Category Archives: Medicine

Skin Cancer

National Cancer Institute Chart. Check yourself and your loved ones for signs of cancer.

It’s Valentine’s Day as I write this. What better time to check your loved one for skin cancer? One in five Americans will get some form of skin cancer in their lifetime, and this is probably true for many other countries, as well.  Even more Australians will get skin cancer than in the U.S.  Although lighter-skinned people are more at risk, people with dark skin also get skin cancer and should also take precautions and check themselves and others.

In recent years, several of my family members have gotten skin cancer, including basal cell, squamous cell and melanoma.

Although there is a genetic component, overexposure to the sun and repeated sunburns greatly add to the risk.  Even in winter, avoid overexposure to the sun and wear sunblock. Stay away from tanning beds.

From Wikipedia:  There are a variety of different skin cancer symptoms. These include changes in the skin that do not heal, ulcering in the skin, discolored skin, and changes in existing moles, such as jagged edges to the mole and enlargement of the mole.

  • Basal cell carcinoma usually looks like a raised, smooth, pearly bump on the sun-exposed skin of the head, neck or shoulders. Sometimes small blood vessels can be seen within the tumor. Crusting and bleeding in the center of the tumor frequently develops. It is often mistaken for a sore that does not heal. This form of skin cancer is the least deadly and with proper treatment can be completely eliminated, often without scarring.
  • Squamous cell carcinoma is commonly a red, scaling, thickened patch on sun-exposed skin. Ulceration and bleeding may occur. When SCC is not treated, it may develop into a large mass. Squamous cell is the second most common skin cancer. It is dangerous, but not nearly as dangerous as a melanoma.
  • Most melanomas are brown to black looking lesions. Warning signs that might indicate a malignant melanoma include change in size, shape, color or elevation of a mole. Other signs are the appearance of a new mole during adulthood or new pain, itching, ulceration or bleeding.
  • Merkel cell carcinomas are most often rapidly growing, non-tender red, purple or skin colored bumps that are not painful or itchy. They may be mistaken for a cyst or other type of cancer.  About skin cancer.

A related post I wrote after I was diagnosed with basal cell cancer.   Vitamin D — The Sunshine Vitamin.

Two important websites:

National Cancer Institute Information on Skin Cancer.

The Skin Cancer Foundation.

Here’s a blog post by my friend Jan describing our spring break trip in college to Padre Island, where we got horribly sunburned within hours of our arrival!  Done With The Sun.

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Research Update in the Fight Against ALS

alsalogo

 
    New Gene Mutation Discovery By ALS Association Consortium
 is Major Breakthrough in Lou Gehrig’s Disease Research, a report from The ALS Association’s National Office  Feb. 26, 2009 
In one of the most significant breakthroughs in the recent history of ALS research, a consortium of scientists organized and funded by The ALS Association has discovered a new gene, ALS6 (Fused in Sarcoma), responsible for about 5 percent of the cases of inherited ALS.The discovery will provide important clues to the causes of inherited ALS, which accounts for 10 percent of all cases, and sporadic ALS, which occurs in individuals with no family history of the disease and accounts for the other 90 percent of cases diagnosed.

“This is a momentous discovery in furthering our understanding of ALS,” said Lucie Bruijn, Ph.D., senior vice president of Research and Development at The ALS Association. “A new gene provides a new piece of the puzzle we can use to shed light on why ALS develops, and where to focus our efforts on creating new treatments and finding a cure.”The results of this groundbreaking research are published in the Friday, February 27 issue of the prestigious journal Science. The project was led by Tom Kwiatkowski M.D., Ph.D., at Massachusetts General Hospital, and Robert Brown, M.D., of the University of Massachusetts School of Medicine, and ALS Association-funded researchers Caroline Vance, Ph.D., and Christopher Shaw, M.D., of Kings College in London.The project was supported by a consortium of leading ALS researchers from around the world, formed as part of The Association’s Gene Identification Project. Their success reflects an unprecedented effort to accelerate the search for genetic mutations linked to all forms of ALS.

Dr. Brown noted, “We are particularly delighted because our trans-Atlantic consortium has pursued the chromosome 16 gene for more than six years. The ALS Association has been an all-important partner in this search. This discovery should lead to new cell and animal models of ALS, which will accelerate drug development.” “Global partnerships between investigators and funding agencies, such as the Motor Neuron Disease Association in the United Kingdom, are crucial to making these kinds of breakthroughs,” Dr. Bruijn commented. “This finding has opened up a whole new avenue of research and has the potential to uncover a common mechanism for most forms of ALS.”

The gene mutations were first identified by Dr. Kwiatkowski and were immediately confirmed by Dr. Vance, who also demonstrated abnormal accumulations of the mutant protein in cells cultured in the laboratory and the motor neurons of people carrying FUS mutations.

The gene, called FUS (“fused in sarcoma”), normally carries out multiple functions within motor neurons. These include regulating how gene messages (called messenger RNAs) are created, modified, and transported in order to build proteins. Some of these same functions also are performed by another gene called TARDPB encoding the protein TDP43, and mutations in the TDP-43 gene were recently linked to ALS as well.

“The fact that these two genes help perform the same function suggests that problems in this function may be critical in the development of ALS,” Dr. Bruijn said. “More research into exactly how these two genes work could ultimately lead to new treatments that are effective in slowing or stopping the progression of ALS and extending the lives of people with the disease.”

The mutations in the ALS6 gene were identified by detailed genetic sequencing in several families with an inherited form of ALS (familial ALS). Normally, the ALS6 protein works in the cell’s nucleus, but the mutations caused it to instead cluster outside the nucleus. Further work will be needed to determine precisely how this leads to ALS. With the gene in hand, scientists will be able to create cell and animal models containing the mutated gene, to examine in detail how the mutation operates and how it causes ALS.

“This suggests there may be a common mechanism underlying motor neuron degeneration,” according to Dr. Shaw. Motor neurons are nerve cells in the brain and spinal cord that control muscles. Motor neurons degenerate in ALS.

This is the second ALS-causing gene to be discovered in the past 12 months. SOD1, discovered in 1993, accounts for 20 percent of inherited cases of the disease. Mutations in the TARDP gene account for another four to five percent. The only well-defined causes of ALS are genetic. In both inherited and sporadic ALS, the disease symptoms and pathology are the same.

The possibility that ALS may be caused by several factors is the rationale for The Association’s policy of funding multiple genetic projects around the world and encouraging these leading geneticists to work together and share information to help locate disease-linked genes for faster, more accurate scientific results. By funding research on a global level, The Association helps put together “genetic pieces” of the ALS puzzle.

“Through our support of research such as this study, The ALS Association is committed to finding the causes of ALS, and using that knowledge to develop a cure as rapidly as possible,” Dr. Bruijn said. “We will build on the discovery of this new gene to carry that effort forward.”

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Vitamin D — the Sunshine Vitamin

The Sun.  It fuels our world.  It's essential to life. The challenge is find the right balance of sun exposure and sun protection.

The Sun. It fuels our world. It's essential to life. We need sunlight to make Vitamin D in our bodies, but the sun's radiation can also cause skin cancer. The challenge is find the right balance of sun exposure and sun protection.

Avoid the sun.  Wear sunblock.  That’s my summer mantra.  Now that I’ve had some skin cancer removed, I’m even more paranoid about sun exposure. 

The darkest time of the year is here, so you’d think I could relax about sun exposure as I enter my annual winter hermit state, covered up and shivering by the hearth.  But no, I have a new worry:  I actually have to get outside to get some sunshine to make Vitamin D.  

Ten to 15 minutes of sunshine (ultraviolet B radiation) three times a week is supposed to be enough for most people, but this is tough in the winter when we’re swathed in fleece. I don’t even like to walk to the mailbox at the end of my driveway when it’s cold.

Vitamin D is a fat-soluble vitamin that helps the body absorb calcium to form strong bones and teeth and has many other important functions in keeping us healthy.   My dermatologist says that Vitamin D is the hot topic at dermatology conferences these days. Yes, I know, we’ve all heard and read about the wonders and miracles of this vitamin and that vitamin, only to find out later that taking extra this or that doesn’t help and can even hurt. I still have a huge jar of Vitamin E capsules that I thought was supposed to be good for me. Then studies reported Vitamin E as a supplement could be harmful.   Now I’m just hanging onto the almost-full bottle in case it comes back into favor. (By then, of course, if will be expired.)

 Researchers are continually finding out more about the importance of Vitamin D, including that we probably need more than previously thought and that it’s even more essential to maintaining good health than we’ve realized.

Vitamin D could play a role in the prevention of colon, prostate and breast cancers, for example.  The amounts in our bodies might affect our mood and our weight.  Vitamin D really could be essential to a sunny disposition and important in keeping us from piling on the pounds. 

Bottom line: Find out how much Vitamin D you need and get a little sunshine at least every other day.

The following information can get a little tedious, but it’s important, so pay attention.

You need sunshine, but not as much as the people in the posters are getting.  This woman is probably getting enough as she walks past posters on a tanning salon while walking from her home in the Seattle area to the grocery store on Dec. 22, 2008.  (AP Photo/Seattle Post-Intelligencer,  Andy Rogers)

You need sunshine, but not as much as the people in the posters are getting. This woman is probably getting enough as she walks past posters on a tanning salon while walking from her home in the Seattle area to the grocery store on Dec. 22, 2008. (AP Photo/Seattle Post-Intelligencer, Andy Rogers)

A multi-vitamin with Vitamin D is probably enough for most people, but one size doesn’t fit all.  As you get older, your body isn’t as efficient at making Vitamin D, so you’ll need more Vitamin D in your diet, usually as an additive or a supplement.  My dermatologist told me to get 1,000 units of Vitamin D and a little sunlight (UV-B) every day, but you need to check with your own physician for the right amount for you. (See link below to article about children’s need for Vitamin D.)

Vitamin D isn’t naturally present in most foods, although it’s added to milk and cereal.  It’s in fish, such as salmon and tuna, in egg yolks and in cheese.  It’s also in cod liver oil, which is why we heard stories of a spoonful of it being forced on children in the past.

There’s also a danger of getting too much, which can cause increased kidney stones, nausea and mental confusion.  Vitamin D is stored in the fat, so if you take excessive amounts it’s difficult to get rid of.

We have to find a balance in protecting our skin from sun damage with the need for sunlight to synthesize Vitamin D.  The darker your skin, the more sunlight you need to make Vitamin D.  One of my biology professors suggested that Vitamin D is so important that it’s probably the main reason for differences in skin color.  The closer you to to the poles, the more difficult it is to get enough sunlight to make Vitamin D.  Conversely, darker skin protects against sun damage.

People with higher skin melanin (pigment) content require more time in sunlight to produce the same amount of vitamin D as do people with lower melanin content. As noted below, the amount of time a person requires to produce a given amount of Vitamin D may also depend upon the person’s distance from the equator and on the season of the year.

These people have the right idea.  Get outside in the winter, even if it's cloudy and snowy.  Just don't get frostbite or sunburned.

These people have the right idea. Get outside in the winter, even if it's cloudy and snowy. Just don't get frostbitten or sunburned. I need to take my own advice, because I don't even like to go to the mailbox when it's cold.

Latitude and altitude determine the intensity of UV light. UV-B is stronger at higher altitudes. Latitudes higher than 30° (both north and south) have insufficient UV-B sunlight two to six months of the year, even at midday, according to researchers.  Latitudes higher than 40° have insufficient sunlight to achieve optimum levels of D during six to eight months of the year. In much of the United States, which is between 30° and 45° latitude, six months or more during each year have insufficient UV-B sunlight to produce optimal D levels. In far northern or southern locations, latitudes 45° and higher, even summer sun is too weak to provide optimum levels of vitamin D.  A simple meter is available to determine UV-B levels where you live.

It’s a complicated, but important, subject.  To read more, here are some websites and articles:

NEW: What do you lack? Probably Vitamin D. (New York Times article)

Vitamin D Deficiency May Lurk in Babies

The Vitamin D Miracle.

What is Vitamin D?

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