5 Minutes with a Dermatologist

May is Skin Cancer Awareness Month, and we've been sharing information all month about skin cancer and sun safety. Many local dermatologists participated in our free skin cancer screening in April, including Dr. Chris Schach and Dr. Eric Stewart of Ozark Dermatology Clinic. We thought you might want to know the answers to a few questions we recently asked their staff - which also includes Dr. Kevin St. Clair, Dr. Robert Brown, and Physician's Assistants Robert Stevens and Joshua Matthews. Feel free to post your own questions in the comments section at the end of the post.

Question: How have your cases changed over the last 10 years with respect to the skin cancer you are seeing?

Answer: Overall, the rate of nonmelanoma skin cancer (primary basal cell and squamous cell carcinomas) has remained about the same. As the baby boomer generation continues to age, however, we are seeing an increased number of nonmelanoma skin cancer in that population. The main concerning change that we have seen is the increased rate of melanoma in younger and younger women. It is not unusual to see malignant melanoma now in women in their late 20s or early 30s. Hopefully, increased awareness of measures to take to prevent sunburn and minimize sun exposure will pay off over time with decreasing rates of all types of skin cancer.


Question: There has been a lot in the news about the danger of tanning beds. Is any indoor tanning safe? What about outdoor tanning - is any level of sun exposure okay?

Answer: There are many efforts underway at the state level to regulate tanning bed use and to prevent minors from using or abusing tanning beds. If the skin darkens in response to exposure to ultraviolet radiation, whether the source is sunlight or a tanning bed, this does result in damage to the skin. This not only increases skin cancer risk, but also the risk of premature aging of the skin. Despite advertising to the contrary by the tanning bed industry, there is no such thing as a "safe tan." There are only degrees of injury. The only tanning that would be considered safe is the spray-on variety where no ultraviolet radiation is used at all. Of course, it is not necessary to avoid sunlight - only avoid sunburn and minimize your overall exposure.

Question: What should we look for in a sunscreen?

Answer: As of June 2012*, the FDA is changing labeling requirements for sunscreen. The new guidelines will include a comment addressing whether or not the sunscreen is "broad spectrum". If the sunscreen product is broad spectrum, this will imply that it provides UVA protection in addition to UVB protection. The Sun Protection Factor, or SPF, which has been used to label sunscreens for many years, implies only the degree of protection against UVB radiation. If a product is considered broad spectrum, a 4-star labeling system will be employed to give consumers some idea of the degree of UVA protection the product provides, with 1 being relatively less protection, and 4 being the maximum.

Another new requirement will be labeling to indicate whether the product is water resistant for 40 minutes or water resistant for up to 80 minutes. Claims of being "waterproof" will no longer be allowed. In my opinion, the best overall sunscreens are titanium dioxide and zinc oxide, which are now available in small enough particles that the sunscreen can be rubbed in without leaving a white film.

*the new label requirements have been delayed by six months.

Question: If the sun is not out, do I need to wear sunscreen?

Answer: Yes, because even though it does not feel as warm and it is not as bright if it is a cloudy day, a significant proportion of ultraviolet radiation will penetrate through clouds and can still cause sunburn. In addition, quite a bit of ultraviolet radiation, especially UVA, can be reflected and scattered, and this is why many people have noticed that one can sunburn even standing under a tree or in a shaded area.

It's Oncology Nurses Week!

If you ask a cancer patient who was one of the most important people they came in contact with while  they were undergoing cancer treatment, they will inevitably mention an oncology nurse. Physicians, counselors and pharmacists all play vital roles in a patient's successful journey through treatment - but at one time or another the nurses they encounter take on some vital roles as well.

For decades, nurses were not very involved in cancer care. Their role was limited to the inpatient care of patients who underwent surgery to treat their cancer (the primary method of treatment until the early 1970s). But with the National Cancer Act of 1971 there began to be a change in the way cancer was treated and managed. Along with those treatment changes, nurses were provided with opportunities to become more involved with the care of cancer patients from diagnosis through recovery.

From the NurseSource.org website:
"The oncology nurse functions as a coordinator of care, collaborating with other cancer care providers and team members to provide required care as effectively as possible. Advanced practice may include the roles of direct caregiver, coordinator, consultant, educator, researcher and administrator."

There are many specialties available to an oncology nurse, including:

• chemotherapy
• biotherapy
• breast oncology
• hematology/oncology
• radiation
• GYN oncology
• head and neck oncology
• surgical oncology
• bone marrow transplant
• cancer genetic counseling
• prevention and early detection
• symptom management
• palliative care

Some of the awesome nurses we work with at Highlands Oncology Group.

Hope Cancer Resources' staff gets to work alongside professional, highly trained and committed nurses in local clinics who are making a difference in the lives of cancer patients in Northwest Arkansas every single day. Join us to thank an oncology nurse this month, and every month.

The Wheels on the Van

It's easy to think that the most difficult part of a battle with cancer is the physical condition that some of the treatments can leave you in. And, for many people, that is certainly the case. Chemotherapy can make you sick, radiation can leave you with uncomfortable rashes that make even the most comfortable clothing in your closet painful to wear. Both forms of treatment cause fatigue that there is simply no cure for except the end of treatment.

But for many people in Northwest Arkansas the first hurdle to be cleared when discussing a treatment plan with their oncologist is figuring out how they will even get to their appointments in order to begin the fight. Some patients may not be able to drive as a result of their disease, others because of treatment side-effects. Friends and family may only be able to help for a short time or on a limited basis. With chemotherapy appointments scheduled every few weeks and radiation plans typically requiring a patient to visit the clinic five days a week for 5-7 weeks, transportation becomes one of the primary obstacles for patients as they go through treatment. Patients can not fight their cancer if they are unable to get to the clinic.

At Hope Cancer Resources we have three vehicles in our transportation program. Our drivers drive hundreds of miles every weekday to provide the support necessary to make sure that treatment plans are carried out as prescribed.

In the first four months of 2012, our drivers put over 54,000 miles on our vehicles and made 927 trips. That's 10,000 miles more than this time two years ago. Sometimes a trip is only a few miles. Other times a driver could be gone all day picking up and taking home to towns in Oklahoma or Carroll county. In 2011, the total miles logged by our vehicles came in at just over 129,000. That's a lot of time behind a wheel, and a lot of doctor's visits that weren't missed. That's a lot of hope given.

If you or someone you know would benefit from transportation assistance, or if you'd like to make a donation to support the program, please contact us.

In the News: Sunscreens and Vaccines

May is Skin Cancer Awareness Month. Since we shared information recently on skin cancer awareness and prevention, we're sharing some related but unique information this week that has recently made the news.

New Sunscreen Labels

In 2009 the U.S. Food and Drug Administration approved new labeling for sunscreen products that will finally go into effect next month. There have always been guidelines in place, but they were adopted on a voluntary basis - which meant many companies didn't adopt them at all. Using terms such as "All Day Protection" and "Waterproof" were not only misleading, they were downright inaccurate. The new guidelines are mandatory.

Here are the major changes in labeling that will help consumers buy exactly what they need, and know exactly what they're getting:

Sunblocks: No product on the market today can completely shield your skin from the sun. For this reason, sunscreens will no longer be labeled as "sunblock".

SPF level: A sun protection factor (SPF) of 15 or more means the product lowers the risk of skin cancer and aging. For SPFs from 2-14, this is not the case. Those products prevent sunburn at best. Sunscreen labels will have to be clear about how much SPF they provide - and whether they actually reduce your risk of developing skin cancer and curb visible aging or just prevent sunburns. The highest level of SPF allowed with the new guidelines will be 50.

One common misunderstandings that lingers today is that the higher the SPF number on a bottle of sunscreen, the better. In truth, a product with a number above 30 really doesn't add enough additional protection to make it worthwhile. That said - you should always choose a sunscreen with an SPF of at least 15.

Broad Spectrum: To be labeled "broad spectrum," sunscreens must provide equal protection against the sun's two types of radiation: UVB and UVA. Both types can lead to cancer - but UVA gives you more wrinkles and UVB causes sunburns.

"Waterproof" and "sweatproof" claims will disappear . Sunscreens can only say how long they offer water resistant protection. And, the company marketing the products must be able to back up their claims with text results.

Instant protection: Sunscreens can't say they provide "instant protection" or protect skin for more than two hours unless the FDA approves the claims for the specific sunscreen in question.

There is a 2-2-2 rule that goes hand in hand with these new requirements, even though it's been around a while:

2 tablespoons. Use at least this much sunscreen on each part of your body.This is about the size of a golf ball. Rub it in until it disappears.
2 hours. That’s how often you should reapply it. Evaluate and apply more often if you're involved in active water activities such as skiing.
2 years. That’s how long you should keep it. The ingredients lose their effectiveness after 2 years. Be sure to check expiration dates if you find overstock sunscreens for sale at thrift stores.

Melanoma Vaccine

Recently, The Mayo Clinic announced that their researchers are working on a melanoma vaccine to combat skin cancer. Melanoma is the most deadly form of skin cancer, with the major risk factor being exposure to UV light. Incidence rates continue to rise, with the largest increase being seen in young women.

The research has been done on mice, using a genetic combination of human DNA from melanoma cells and a cousin of the rabies virus. In early studies, 60 percent of the mice with tumors were cured in fewer than three months with minimal side effects. Human clinical trials related to this research aren't anticipated for a few more years, but the results look very promising. More information on this research can be found in the story originally shared by Mayo Clinic here.