At first glance, Hartford, Salt Lake City and Denver might not seem to have much in common. But a new survey by the American Academy of Dermatology (Academy) found these three cities outshine other U.S. cities in heeding dermatologists' advice on preventing and detecting skin cancer.
The “Suntelligence: How Sun Smart is Your City?” online survey polled more than 7,000 adults nationwide to determine their knowledge, attitudes and behaviors toward tanning, sun protection and skin cancer detection. Twenty-six cities were ranked based on respondents’ answers to several questions in each category.
“One common thread we found encouraging is that the majority of people polled expressed concern about skin cancer and had awareness of the importance of proper sun protection,” said dermatologist William D. James, MD, FAAD, president of the Academy. “However, we found that people’s behaviors did not always correlate with their concerns.”
While Hartford, Salt Lake City and Denver ranked No. 1, 2 and 3, respectively, Cleveland, Chicago and Pittsburgh fell to the bottom of the sun-smart spectrum with rankings of 24, 25 and 26, respectively. when results for these cities were compared to the average collective responses for all survey respondents, significant differences were observed in the top- and bottom-ranked cities.
Hartford respondents excelled in their knowledge of sun protection and the risks associated with tanning, scoring above the average of adults overall. For example, only about one-third of respondents (35 percent) nationwide correctly answered the question that asked whether some types of ultraviolet (UV) rays are safe for your skin. Forty-two percent of Hartford respondents knew that this statement was not true – that all forms of UV exposure, from natural sunlight and artificial light sources such as tanning beds – are harmful.
Similarly, residents of Salt Lake City, Denver and Hartford all scored better than the national average when they disagreed with the statement that they are not too concerned about skin cancer because it is easily detected and treated. Overall, 76 percent of respondents nationwide disagreed with this statement, while 85 percent of respondents from Salt Lake City disagreed.
“While skin cancer can be successfully treated if detected early, the five-year survival rate for individuals with regional and distant stage melanomas are 65 percent and 16 percent, respectively. That’s why people must be vigilant about protecting their skin from sun exposure and aware of the early warning signs of skin cancer,” said Dr. James.
However, when examining skin cancer detection behaviors, nationally 59 percent of respondents had never been screened for skin cancer by a health-care provider. Respondents from Pittsburgh and Chicago fared even worse, with 69 percent of Pittsburgh respondents and 67 percent from Chicago admitting they had never had an examination. On the other hand, 48 percent of Hartford residents had never undergone a skin examination.
Despite dermatologists’ repeated warnings about the dangers of tanning, Dr. James added that respondents in last-place Pittsburgh scored significantly worse than the overall average when asked if people look more attractive with a tan. Specifically, 81 percent of Pittsburgh respondents agreed with this statement compared to 72 percent of the general public.
“We’re hoping the results of this survey will draw attention to the public’s need to change its attitudes toward tanning, which is the first step in changing behavior,” said Dr. James. “Our data show that most people are concerned about skin cancer, but they still need to modify their attitudes, behavior and knowledge to reduce their risk.”
To minimize your risk of skin cancer, the Academy recommends that everyone Be Sun Smart®:
Generously apply a broad-spectrum water-resistant sunscreen with a Sun Protection Factor (SPF) of at least 30 to all exposed skin. “Broad-spectrum” provides protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Re-apply approximately every two hours, even on cloudy days, and after swimming or sweating.
Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, where possible.
Seek shade when appropriate, remembering that the sun's rays are strongest between 10 a.m. and 4 p.m. If your shadow is shorter than you are, seek shade.
Protect children from sun exposure by playing in the shade, using protective clothing, and applying sunscreen.
Use extra caution near water, snow and sand as they reflect the damaging rays of the sun which can increase your chance of sunburn.
Get vitamin D safely through a healthy diet that may include vitamin supplements. Don't seek the sun.
Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look like you've been in the sun, consider using a sunless self-tanning product, but continue to use sunscreen with it.
Check your birthday suit on your birthday. If you notice anything changing, growing, or bleeding on your skin, see a dermatologist. Skin cancer is very treatable when caught early.
Wednesday, July 14, 2010
Friday, November 13, 2009
New Compound Shrinks Skin Cancers
An experimental cancer drug that switches off the so-called "Hedgehog" pathway beat back tumors in more than half of patients with advanced basal cell carcinoma, a type of skin cancer.
The drug also helped a 26-year-old man suffering from medulloblastoma, the most common form of brain cancer in children.
"We were both pleased and surprised. We had hoped that we might see responses like this but we in no way anticipated that, within the context of a phase 1 clinical trial, we would see this level of anti-tumor activity," said Dr. Charles M. Rudin, who authored two papers on the findings that appear in the Sept. 2 online edition of the New England Journal of Medicine. "These are the first reports in the literature of any Hedgehog inhibitor being used clinically."
Phase 1 trials are conducted to look at a drug's safety profile and determine the right dose. Phase 2 and phase 3 trials typically look at effectiveness.
Also exciting, however, is the fact that the Hedgehog pathway has been implicated in other cancers, notably colon cancer and ovarian cancer, albeit in a different way.
Researchers are going forward to look at the potential of the molecule, known as GDC-0449, to treat these types of cancers as a one-drug regimen, and in combination with other drugs for other solid tumor malignancies, said Rudin, who is associate director for clinical research at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University in Baltimore.
One expert noted that finding a compound that might control the Hedgehog pathway could have far-reaching implications.
"These are phase 1 trials so they're quite preliminary, but the drug is quite effective in at least a subset of the patients treated," said Dr. Andrzej Dlugosz, author of an accompanying editorial and a professor in the department of dermatology at the University of Michigan Medical School and Comprehensive Cancer Center in Ann Arbor. "The reason we're so excited is that there are now a large number of cancers that have also been linked to abnormalities in this pathway, including pancreatic, colon, ovarian and prostate. It's quite an impressive list. The data is pretty strong suggesting that if you shut down the pathway, it can have a pretty profound effect on those tumor cells. If it can work in these cancers, maybe it can work in other cancers, even though the signaling there is more complex."
But another researcher warned that it is premature to get too excited about the results.
"It's great to see something with so much potential, but it really is potential," said Dr. Clifford Perlis, director of Mohs Micrographic Surgery and Dermatologic Surgery at Fox Chase Cancer Center in Philadelphia.
However, he added, "there are other companies developing Hedgehog inhibitors as well, so I think people should be paying attention to this."
The Hedgehog gene, so named because it was first discovered in flies with hair resembling the spikes of hedgehogs, "is really important during early embryonic development in pretty much all animal species from flies to mice to humans, and for pretty much every tissue you can imagine," explained Frederic de Sauvage, also an author on both papers. "But remarkably in adults, it seems to be mostly turned off."
De Sauvage is vice president of research, molecular biology, at Genentech, which developed the molecule and funded the study.
Some 1 million Americans get basal cell carcinoma each year. It often doesn't spread but, once it has, there are no approved treatments. Medulloblastoma is an aggressive form of brain tumor.
The first trial enrolled 33 individuals whose basal cell carcinoma had spread locally or to distant organs.
Half of the participants who had distant metastases saw a reduction in tumor size, as did 60 percent of those with locally advanced cancer. The rest had either stable or progressive disease after 10 months of follow-up.
But "stable" in this population may not mean much, Perlis pointed out, as it is generally a very slow-growing cancer.
The man with medulloblastoma also saw a significant shrinkage of his tumor, along with vastly improved quality of life, but only for two months. He later died.
A third study by some of the same authors, this one published online Sept. 2 in Science Express, discovered that treatment with GDC-0449 actually spurred another mutation in a gene called SMO, which caused the brain tumor to become resistant to the drug.
Because the Hedgehog pathway does not actually do much in adults, side effects were minimal, said de Sauvage.
GDC-0449 would likely be used very differently, depending on which type of cancer it is targeting.
In the case of basal cell carcinoma and medulloblastoma, the mutation in the Hedgehog pathway "really drives the formation of these tumors," de Sauvage said. "This molecule inhibits the pathway very specifically and, to date, we only know of these two types of tumor where the pathway is mutated." That means GDC-0449 is effective on its own.
But in colon and ovarian cancer, he continued, the pathway recruits surrounding cells to promote the cancer. In these types of tumors, GDC-0449 would have to be combined with other drugs.
The drug also helped a 26-year-old man suffering from medulloblastoma, the most common form of brain cancer in children.
"We were both pleased and surprised. We had hoped that we might see responses like this but we in no way anticipated that, within the context of a phase 1 clinical trial, we would see this level of anti-tumor activity," said Dr. Charles M. Rudin, who authored two papers on the findings that appear in the Sept. 2 online edition of the New England Journal of Medicine. "These are the first reports in the literature of any Hedgehog inhibitor being used clinically."
Phase 1 trials are conducted to look at a drug's safety profile and determine the right dose. Phase 2 and phase 3 trials typically look at effectiveness.
Also exciting, however, is the fact that the Hedgehog pathway has been implicated in other cancers, notably colon cancer and ovarian cancer, albeit in a different way.
Researchers are going forward to look at the potential of the molecule, known as GDC-0449, to treat these types of cancers as a one-drug regimen, and in combination with other drugs for other solid tumor malignancies, said Rudin, who is associate director for clinical research at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University in Baltimore.
One expert noted that finding a compound that might control the Hedgehog pathway could have far-reaching implications.
"These are phase 1 trials so they're quite preliminary, but the drug is quite effective in at least a subset of the patients treated," said Dr. Andrzej Dlugosz, author of an accompanying editorial and a professor in the department of dermatology at the University of Michigan Medical School and Comprehensive Cancer Center in Ann Arbor. "The reason we're so excited is that there are now a large number of cancers that have also been linked to abnormalities in this pathway, including pancreatic, colon, ovarian and prostate. It's quite an impressive list. The data is pretty strong suggesting that if you shut down the pathway, it can have a pretty profound effect on those tumor cells. If it can work in these cancers, maybe it can work in other cancers, even though the signaling there is more complex."
But another researcher warned that it is premature to get too excited about the results.
"It's great to see something with so much potential, but it really is potential," said Dr. Clifford Perlis, director of Mohs Micrographic Surgery and Dermatologic Surgery at Fox Chase Cancer Center in Philadelphia.
However, he added, "there are other companies developing Hedgehog inhibitors as well, so I think people should be paying attention to this."
The Hedgehog gene, so named because it was first discovered in flies with hair resembling the spikes of hedgehogs, "is really important during early embryonic development in pretty much all animal species from flies to mice to humans, and for pretty much every tissue you can imagine," explained Frederic de Sauvage, also an author on both papers. "But remarkably in adults, it seems to be mostly turned off."
De Sauvage is vice president of research, molecular biology, at Genentech, which developed the molecule and funded the study.
Some 1 million Americans get basal cell carcinoma each year. It often doesn't spread but, once it has, there are no approved treatments. Medulloblastoma is an aggressive form of brain tumor.
The first trial enrolled 33 individuals whose basal cell carcinoma had spread locally or to distant organs.
Half of the participants who had distant metastases saw a reduction in tumor size, as did 60 percent of those with locally advanced cancer. The rest had either stable or progressive disease after 10 months of follow-up.
But "stable" in this population may not mean much, Perlis pointed out, as it is generally a very slow-growing cancer.
The man with medulloblastoma also saw a significant shrinkage of his tumor, along with vastly improved quality of life, but only for two months. He later died.
A third study by some of the same authors, this one published online Sept. 2 in Science Express, discovered that treatment with GDC-0449 actually spurred another mutation in a gene called SMO, which caused the brain tumor to become resistant to the drug.
Because the Hedgehog pathway does not actually do much in adults, side effects were minimal, said de Sauvage.
GDC-0449 would likely be used very differently, depending on which type of cancer it is targeting.
In the case of basal cell carcinoma and medulloblastoma, the mutation in the Hedgehog pathway "really drives the formation of these tumors," de Sauvage said. "This molecule inhibits the pathway very specifically and, to date, we only know of these two types of tumor where the pathway is mutated." That means GDC-0449 is effective on its own.
But in colon and ovarian cancer, he continued, the pathway recruits surrounding cells to promote the cancer. In these types of tumors, GDC-0449 would have to be combined with other drugs.
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