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A Reminder About Sun Safety in the Form of SYSF Board Member, Christian Mosley

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May is Melanoma Awareness Month, in the spirit of which Save Your Skin would like to lend a reminder about sun safety in the form of Christian Mosley, a member of our board. Christian is not only the Head of Client Success at Chimp, a company that facilitates fundraising for charities, he’s also a Reservist in the navy and an outdoorsy thirty-four year old. Christian’s time in the sun has come back to haunt him recently, with the presence of stage 1B melanoma in a mole on the top of his head. Christian had been aware of this mole for a while; a barber pointed it out to him when he was joining the military twelve years ago. Forgotten about, this same mole reappeared in the summer of 2014, when it began to bleed on a sailing trip. Christian then saw a Doctor and a Dermatologist, both of whom identified the mole as melanoma. Two surgeries later, the mole was gone and Christian was left with what he described as “a row of staples down the back of my head”. 

Christian told me that his encounter with melanoma was an “emotional experience”, and explained how the surgeries caused him to cancel his summer plans, and interrupted his normal activities; even smiling would “put pressure on, and stretch, the incision”. While these outdoor activities can be pointed to as a contributing factor of Christian’s melanoma, he claims that he always practiced sun safety. He was conscious of skin cancer because of the history of melanoma in his family, which made him genetically prone to the disease. “I would say that most of the time I was proactive,” Christian told me, “but I still definitely had some bad burns, and I didn’t always wear hats. I think that contributed to it.” Melanoma can develop in many ways, which can slip past people who are aware of sun safety. One common error is the assumption that a good track record of wearing sunscreen makes the occasional tan, or burn, forgivable; an assumption that Christian hearkened to by asserting that there’s no such thing as a “base tan”, or a “good burn”. Christian also cites not always wearing hats as a contributor to his own melanoma, telling me “I think that I neglected the top of my head because it’s not an area that you’re conscious of when you’re considering sun protection”. The top of the head, along with the ears, neck, back of the hands, and tops of the feet, are the most commonly forgotten areas during sunscreen application. The top of the head is especially at risk without the protection of a hat, and, as Christian noted: “you don’t think to put sunscreen in your hair”. 

Christian’s story demonstrates how easy it is for certain aspects of sun safety to fall between the cracks, even when you think you’re protecting yourself. “When you’re a male in your twenties, you think you’re invincible”, he told me, “I thought I was doing everything right.” In addition to sun safety, it is important to consider the history of skin cancer in your family, and, if you have moles, to get them checked frequently. Of skin cancer awareness, Christian thinks that, “people need to be more proactive and less reactive”, a shift that is demonstrated by his attitude towards moles. Christian told me that, before his diagnosis, “I did have the moles checked out, then I forgot about it for a while. But they can change.” Having learned this fact the hard way, he now visits his dermatologist frequently and has had other moles removed. Looking for a “wider, collective mind shift” in regards to sun safety, Christian meditates on the military attitude towards sun burns as a guide: “if you get a sunburn in the navy, it’s a chargeable offence. It’s considered a self inflicted wound, and it interferes with your duty”, an anecdote that demonstrates the preventability of sunburns, and their potential consequences. 

Christian is not just making a call for sun safety, but is putting this mind shift into action. After being diagnosed with melanoma, Christian went to the internet (“a horrible place to go”) for guidance. Fortunately, google brought him to Save Your Skin, and put him in contact with Kathy. “It really felt like I was talking to someone who was not only super informed, but also cared,” he told me, “She [Kathy] was really able to give me perspective that I was unable to get from the medical community.” Christian joined the Save Your Skin Board in September 2014, and has been working on the solidification, internally and externally, of what he calls the ‘core values’ of the foundation. When I asked him what these core values are, Christian told me that he views Save Your Skin as a “patient-centric” organization. “It’s okay to do a lot of stuff,” he said, “but what is really important is that you have a primary focus. And with Save Your Skin that focus is patient-centric. Patients first. That is how Save Your Skin differentiates itself in the charitable marketplace.”

While it is fortunate that people who want to put “patients first” like Christian exist, it is unfortunate that they often have to encounter a disease before they learn from it, especially one that is as preventable as melanoma can often be. Hopefully this Melanoma Awareness Month can generate the “collective mind shift” that Christian hopes for, with a better consciousness of sun safety and other preventability measures against skin cancer.

Written by Taylor

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The hard questions – how I explain a really complicated cancer and treatment to my friends and family

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I’ve just been diagnosed with stage 3 melanoma and begin frantically searching the internet.  Basal cell carcinoma, squamous cell carcinoma, melanoma – all with very different outcomes, under the heading skin cancer.  I finally stumble upon the 10-year survival statistic calculator.  Plug in my age, the site of my melanoma, how thick it is, ulceration and mitotic rate, any spread to lymph nodes or distant sites in the body and I get the magic percentage – the odds I will still be alive 10 years from now.

I barely understand.  This is heavy.  How do I tell people?  The questions start flying.

Why did you get this?

It was probably a mix of sun exposure, using tanning beds and genetics.  There is no such thing as a base tan.  Stay out of the sun and use sunscreen.  

What did your mole look like?

Mine was tan colored, but began to grow.  If there is anything new, growing, bleeding or itchy you should have it looked at and potentially removed.  The classic teaching is asymmetric, irregular borders, multicolored or black, diameter bigger than a pencil eraser, or evolving (A, B, C, D, E).  

You’ve had surgery to remove the skin cancer, it is gone right?  

Well, the parts we can see are gone.  The spot is removed, and 2cm around it to make sure there is no microscopic remnants.  I’ve had lymph nodes removed and there is nothing they can see on the CT scans.  So, for now, I’m “cured”.  I use this word with caution.  The chance that my melanoma will come back is high, 30-60%, so I am optimistic that I will be ok, but I am guarded. 

But it’s just skin cancer?

It depends what kind you have – melanoma is the most aggressive of the skin cancers.  If caught when it is thin in the early stages – removing the spot can be curative.  If it is thick or spread to other sites in the body it is more difficult to treat.

But I have a friend who had (insert cancer here) and they’re ok.

Melanoma is very different from other cancers, like lymphoma or breast cancers, in how we treat it.  It doesn’t respond well, or at all, to chemotherapy and radiation like other types of cancers.  The best treatment is using the body’s own immune system to recognize the melanoma and “attack” it.  In the past few years there have been several new drugs that have come out that are working better than any other treatments we’ve had before, especially in stage 4 melanoma, but they are very expensive for the provinces to pay for.

What kind of treatment is available for stage 3 melanoma that has been surgically removed (resected)?

Currently, some of the options in Canada are drug trials or interferon (which is a controversial treatment).  I opted for interferon.

But you don’t look sick?

I’m on a biological therapy, which is not traditional chemotherapy, and the side effects are slightly different.  I still feel very sick, and need to do the treatment for a year.

Is the treatment working?

Maybe.  We won’t know unless the cancer comes back, or doesn’t.  It is called adjuvant therapy.  As far as the CT scans can see, I was cured from the cancer after my surgery.  But the chance that it can come back (because of microscopic deposits we can’t see) is high.  I hope the interferon does work, but I am cautiously optimistic.

You’ll be ok, right?

Yes.  (Is my usual answer to keep the mood light, what I really should say is):

Maybe.  I was told I have a 50% chance of living 5 more years.  

How do you tell that to your family and friends when you are only in your mid-twenties?  I take all the statistics with a skeptical eye, many of those people included in those statistics are very old, or have other diseases.  Up until a few years ago there were not any good treatments for melanoma, I expect these numbers to change for the better because of our new treatments.  Odds and statistics won’t tell you what your own personal outcome will be – no one can predict that.

One of the most challenging parts of explaining this cancer is that the answer is often “no-one knows for sure”, so I try my best to field questions without making things too complicated or getting into the nitty gritty.  Melanoma is serious and scary, but also at a point where there are lots of new exciting treatments, and with that comes hope.

As a closing note I would like to extend a big thank you to Kathy and the SYSF team for their education and support throughout my treatment.

Sam

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One Melanoma Patient’s Need for Community

 I find it comforting to meet or speak with others surviving the melanoma maze. Visiting my cancer centre on a regular basis for all of my appointments and treatments, I sit quietly with my peers awaiting theirs, but I almost eagerly strike up conversation if someone even glances my way. I must startle some of these unknown strangers, likely appearing like some overzealous puppy jumping up to make friends, panting all over the place. I have plenty of wonderful friends already, but I seem to crave new friends. I want cancer friends, I need common ground.

Since my diagnosis and countless consultations with medical professionals of all types, I still find the greatest comfort speaking with others in the same boat as I am. We compare facilities and oncologists, pain levels, side effects, and remedies for improvement of our symptoms.

We are all there for the same reason, and we seem keen to exchange stories and curious questions about clinical trials and treatment options and number of surgeries under our belts. It is a strange language, one I have learned a lot about in the past year, but one that I believe I will never fully understand.

I have happened to have met three people with melanoma, but that’s it. It is not the most common ailment along my traveled path. All cancer cases are personal of course, but I quickly learned that melanoma is even more a mysterious beast.

Melanoma patients are a unique breed, fighting a unique battle, and we need comrades on our side. Talking it out with someone with the same type of metastatic cells not only eases our psychological burden, but it lends hope to the fight. It reinforces in our minds and bodies that we may have other options to explore or other questions to ask our oncologists. There are other people ALIVE coping with what we are coping with, and they may be able to help.

Life raft thrown out! Even if for just one day, that is one day’s worth of hope that I may not have had if I hadn’t spoken with my comrade.

Online resources are a huge help also – when first diagnosed I was banned by my doctor from the internet, but now that I have learned more and I am more comfortable with the way things seem to work, I feel less panic about reading things online about my disease. Even the venting of fellow bloggers is comforting, I feel relief when reading their words and knowing that I am not the only one who is afraid or discouraged or angry.

I can sift through the medical terms and look past the statistics, and every now and then I find a nugget of information that sends me in an entirely different direction, usually uncovering another piece of my puzzle. Whether about melanoma or the likes of a new meditation technique, it gives me the feeling that there is something I can do about my situation, and that there are others who are doing the same.

I remember feeling when I was first diagnosed that I was walking around with a giant digital clock above my head, with large green numbers counting down to my expiry date. I felt I stuck out like a sore thumb, wore that clock around like a black cloud, wondering how to get it away from me. I ducked and dodged and denied until I was blue in the face, now I focus my energy on positive action, namely, writing or talking with anyone willing to show their community flag.

The clock seems to have faded this year later, but it is not gone. That is in part due to those that I have connected with, in person or online, that have said the same things I have felt, or that have experienced the situation I am in. Venting, learning, sharing: all coping mechanisms.

I trust my oncologists, but I gain extra strength when I speak to people who have walked the same steps I am being directed to take. I hear it repeated and think it is a good sign that I am not some entirely solitary being receiving a mystical treatment unknown to anyone outside of the chemical laboratory that mixes up my IV bag of potion.

Every day I push on, hanging out with my family and friends, going to my appointments, resting with my cat, and seeking the additional community that I need in order to properly fulfill my ambition to fight melanoma. I have to fight my individual battle my way, but I am also content to share that fight with others, either gaining from their perspective, or being able to help someone else in some small way. We are all neighbours on this ship, and I think we can paddle together to keep it afloat.

Natalie Richardson – www.impatientpatientmomma.blogspot.ca

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What is Sun Safe Clothing and How Does It Protect from Harmful UV Exposure?

Every week our team scours the internet looking for information that helps our communities stay sun safe and sun aware. Recently, we came across this article on Sun Safe Clothing that we wanted to share.

What’s the best way to protect yourself from the sun’s harmful ultraviolet rays (UVR), given that we need to work, travel, and sometimes play outside? Clothing is the most basic and generally the best means of sun protection. Not all clothing is equal, however, and some of it isn’t actually very good at protecting us. So, what makes a piece of clothing sun-safe?

More Is More

The sun damage done to every exposed part of your body is cumulative over your lifetime, continually adding to your risks of premature skin aging and skin cancer. So, to put it simply, the more skin you cover, the better. A long-sleeved shirt covers more skin than a T-shirt, especially if it has a high neckline or collar that shields the back of the neck; long pants cover more skin than shorts. A wide-brimmed hat protects more of the face than a baseball cap, and close-fitting wraparound sunglasses protect more of the area around the eyes than small lenses do. Cover up.

Fabric Factors

Of course, you can have clothing over every square inch of your body, but if the sun goes right through it, it’s not much use. Fabrics are made of tiny fibers woven or knitted together. Under a microscope, we can see lots of spaces between the fibers; UV can pass directly through these holes to reach the skin. The tighter the knit or weave, the smaller the holes and the less UV can get through. Twill, used to make tweeds or denim, is an example of a tightly woven fabric. Open weave fabrics provide much less protection.

Fabrics can be made from many types of fibers, including cotton, wool, and nylon. Most fibers naturally absorb some UV radiation, and some have elastic threads that pull the fibers tightly together, reducing the spaces between the holes. Synthetic fibers such as polyester, lycra, nylon, and acrylic are more protective than bleached cottons, and shiny or lustrous semi-synthetic fabrics like rayon reflect more UV than do matte ones, such as linen, which tend to absorb rather than reflect UV. Finally, consider the fabric’s weight and density — light, sheer silk gauze will provide far less UV protection than heavy cotton denim.1,2,3

Five examples of real fabrics, all with different amounts of fiber or yarn per unit of surface area and providing different amounts of sun protection. The higher the UPF (ultraviolet protection factor), the greater the protection.

Color Comparisons

Most of our clothing is dyed attractive or functional colors. Many dyes absorb UV, which helps reduce exposure. Darker colors tend to absorb more UV than lighter colors, including whites and pastels, but bright colors such as red can also substantially absorb UV rays.3 The more vivid the color, the greater the protection; a bright yellow shirt is more protective than a pale one. But even a pale fabric can offer good protection if the weave, material, weight, etc. are effective at keeping out UV. And many white fabrics have “optical whitening agents,” chemical compounds that strongly absorb UVR, especially UVA.1,2

UPF Rating

Though loosely evaluating fabric content, color, weight and weave by eye are helpful at sizing up UV protection, it is difficult to pinpoint just how protective a piece of clothing is simply by looking at it. Holding it up to the light helps show how much light passes through, but this isn’t ideal, because the human eye sees visible light but not UV radiation.2

One solution is to choose garments with UPF labels. UPF, a concept originally standardized in Australia in 1996, stands for ultraviolet protection factor, which quantifies how effectively a piece of clothing shields against the sun.4 The label means the fabric has been tested ina laboratory and consumers can be confident about the listed level ofprotection. It is based on the content, weight, color, and construction of the fabric, and indicates how much UV can penetrate the fabric. For instance, a shirt with a UPF of 50 allows just 1/50th of the sun’s UV radiation to reach your skin. This would provide excellent sun protection, in contrast to a thin white cotton T-shirt, which has a UPF of about 5, which allows 1/5th of the sun’s UV through — even more when wet. In studies done in Australia, lycra/elastane fabrics were the most likely to have UPFs of 50 or higher, followed by nylon and polyester.3

Today, systems for testing and determining UPF are similar around the world. In many countries, including the US, the ASTM International (formerly called the American Society for Testing and Materials) criteria for UPF assessment are used; UPF labels in the US often state that an item meets ASTM International standards.

Does all of this mean that everyone should specifically buy UPF-tested/UPF-labeled clothing, which most often carries a brand name? Is it so superior to everyday clothing that it is worth the extra expense and trouble to find? Not necessarily. Some items of clothing, such as denims and corduroys, are among the most sun-protective of all garments, UPF labels or not. However, a specially made high-UPF shirt, say, with long sleeves and a double layer of fabric at the shoulders — a high UV exposure area — might be constructed with a lightweight material that gives the wearer superior comfort and coolness as well as added sun safety. And the UPF label always adds a measure of certainty.

Do-It-Yourself

As an alternative, consumers themselves can improve a piece of clothing’s UPF. First, wash it. This generally makes the garment shrink slightly, closing up holes in the fabric that can let UV radiation in. Tests have also shown that you can wash in extra protection and raise the UPF with UV-filtering dyes and other additives.1,2

Here are some key tips for buying and staying sun-safe with clothing:

  1. Buy garments that suit your purpose. You don’t need a heavy work shirt for the beach, but a longsleeved, tightly woven linen shirt can be both cool and sun-smart.
  2. If you are buying elastic garments like leggings, make sure you purchase the right size — overstretching will lower the UPF rating.
  3. Look for garments with a UPF of at least 30 so that you know you’re getting effective sun protection.
  4. Choose garments that cover more skin—there’s no point in a high-UPF bikini. Instead, consider a rash guard or swim shirt. Made of lightweight, elastic materials like spandex, these athletic tops will cover your upper body without weighing you down. You can also have beach skirts or sarongs ready for when you leave the water.
  5. Wash new garments made from cotton or cotton blends two or three times at least. This can often permanently raise the UPF rating due to shrinkage of the spaces between the fibers.
  6. Select wide-brimmed hats (at least 3” in diameter) that shade your face, neck and ears.
  7. When outdoors, seek out shaded areas under awnings or trees and minimize your time in the direct sun.
  8. Be aware that UV light can bounce off surfaces such as water, snow and glass, hitting your skin twice and increasing the intensity of exposure.
  9. Use UV-filtering sunglasses and sunscreen with a sun protection factor (SPF) of at least 15 for everyday incidental exposure and 30 or higher for extended exposure. Apply sunscreen on all exposed areas — clothing can’t cover everything.5

Remember, sun-protective clothing doesn’t have to be boring: it can be light and bright and fashionable and fun. And when chosen and used correctly, it’s the best form of sun protection you can find.

DR. PETER GIES is Senior Research Scientist, Ultraviolet Radiation Section, Non Ionizing Radiation Branch, Australian Radiation Protection and Nuclear Safety Agency. Key focuses for Dr. Gies are measurement of ultraviolet radiation (UVR), including solar UVR; hazard assessment of UVR sources; assessment of protective measures (sunglasses, hats, clothing, materials, car windows and sunscreens); and personal exposure studies of various population groups using polysulphone film dosimetry and time-stamped electronic UV dosimeters. Dr. Gies is a member of Standards Australia committees on Sunglasses and Fashion Spectacles, Sunscreens, Sun Protective Clothing, and Solaria. Formerly Chairman of the Commission Internationale d‘Eclairage Technical Committee TC 6-29 “UV Protection and Clothing,” he has authored more than 115 scientific publications.

ALAN MCLENNAN is Senior Technical Officer in the Ultraviolet Protection Factor Testing Service at the Australian Radiation Protection and Nuclear Safety Agency.

References

  1. CIE (International Commission on Illumination) Technical report. UV protection and clothing. CIE 172:2006 CIE Central Bureau, Vienna, Austria, 2006.
  2. Osterwalder U, Schlenker W, Rohwer H, et al. Facts and fiction on ultraviolet protection by clothing. Radiat Prot Dosimetry 2000; 91(1):255–259.
  3. Gies P. Photoprotection by clothing. Photodermatol Photoimmunol Photomed 2007; 23:264-274.
  4. Standards Australia/Standards New Zealand. Sun protective clothing—evaluation and classification. AS/NZS 4399. 1996; Standards Australia, Sydney and Standards New Zealand, Wellington.
  5. Diffey BL. Sunscreens: expectation and realization. Photodermatol Photoimmunol Photomed 2009; 25:233-236.

Original article: http://www.skincancer.org/prevention/sun-protection/clothing/protection

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