Gimme an E
How do you know the difference between a suspicious spot on your skin that could be the early signs of skin cancer, and those little beauty marks you’ve had your whole life?
The way that doctors have been trained to spot it is to remember a simple ABCD acronym: asymmetry, border irregularity, color variegation, and diameter greater than 6 mm.
Now, researchers are proposing that an E should be added to the equation — for “evolving.” After looking at dozens of past studies that included 30 subjects or more, authors of a new report found that 88 percent of patients noted an evolution of their melanoma before it was removed. Enlargement was reported most often, but changes in shape, symptoms (itching, tenderness), surface (especially bleeding), and shades of color were also noted. That’s why they’ve chosen the word evolving, rather than enlargement as the basis for the ‘E.’
We’ve been led to believe that if we slather on sunscreen, we’re safe from skin cancer. But this connection doesn’t quite add up, considering that our use of sunscreen has skyrocketed in recent years — from sales of $18 million in 1972 to $500 million in 1996 — and so has the incidence of skin cancer. In fact, some experts believe that sunscreen might actually be contributing to increasing skin cancer rates by offering a false sense of security and keeping people from looking toward better protection.
And speaking of better protection, a 1993 study showed a 40 percent risk reduction in those participants who ate the most fish. It also showed that alcohol consumption might increase risk, as well as high consumption of polyunsaturated fats. The study also concluded that antioxidants such as beta-carotene and vitamin E, as well as zinc and iron warranted further investigation as possible skin cancer protectors.
Dr. Wright has written a great deal on the sun exposure and sunscreen myths, and has also offered detailed advice about alternative ways to stave off skin cancer. Check out the June 2002 issue of Nutrition & Healing for some of his tips. Subscribers can access this issue for free by visiting www.nutritionandhealing.com and logging in with the username and password listed on page 8 of your most recent issue. (If you’re not already a subscriber, the website also offers complete information on becoming one.)
In the meantime, keep an eye on any skin spots — and apply the ABCD and E test to them. Don’t hesitate for a minute to get a suspicious spot checked out by your dermatologist since early detection makes such a big difference in treatment and outcome.
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Going to bed?
Q: Dr. Wright, I know that you promote the idea of getting enough sun for our body to manufacture vitamin D. I use a tanning bed occasionally in the winter because of lack of sunlight and I’m wondering if you can get the same benefits with a tanning bed as with the sun?
JVW: Theoretically, yes, but it is not advisable. However, you also get something that you probably don’t want and that is electromagnetic radiation.
Electromagnetic fields (EMFs) are emitted from power sources such as power lines, home wiring, appliances, transformers, computers, cell phones, and a number of other things — including the bulbs in tanning beds. The health risks associated with repeated exposure to EMFs have been a concern for more than 20 years.
Your best route would be to stick with getting some good old-fashioned natural sun, staying out just until your skin turns just slightly pink. And if you can’t do that, then consider vitamin D supplementation.
The times you’ll definitely need to supplement are fall, winter, and early spring. I generally recommend 2,000 to 3,000 units of vitamin D daily. For those over 35, I usually advise raising that to 4,000 units to help with osteoporosis prevention.
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What is…melanoma?
Melanoma is a form of skin cancer. While it is less common than the other two types of skin cancer — basal cell and squamous cell — it is the most dangerous.
Melanoma is a malignant tumor that originates in melanocytes, which are the cells that produce the melanin or pigment that colors our skin, hair, and eyes. Most often, it shows up first in new or pre-existing moles, which are a concentration of melanocytes. Although sometimes, melanomas stop producing pigment altogether and become pink, purple, or skin-colored.
There are four types of melanoma: superficial spreading, lentigo maligna, acral lentiginous, and nodular. Each type has its own unique markers. For example, acral lentiginous is most common in Asians and African-Americans and is usually found under the nails or on the soles of the feet or the palm of the hand.
Yours in good health,
Amanda Ross
Managing Editor
Sources:
Abbasi NR, et al. “Early diagnosis of cutaneous melanoma: revisiting the ABCD criteria.” JAMA 2004; 92(22): 2,771-2,776.
Bain C, Green A, Siskind V, Alexander J, Harvey P. “Diet and melanoma. An exploratory case-control study.” Ann Epidemiol 1993; 3(3): 235-238.
