women with lower amounts of regular sun exposure, according to a study in the American Journal of Epidemiology.
  • A study by Dr. William Grant, Ph.D., internationally recognized research scientist and vitamin D expert, found that about 30 percent of cancer deaths — which amounts to 2 million worldwide and 200,000 in the United States — could be prevented each year with higher levels of vitamin D.

                                  When Using the Sun to Fight Cancer, the Dose is What Matters

When I recommend using the sun therapeutically, this means getting the proper dosage to optimize your vitamin D levels. This typically means exposing enough of your unclothed skin surface to get a slight pink color on your skin. Your exact time will vary radically depending on many variables, such as you skin color, time of day, season, clouds, altitude and age.  The key principle is to never get burned, while still spending as much time as you can in the sun during the peak hours, as it is virtually impossible to overdose as long as you don’t get burned.

A common myth is that occasional exposure of your face and hands to sunlight is “sufficient” for vitamin D nutrition. For most of us, this is an absolutely inadequate exposure to move vitamin D levels to the healthy range. Further, if you use sunscreen, you will block your body’s ability to produce vitamin D!

And, contrary to popular belief, the best time to be in the sun for vitamin D production is actually as near to solar noon as possible which is 1 PM in the summer for most (due to Daylight Saving Time).. The more damaging UVA rays are quite constant during ALL hours of daylight, throughout the entire year — unlike UVB, which are low in morning and evening and high at midday.When using the sun to maximize your vitamin D production and minimize your risk of malignant melanoma, the middle of the day (roughly between 10:00 a.m. and 1:00 p.m.) is the best and safest time. During this time you need the shortest exposure time to produce vitamin D because UVB rays are most intense at this time. Plus, when the sun goes down toward the horizon, the UVB is filtered out much more than the dangerous UVA.

Once you reach this point your body will  peak at about 10,000-40,000 units of vitamin D. Any additional exposure will only cause harm and damage to your skin. Most people with fair skin will max out their vitamin D production in just 10-20 minutes, or, again, when your skin starts turning the lightest shade of pink. Some will need less, others more. The darker your skin, the longer exposure you will need to optimize your vitamin D production.

                                           Why Not Just Take Vitamin D from a Supplement?

You can get vitamin D3 in supplement form, and if sunlight or a safe tanning bed is not an option, this is a better choice than getting no vitamin D at all. If you do use a supplement, it now appears as though most adults need about 8,000 IU’s of vitamin D a day in order to get their serum levels above 40 ng/ml.

However, sunlight is really the superior source for vitamin D, as when you expose your skin to sunshine, your skin synthesizes vitamin D3 sulfate. This form of vitamin D is water soluble, unlike oral vitamin D3 supplements, which is unsulfated. The water-soluble form can travel freely in your bloodstream, whereas the unsulfated form needs LDL (the so-called “bad” cholesterol) as a vehicle of transport.

The oral non-sulfated form of vitamin D may not provide all of the same benefits as the vitamin D created in your skin from sun exposure, because it cannot be converted to vitamin D sulfate.

I believe this is a very compelling reason to really make a concerted effort to get your vitamin D requirements from exposure to sunshine, or by using a safe tanning bed (one with electronic ballasts rather than magnetic ballasts, to avoid unnecessary exposure to EMF fields). Safe tanning beds also have less of the dangerous UVA than sunlight, while unsafe ones have more UVA than sunlight. If neither of these are feasible options, then you should take an oral vitamin D3 supplement.

                                   What Should Your Vitamin D Levels be for Cancer Protection?

In 2007 the recommended level was between 40 to 60 nanograms per milliliter (ng/ml). Since then, the optimal vitamin D level has been raised to 50-70 ng/ml, and when treating cancer or heart disease, as high as 70-100 ng/ml

I recommend you have your levels tested and regularly monitored to make sure they are in the therapeutic range. Your physician can do this for you, or another alternative is to join the D*Action study. D*Action is a worldwide public health campaign aiming to solve the vitamin D deficiency epidemic through focus on testing, education, and grassroots word of mouth.

When you join D*action, you agree to test your vitamin D levels twice a year during a five-year program, and share your health status to demonstrate the public health impact of this nutrient. There is a $60 fee each 6 months ($120/year) for your sponsorship of the project, which includes a complete new test kit to be used at home, and electronic reports on your ongoing progress.

You will get a follow up email every six months reminding you “it’s time for your next test and health survey.” To join now, please follow this link to the sign up form.

                                       Natural Treatment for Non-Melanoma Skin Cancer

Melanoma skin cancer is the deadliest form, but far more common are non-melanoma skin cancers, which impact millions of Americans every year.

If you or someone you love is affected, a cream containing eggplant extract, known as BEC and BEC5, appears to cure and eliminate most non-melanoma skin cancers in several weeks time. Unlike conventional skin-cancer treatment, which is often surgery, the eggplant-extract cream leaves no scarring and no visible sign a tumor or lesion was ever present. The eggplant extract appears to be exceptionally safe and only kills cancerous cells, leaving healthy cells untouched, and causes only minor side effects, such as itching and burning.

The leading researcher in this area today is Dr. Bill E. Cham, who reported as early as 1991 in Cancer Letters that:

“A cream formulation containing high concentrations (10%) of a standard mixture of solasodine glycosides (BEC) has been shown to be effective in the treatment of malignant and benign human skin tumors.

We now report that a preparation … which contains very low concentrations of BEC (0.005%) is effective in the treatment of keratoses, basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) of the skin of humans. In an open study, clinical and histological observations indicated that all lesions (56 keratoses, 39 BCCs and 29 SCCs) treated with [the preparation] had regressed.”

Dr. Cham’s latest study was published in the International Journal of Clinical Medicine this year. The paper includes two impressive case reports of 60-something men who were suffering from large basal cell carcinoma (BCC) or squamous cell carcinoma (SCC), which had plagued them for years.  The results upon treatment with a cream formulation of BEC (eggplant extract) twice a day are astounding, and you can view the pictures here.

Unfortunately, simply eating eggplant, tomatoes, peppers or similar veggies, while beneficial for many reasons, will not induce this same effect because the active components are not able to effectively penetrate your cells. This requires the addition of glycosides, molecules with various simple sugars attached to them that can latch on to receptors found on skin cancer cells.

                                                  Simple Skin Cancer Prevention Strategies

What’s even better than an inexpensive, safe and natural cure for skin cancer is, of course, preventing it in the first place. Your body is made to be in the sun, and, when done properly, sun exposure will be one of the best ways you can help reduce your risk of skin, and many other forms of, cancer. Along with optimizing your vitamin D levels, the carotenoid astaxanthin has also piqued the interest of researchers due to its ability to reduce signs of aging by helping protect your skin from sun damage. I personally take 8 mg every day to help limit any potential damage from sun exposure as most of the year I am able to spend one to two hours a day in the sun.

Consuming a healthy diet full of natural antioxidants is another useful strategy to avoid sun damage to your skin, as fresh, raw, unprocessed foods deliver the nutrients that your body needs to maintain a healthy balance of omega-6 and omega-3 oils in your skin, which is your first line of defense against sunburn.

Fresh, raw vegetables also provide your body with an abundance of powerful antioxidants that will help you fight the free radicals caused by sun damage that can lead to burns and cancer.

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  •   Written by Dr. Mercola on January 29, 2012

     

     

     

     

     

     

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    Dr. Mercola has been passionate about health and technology for most of his life. As a doctor of osteopathic medicine, he treated many thousands of patients for over 20 years. In the mid 90’s he integrated his passion for natural health with modern technology via the internet and developed a website, Mercola.com to spread the word about natural ways to achieve optimal health.

  • Live 4 today. Thank God for all he has done for us. Looking forward to enjoying tomorrow.

    Anonymous - (2/1/2012 - 12:17pm)

    How can a "benign lesion" be classified as as stage 1 melanoma?

    Makes no sense.

    This doctor is only an osteopath not an M.D., not an oncologist that specializes in melanoma. I don't think osteopaths know much about cancer to begin with and they take an alternative or holistic approach to medicine

    Sedona neighbor:

    Surprised to find you here.  Where are you getting tx?  What has been done and how are you doing?

    West Sedona near Dry Creek Rd.:

    All anyone needs to know about this guy is that on his website he sells suplements  such as organic body butter, tanning oil, and green tea sun screen (that doesn't block UV rays but claims to reflect them).  Maybe this guy would have an ounce of credibility if he wasn't hocking his unproven organic products on his website. 

    He repeatedly refers to studies, several studies, thousands of studies etc.  what studies? where is the proof?

    "without the bitter the sweet ain't so sweet"

    mob - (2/2/2012 - 1:14pm)

    Yes, and as Emily points out below, he also flogs tanning beds. ( He was on Oz last month doing just that.)

     I clicked through to some of the studies he references, they are old and flawed. (Much like Mercola himself.)

    While on the topic of  VitD and tanning beds, I'd like to share the following just released congressional report with readers.. ( see section E for D hype).  

    http://democrats.energycommerce.house.gov/sites/default/files/documents/Tanning%20Investigation%20Report%202.1.12.pdf

    U. S. HOUSE OF REPRESENTATIVES COMMITTEE ON ENERGY AND COMMERCE – MINORITY STAFF
    False and Misleading Health Information Provided to Teens by the Indoor Tanning Industry
    Investigative Report

    Prepared for Rep. Henry A. Waxman, Rep. Diana DeGette, Rep. Rosa DeLauro, and Rep. Carolyn Maloney
    2/1/2012

    Table of Contents

    I. EXECUTIVE SUMMARY 2
    II. BACKGROUND 3
    A. The Growing Popularity of Indoor Tanning 3
    B. Cancer and Other Health Risks 4
    C. Federal and State Regulation 7
    III. PURPOSE AND METHODOLOGY 9
    IV. FINDINGS 10
    A. Tanning Salons Provided False Information about the Health Risks of Indoor Tanning 10
    B. Tanning Salons Provided Inaccurate or Misleading Information about Health Benefits of Indoor Tanning 12
    C. Tanning Salons Regularly Disregarded FDA Safety Recommendations 12
    D. Tanning Salons Targeted the Teen Market in Advertisements 13
    E. Tanning Industry Websites Provide Misleading Information 14
    V. CONCLUSION 15

    I. EXECUTIVE SUMMARY

    The World Health Organization and the National Toxicology Program classify indoor tanning beds as a “known” human carcinogen. The American Academy of Pediatrics calls indoor tanning beds “generally unsafe for children” and, along with the American Academy of Dermatology Association, recommends a ban on their use by anyone under 18. Yet despite the mounting evidence of the dangers of indoor tanning, millions of young people use tanning salons each year – and this use is on the rise. The most frequent indoor tanners are young white females.

    Rep. Henry A. Waxman, Ranking Member of the House Committee on Energy and Commerce, and Rep. Diana DeGette, Ranking Member of the House Committee on Energy and Commerce Subcommittee on Oversight and Investigations, along with Reps. Rosa DeLauro and Carolyn Maloney, requested this investigation to determine if tanning salons are providing accurate information about cancer and other risks to teenage girls who purchase indoor tanning sessions. Committee investigators representing themselves as fair-skinned teenage girls contacted 300 tanning salons nationwide, including at least three in each state and the District of Columbia. The investigators asked each salon a series of questions about its policies and the risks and benefits of tanning. Committee investigators also reviewed the print and online advertising of tanning salons.

    The vast majority of tanning salons contacted by Committee investigators provided false information about the serious risks of indoor tanning and made specious claims about the health benefits that indoor tanning provides. Specifically, Committee investigators found:

    · Nearly all salons denied the known risks of indoor tanning. When asked whether tanning posed any health risks for fair-skinned teenage girls, 90% of the salons stated that indoor tanning did not pose a health risk. When asked about the specific risk of skin cancer, over half (51%) of the salons denied that indoor tanning would increase a fair-skinned teenager’s risk of developing skin cancer. Salons described the suggestion of a link between indoor tanning and skin cancer as “a big myth,” “rumor,” and “hype.” 

    · Four out of five salons falsely claimed that indoor tanning is beneficial to a young person’s health. Four out of five (78%) of the tanning salons claimed that indoor tanning would be beneficial to the health of a fair-skinned teenage girl. Several salons even said that tanning would prevent cancer. Other health benefits claimed by tanning salons included Vitamin D production, treatment of depression and low self-esteem, prevention of and treatment for arthritis, weight loss, prevention of osteoporosis, reduction of cellulite, “boost[ing] the immune system,” sleeping better, treating lupus, and improving symptoms of fibromyalgia. 

    · Salons used many approaches to downplay the health risks of indoor tanning. During their calls, Committee investigators representing themselves as fair-skinned teenage girls were told that young people are not at risk for developing skin cancer; that rising rates of skin cancer are linked to increased use of sunscreen; that government regulators had certified the safety of indoor tanning; and that “it’s got to be safe, or else they wouldn’t let us do it.” Salons also frequently referred the investigators to industry websites that downplay indoor tanning’s health risks and tout the practice’s alleged health benefits.

    · Tanning salons fail to follow FDA recommendations on tanning frequency. The Food and Drug Administration recommends that indoor tanning be limited to no more than three visits in the first week. Despite this recommendation, three quarters of tanning salons reported that they would permit first-time customers to tan daily; several salon employees volunteered that their salons did not even require 24-hour intervals between tanning sessions.

    · Tanning salons target teenage girls in their advertisements. The print and online advertising for tanning salons frequently target teenage and college-aged girls with student discounts and “prom,” “homecoming,” and “back-to-school” specials. These youth-oriented specials often feature “unlimited” tanning packages, allowing frequent — even daily — tanning, despite research showing that frequent indoor tanning significantly increases the likelihood that a woman will develop melanoma, the deadliest form of skin cancer, before she reaches 30 years of age.

    II. BACKGROUND
    A. The Growing Popularity of Indoor Tanning
    Tanning salons first appeared in the U.S. in the 1970s. Their popularity grew slowly at first. By 1988, only 1% of American adults reported using indoor tanning facilities. But by 2007, that number had reached 27%. 
    Millions of young people use tanning salons each year — often without full knowledge of the risks of indoor tanning — and this use is on the rise. The most frequent indoor tanners are young white females. Researchers consistently find high rates of indoor tanning among white 16- to 18-year-old girls, with some studies reporting that as many as 40% of youth in this demographic have used indoor tanning facilities. Having a parent or guardian who has used indoor tanning in the last year is associated with a 70% increase in the likelihood that a young person will visit a tanning salon. 
    Tanning salons tend to be concentrated in areas with more teenagers and young women aged 15 to 24. This proximity is itself associated with a 40% increase in likelihood of indoor tanning among teens. 
    B. Cancer and Other Health Risks
    Ultraviolet (UV) light is electromagnetic radiation with a wavelength longer than visible light but shorter than X-rays. Sunlight contains UV radiation and emits three bands of the UV spectrum: UVA, UVB, and UVC. Exposure to either UVA or UVB light can cause DNA damage that leads to carcinogenesis. The primary culprit in sunburn is UVB, and scientists once believed it to be the only carcinogenic part of the solar spectrum. Recent research, however, has confirmed that UVA exposure also contributes to development of skin cancer. 
    Indoor tanning is a potent source of ultraviolet radiation, especially UVA. While many assume that the lamps in tanning beds contain less or similar amounts of light to that emitted by the sun, the UVA radiation emitted by these devices can be as much as 10 to 15 times more powerful than midday sunlight. Tanning lights also emit UVB radiation, although depending on the type of tanning device, the UVB emitted may be similar to or less powerful than the UVB emitted by the sun.

    This radiation makes tanning beds dangerous. Medical research has identified indoor tanning as a cause of skin cancer, including melanoma, the deadliest form of the disease. The World Health Organization’s International Agency for Research on Cancer (IARC) classifies tanning beds as a “Group 1” carcinogen, a category that also includes asbestos, arsenic, and tobacco smoke. Similarly, the National Toxicology Program classifies tanning beds as “known to be human carcinogens.” 

    The risk of melanoma is especially high for youth and young adults who engage in indoor tanning. According to the IARC, the melanoma risk is “increased by 75% when use of tanning devices starts before 30 years of age.” For those who report having undergone ten or more indoor tanning sessions in the first three decades of life, the risk of being diagnosed with melanoma before the age of 30 is six times higher than the risk for those who have never tanned indoors. Scientists have found this risk to persist after controlling for sunburns and outdoor sunbathing habits of melanoma victims. One recent study determined that for young people diagnosed with melanoma between the ages of 18 and 29 years old, “76% of melanomas were attributable to sunbed use.” 

    Indoor tanning can cause “sunburn,” just like too much sun exposure. Nearly 60% of indoor tanners report experiencing burns after indoor tanning sessions, a major risk factor for melanoma. The risk of melanoma is highest for women reporting sunburns during adolescence. 

    Scientists have also documented a link between indoor tanning and other forms of skin cancer. Researchers have found that a single use of a tanning bed can increase one’s chance of acquiring basal cell carcinoma, even after controlling for a history of sunburns, sun exposure, and sunbathing. Recently published peer-reviewed research by scientists at the Yale Cancer Center showed that young people who have ever tanned indoors see a 69% increase in risk for developing basal cell carcinoma before the age of 40. Approximately one in four of these cancers, and 43% of the basal cell carcinomas in young women, could be prevented if people never used indoor tanning beds. The IARC found a similar link between indoor tanning and squamous cell carcinomas. The risk associated with indoor tanning is especially high for people with fair skin. 

    The increased popularity of indoor tanning has coincided with a sharp rise in skin cancer. Melanoma is now the most common form of cancer for white women between the ages of 15 and 29 years old. Since 1980, the rate of melanoma in this group has increased by 50%. Non-melanoma skin cancers have also seen a dramatic rise; by 2007, about 13 million Americans had had at least one such cancer. According to peer-reviewed research published in the Archives of Dermatology, the rate of non-melanoma skin cancer in the U.S. is “reaching epidemic proportions.” 

    In addition to increasing cancer risks, tanning can cause ocular damage, premature aging of the skin, and exacerbate other medical conditions. 

    There are no health benefits to indoor tanning that outweigh the risks associated with the practice. There is no “safe or moderate tan.” Even short exposure to tanning can cause DNA damage. While many indoor tanners report using tanning beds to develop a “base tan” to protect against sunburns, researchers have concluded that indoor tanning offers no effective sunburn protection. 

    The tanning industry frequently promotes the benefits of Vitamin D and its association with UV light as an advantage of indoor tanning. Peer-reviewed medical research, however, shows that indoor tanning is an ineffective source of Vitamin D promotion. Although exposure to UVB light can produce Vitamin D, those most at risk of Vitamin D deficiency — people with darker skin — photosynthesize less Vitamin D. Moreover, the amount of UVB emitted from tanning devices varies, with some popular devices emitting relatively low levels. For most individuals, five to thirty minutes of midday sun twice each week accompanied by a healthy diet provides sufficient Vitamin D. For those with Vitamin D deficiency, physicians recommend oral supplements rather than increased exposure to UV radiation. 
    C. Federal and State Regulation
    Under the Federal Food, Drug, and Cosmetic Act (FDCA), the Food and Drug Administration currently regulates tanning beds as Class I medical devices, the most lightly regulated device category. Other medical products regulated as Class I devices include band-aids, rubber gloves, and tongue depressors. Class I devices are subject to limited federal oversight; they are supposed to be those devices that “present minimal potential harm” to the user. 
    Tanning beds are subject to FDA’s general controls for medical devices (including rules about good manufacturing practices, recordkeeping, reporting, adulteration, and misbranding) and performance standards specific to tanning beds. These standards: (1) establish limits on a tanning bed’s irradiance emissions; (2) require a mechanism by which a user of the device may terminate the tanning session at any time; (3) mandate that tanning bed manufacturers include protective eyewear with their products when distributed; (4) mandate the presence of a timer on each tanning bed (though the regulations state explicitly that “[t]he timer requirements do not preclude a product from allowing a user to reset the timer”); and (5) require that all tanning beds include the following warning label:
    DANGER--Ultraviolet radiation. Follow instructions. Avoid overexposure. As with natural sunlight, overexposure can cause eye and skin injury and allergic reactions. Repeated exposure may cause premature aging of the skin and skin cancer. WEAR PROTECTIVE EYEWEAR; FAILURE TO MAY RESULT IN SEVERE BURNS OR LONG-TERM INJURY TO THE EYES. Medications or cosmetics may increase your sensitivity to the ultraviolet radiation. Consult physician before using sunlamp if you are using medications or have a history of skin problems or believe yourself especially sensitive to sunlight. If you do not tan in the sun, you are unlikely to tan from the use of this product. 
    While FDA does not prescribe any particular limits on the frequency or duration of indoor tanning sessions, it has issued guidance to manufacturers on recommended exposure frequency during the first week of indoor tanning. FDA requires that manufacturers of tanning devices provide directions for a tanning device’s use to purchasers. These directions must include a recommended exposure schedule, and FDA guidance suggests that this schedule recommend no more than three tanning sessions in the first week of indoor tanning exposure. 
    FDA is presently considering a reclassification of tanning beds, potentially triggering more stringent protections. On March 25, 2010, the General and Plastic Surgery Devices Panel of FDA's Center for Devices and Radiological Health Advisory Committee met to review recent scientific literature on risks posed by indoor tanning and to recommend whether changes to the devices’ classification or regulatory controls are needed. The panel considered a presentation by FDA staff and testimony from the medical community and tanning salon industry. Testifying on behalf of the American Academy of Pediatrics, Johns Hopkins University Professor of Pediatrics and Dermatology Bernard Cohen stated that “the Academy believes that tanning lamps are generally unsafe for children and calls on the Food and Drug Administration to regulate them as such.” He said the American Academy of Pediatrics supports a ban on tanning by children and teenagers, testifying: “In order to safeguard children and adolescents from the dangers of unsafe ultraviolet radiation exposure, the American Academy of Pediatrics recommends a ban on the use of tanning devices by individuals under the age of 18, unless under the guidance of their physician.” 

    The FDA advisory panel concluded unanimously that tanning beds should not be Class I medical devices, with panelists split as to whether they should be Class II devices or Class III devices, which are subject to the strictest FDA controls. A majority of the panel favored age restrictions for tanning bed use. The panel also recommended enhanced education, training, and testing of tanning bed operators and improved labeling of tanning beds. In the words of one physician on the panel, dermatologist Dr. Erin Walker, such revisions to current regulations must make clear the medical consensus that “there is no such thing as a safe tan.” The FDA is currently considering these recommendations. 

    Some states have responded to the growth in the tanning industry and the mounting medical evidence of a link between tanning and skin cancer with regulations limiting access to tanning beds by children and adolescents. Over 30 states have enacted legislation regulating indoor tanning by teens — most commonly, by requiring parental consent for use of a tanning bed. Even in states with these restrictions, the effectiveness of the regulations remains a concern. Studies of compliance with parental consent laws in Texas, North Carolina, and Minnesota and Massachusetts have found tanning salon compliance rates of 11%, 13%, and 19%, respectively. Despite an increase over the last decade in states requiring some form of parental permission for indoor tanning, researchers have found no measurable decrease in indoor tanning among older adolescent girls. 

    California recently enacted legislation banning indoor tanning by children altogether. The law took effect on January 1, 2012. California is the first and only state to protect children via a ban on indoor tanning. The indoor tanning industry opposed California’s ban, while the American Academy of Dermatology praised it, commending the state for “protecting youth from the dangers of indoor tanning.” 

    III. PURPOSE AND METHODOLOGY

    Ranking Members Waxman and DeGette, along with Reps. DeLauro and Maloney, requested that the Democratic Committee staff investigate how tanning salons communicate risks to teens who seek information about indoor tanning sessions. In response to this request, Committee staff investigators, including college students interning with the Committee, telephoned indoor tanning salons across the country representing themselves as fair-skinned 16-year-old girls considering purchasing indoor tanning sessions for the first time. Committee investigators spoke with employees at 300 indoor tanning salons nationwide, including at least three salons in all 50 states and the District of Columbia.

    On calls with salons, investigators asked: (1) whether the salon offered discounts to students or teens; (2) how frequently a new customer would be permitted to use the salon’s tanning beds; (3) whether indoor tanning posed any risks for people with fair skin; (4) whether indoor tanning increased one’s risk of acquiring skin cancer; and (5) whether indoor tanning provided any health benefits. When salons referred callers to information provided on a website, investigative staff reviewed these materials.

    Committee staff also collected and reviewed advertising and promotional material created by indoor tanning salons. In particular, staff reviewed tanning salon websites, Facebook pages and posts for and by tanning salons, and print advertising.

    IV. FINDINGS

    A. Tanning Salons Provided False Information about the Health Risks of Indoor Tanning 
    The vast majority of the 300 tanning salons contacted by Committee staff provided inaccurate and misleading information about the health risks of indoor tanning. When Committee staff representing themselves as fair-skinned 16-year-old girls asked tanning salons whether indoor tanning would present any health risks, 90% of the salons reported that it presented no risk and only 7% reported that risks were present. The remaining 3% of salons did not provide clear answers about health risks.
    Figure 1: 
    90% of Salons Provided Inaccurate Information about 
    Tanning Risks
    When Committee investigators pressed salons about the specific threat of skin cancer, the majority of tanning salons provided information that was inaccurate and misleading. More than half (51%) of the 300 salons claimed that indoor tanning would not increase a young, fair-skinned person’s risk of developing skin cancer. “No, no, no — that’s not true whatsoever,” insisted one salon employee. “Tanning beds do not cause melanoma,” another assured Committee staff. Others described cancer risks as “a big myth,” “rumor,” and “hype” that had not been “proven.” “People who are meant to get skin cancer are just going to get skin cancer,” one employee explained. “We wouldn’t offer it if we thought it caused cancer,” stated another.

    Figure 2: 
    51% of Salons Denied a Link between Indoor Tanning and 
    Skin Cancer
    Even salons that accurately reported skin cancer risks misleadingly described those risks. One equated the skin cancer risk associated with indoor tanning as similar to that posed by the sunlight absorbed while “walking to your car.” Another compared the risk of cancer from indoor tanning to that presented by “standing in front of the microwave” oven.

    Several salons provided misleading advice about who is at risk for skin cancer. Employees at two salons told investigators representing themselves as 16-year-olds that skin cancer from indoor tanning is only a concern for “for an old person” or “older people.” Another suggested that use of sunscreen could actually increase one’s risk for skin cancer, explaining that “skin cancer rates increased when sunscreen started being promoted.”

    In discussing cancer risks, some salons pointed to the regulatory environment for indoor tanning as evidence of a lack of risk. These salons suggested that the current state of regulation amounted to confirmation of the practice’s safety, telling Committee investigators: “If it was incredibly bad for you, you wouldn’t be allowed to do it”; “It’s got to be safe, or else they wouldn’t let us do it”; “you can get skin cancer from being outside . . . but our [tanning] beds are certified and regulated”; and “the FDA wouldn’t approve tanning salons if it weren’t safe.”

    Salons also provided false information about skin damage and the risk of burns that might occur in a fair-skinned, first-time indoor tanner. Several suggested that indoor tanning is significantly less risky than casual exposure to natural sunlight. Others were unconcerned about skin damage from any source. One suggested that “aggressive tanning” is necessary when trying to build a tan in a fair person. Another told the caller that fair-skinned clients “just have to get that burning out of the way.”

    B. Tanning Salons Provided Inaccurate or Misleading Information about Health Benefits of Indoor Tanning

    Tanning salons frequently claimed that indoor tanning would be beneficial to the health of teenagers, despite medical consensus to the contrary. Overall, 78% of the salons reached by Committee staff claimed that indoor tanning would provide health benefits. “Tanning is very good for you,” one salon employee volunteered.

    Figure 3: 
    78% of Salons Claimed Indoor Tanning Is Beneficial to Health
    The most common benefit claimed by salons was promotion of Vitamin D production, with 60% of salons asserting that indoor tanning would be a good source of Vitamin D. Physicians do not recommend indoor tanning as a source of Vitamin D, however. Those most at risk of Vitamin D deficiency are least likely to increase Vitamin D levels through tanning because they typically have darker skin. Moreover, the level of UVB radiation from tanning devices, which is what can produce Vitamin D, can vary considerably, with several popular devices emitting relatively low levels that would not contribute significantly to Vitamin D production. 

    Employees at eleven salons claimed that indoor tanning would prevent cancer. One named skin cancer, breast cancer, colon cancer, and prostate cancer as diseases that could be prevented though use of tanning beds.

    Other health benefits mentioned by salons contacted by Committee staff include treatment of depression and low self-esteem, treatment for acne, prevention of and treatment for arthritis, weight loss, prevention of osteoporosis, “skin tightening,” reduction of cellulite, “boost[ing] the immune system,” improved sleeping, treating lupus, and improving symptoms of fibromyalgia.

    C. Tanning Salons Regularly Disregarded FDA Safety Recommendations

    Three quarters of tanning salons did not follow FDA recommendations on tanning frequency. The FDA recommends that indoor tanning be limited to no more than three visits in the first week. Despite this recommendation, 74% of the salons that Committee staff contacted stated that they would permit first-time, fair-skinned teenage girls to tan daily, and four salon employees volunteered that their salons did not require 24-hour intervals between tanning sessions.
    D. Tanning Salons Targeted the Teen Market in Advertisements

    The tanning salons contacted by Committee investigators frequently targeted youth in their marketing promotions. Among the tanning salons contacted by Committee investigators, over half (52%) offered discounts to students or teens. 

    Committee investigators reviewed over one hundred tanning salon websites and newspaper advertisements and found that “prom,” “homecoming,” and “back-to-school” specials are common. “It’s time to start on that Homecoming tan!!!” states a typical advertisement. Committee investigators also found that tanning salons are active users of social media, with many maintaining Facebook pages and Twitter accounts. Salons post notices about discounts on their own social media sites and also on Facebook pages for student groups, such as cheerleading squads.

    The most common discounts offered to young people in the advertising materials reviewed by Committee staff were reduced rates on “unlimited” tanning packages, which allow customers to visit a salon as often as they wish in a particular period of time (typically, one month). This type of discounting raises concern because, while any use of indoor tanning increases skin cancer risks, frequent tanning sessions significantly increase the chance of acquiring melanoma.

    E. Tanning Industry Websites Provide Misleading Information

    When presented with requests for health information about indoor tanning, tanning salons frequently directed investigators to tanning industry websites that create a misleading picture of the risks and benefits of indoor tanning. Most commonly, they suggested that teens curious about the health impact of indoor tanning visit Tanning Truth or Smart Tan | Tan With Confidence | How Can We Help You?. Both sites are associated with the “International Smart Tan Network,” a tanning industry trade association. The sites downplay the cancer risk associated with indoor tanning and tout the practice’s alleged health benefits. 

    Visitors to Tanning Truth see a series of large-print pro-tanning statements running across the top of the screen while navigating the website. The statements begin with an assertion that “[s]aying sunlight is harmful and therefore we should avoid it is as misleading as saying that water causes drowning, and therefore we should avoid it.” Statements that follow suggest that medical advice about the use of sunscreen and avoidance of indoor tanning is driven by the profit motives of pharmaceutical companies and dermatologists.

    The website’s discussion of the health impacts of tanning present a different picture than that provided by peer-reviewed medical research. Under a tab labeled “What are the real risks of indoor tanning?” the industry website questions the link between indoor tanning and melanoma, saying that “the relationship between melanoma and ultraviolet light remains unclear.” Under a tab labeled “Are there any benefits to indoor tanning?” the trade association claims that tanning is “nature’s sunscreen,” treats cosmetic skin conditions, and promotes Vitamin D production. The site then suggests that indoor tanners produce a “sufficient” level of Vitamin D, “non-tanners” produce a “deficient” level, and dermatologists experience a “severe deficiency” of Vitamin D.

    The other industry website, Smart Tan | Tan With Confidence | How Can We Help You?, also provides misleading information about Vitamin D and tanning. On this website, salon operators may purchase “D-Angel” training, which “teaches [salon] employees why Smart Tanning is vindicated and why they should spread the truth about UV and Vitamin D to their friends and family.” It provides a link to a website for the “Vitamin D Council,” which suggests that Vitamin D promotion yields a host of health benefits, including prevention of cancer, heart disease, diabetes, autism, multiple sclerosis, chronic digestive diseases, food allergies, and tuberculosis, as well as treatment for lupus.

    V. CONCLUSION

    Indoor tanning significantly increases skin cancer risks and presents a number of other significant health concerns. These risks are particularly acute for teenagers and young adults. Indoor tanning salons, however, regularly deny these risks. When Committee investigators contacted 300 tanning salons to ask about the risks indoor tanning posed to fair-skinned teenage girls, the vast majority of salons denied that indoor tanning increases health risks. 

    The dangers to teenage girls are exacerbated by tanning industry practices. Committee investigators found that the marketing practices of tanning salons target teenagers and young adults, often offering back-to-school, homecoming, and prom promotions.

    Isn't "minimal stage 1" melanoma the same as ",  a little bit pregnant" in that, left untreated, it will eventually be stage IV?

     

    Lori

    Dear Dr. Mercola:

    Many people have been swayed by your anti-establishment thinking (vacine, induced birthing, etc).  I know my PhD, DC daughter is quite the fan of your publications.  Many of these publications, such as the one on sunlight/vit D, will be distressing to the melanoma community.  Data can always be manipulated to say what you want it to.  This article sounds like it was written by a drug salesperson who had too many words in the argument.  I, for one, will continue to support sunscreen.

    When Melanoma is diagnosed at stage III and rapidly progresses to stage IV, the use of sunscreen becomes mute.  But I will continue to recommend sunscreen to my blond-haired, blue-eyed, light skinned children whom I unfortunately exposed to sunburns as children, and now they also have bad genes.  I will also recommend regular screening by a dermatologist.

    Last time someone posted this article I had to reply with this one important bit of info..Mercola sells tanning beds. http://tanningbeds.mercola.com/

    I had family members send me this article and while I agree with some parts ..as a whole this information is misguided and it pisses me off when people believe it because he is a "doctor"

    Our experience with melanoma: http://emandmichael.wordpress.com/

    For many reasons, I sensed that most replies to this posting would be negative so here are my thoughts on this subject:

    To me, it is so SAD that people following this article (thread) just DON'T GET IT !!!

    Most people reading this are Vitamin D-3 deficient Period! If you never get real vitamin D-3 from the Sun ( Note: God wouldn't  make a artificial or junk version or a supplement pill) you can expect to have health problems...period!  For sure breast and colon cancer (much research has proved this) and I believe that melanoma (the reason that you are reading this) is caused by the lack of proper amount of sunshine. This means only about 15 minutes a day, not until you are a piece of dried leather. Sunscreen and sunblockers cause cancer!

    Chemicals... Damm chemicals! = $$$$$$$$       My Best suggestion... if you won't eat it, don't put it on you skin!

    So if you work indoors or the night shift (as I did so for 40 years) how can you get the proper vitamin D-3 your body requires?  Answer, you can't!  So if you take off your blinders, you will see that Dr. Mercola has researched that a particular type of tanning bed is safe and will provide you with the right type of vitamin D-3. There are also table top units available to get the proper kind of vitamin D-3.

    He is not recommending that you go to the local tanning bed in your neighborhood as they most likely have the wrong type of tanning beds (the one that causes cancer) so get your facts together before you condemn Dr. Mercola!

    BTW, There is a reason that he is the number one alternative doctor related web site for health info...

    Also this is why Dr. Oz has him (Dr. Mercola) coming back on his show (3 times so far)  Dr. Oz wants to learn, and I appreciate his show and his keen interest in moving health issues forward.

    Best Wishes,

    Gene

    PS. The sure thing to do if you have melanoma is to get your blood tested for vitamin D-3, it costs less than $100.00 dollars. and when you get your sad results from your blood test, order a solution to solve the problem!  My personal solution is a vacation in the SUN!

    ---------------------------------------------------------------------------------------------------------------------

    All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.

    Arthur Schopenhauer, German philosopher (1788 – 1860)

     

    Live 4 today. Thank God for all he has done for us. Looking forward to enjoying tomorrow.

    mob - (2/3/2012 - 2:48am)

    Now Gene, I take Vit D3  I am not deficient. Nor am I slathered in chemicals. And I have never been a piece of dried leather ( but I see you are getting yourself into one heck of a lather..) 

    Dr Mercola says his tanning beds are better, but it appears some industry folks are not so sure- time will tell on that one.  He also says his $3000.00 plus artificial UV beds help reduce wrinkles, guess time will tell on that one too.

    http://tanningbeds.mercola.com/tanning-beds/vitality-tanning-bed.aspx?s_kwcid=TC|15735|safe%20tanning%20beds%20mercola||S|b|10539835624&gclid=CN2625Ojga4CFeUaQgod5lw06Q

    Oh and Dr Oz had a change of heart ('twas but a fleeting intrigue after all..) 

    Maybe you missed that part. 

     

    best wishes,  bcl

     

     
     

     

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    “Safe” Tanning Beds? Think Again.

    Recently, I had Dr. Joe Mercola on as a guest of the show. His views on alternative medicine are cutting edge – and often very controversial – garnering millions of online followers as well as the scorn of mainstream medicine.

     

    During our segment, Dr. Mercola recommended the use of “safe” UVB tanning beds for getting vitamin D. While vitamin D plays a number of major roles in our health and many Americans are deficient in this nutrient, the use of tanning beds is a highly controversial suggestion: The World Health Organization has recommended that no one use a tanning bed for cosmetic purposes, now listed as a “known human carcinogen.” This declaration was also made  by the US Department of Health and Human Services, which placed tanning beds in the same cancer-causing category as tobacco.

     

    During this same segment, I was intrigued by Dr. Mercola's claims on the therapeutic value of these specific UVB-emitting tanning beds (most tanning beds use only UVA rays, which can cause damage far below the surface of the skin). As a doctor, it is my natural inclination to evaluate and question emerging information in science and medicine – but please do not misconstrue this as me changing my stance on the dangers of indoor tanning.

     

    My beliefs are firmly aligned with those of the American Academy of Dermatology (AAD): Research shows that excessive ultraviolet radiation can lead to skin cancer. The bottom line is both UVA and UVB rays cause cancer. 

     

    And it’s not just sunburn we’re talking about – the use of tanning beds can cause damage to collagen and elastin fibers, dermal blood vessels and other structures. Tanning can cause blotchy skin discolorations. To learn even more about the ugly side of tanning, click here.

     

    Studies must be done to determine the value of UVB radiation, as suggested by Dr. Mercola. In the meantime, no one can conclusively claim that any tanning bed is safe. 

     

    Until these assessments are complete, I recommend that you enjoy up to 15 minutes – at most – of natural sunlight without sunscreen to get your vitamin D and other sun-derived benefits. Or get it other ways: Many foods in the American diet are fortified with this essential nutrient. I also recommend a dose of 400 to 1000 IU of vitamin D a day via a supplement. To learn more about how to get your daily dose of vitamin D safely, click here.

     

    Spread the word on the risks of tannning and just how serious and deadly skin cancer is. Read this moving story from the American Academy of Dermatology's recent Melanoma Awareness Campaign where a mother speaks about the loss of her 29-year-old daughter to melanoma.

     

    Added to Smart PatientIllness PreventionHealth NewsCancerAnatomy on Fri 01/13/2012