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The UV Index and You

If you ever need scientific motivation to put on sunscreen, let the UV index be your guide! As UV radiation is the greatest risk factor for the development of melanoma and other skin cancers, the UV Index is an important tool for sun safety and the prevention of skin cancers. The UV Index is dictated by the strength of UV rays in a particular area, along with the UV reflection off of snow and sand in that area. The UV index changes throughout the day, but is the highest (like the summer heat!) at midday.

The UV Index ranges generally ranges 1-11, though higher UV is possible on exceptionally hot days. As the chart below demonstrates, taking sun precautions are recommended for UV Index levels of 3 or higher. These precautions can include limiting your time in the sun or seeking shade, applying sunscreen, and wearing UV protective clothing, sunglasses, or a hat; don’t forget to reapply that sunscreen every two hours, and more frequently if you are swimming, exercising, or near reflective surfaces such as snow or sand! Because the UV Index is often indicative of heat, we also recommend keeping hydrated to avoid conditions such as heatstroke. When the UV Index reaches 6 or greater, it is officially a ‘high’ UV Index, and it is imperative that these sun safety precautions be followed.

(“UV Index”, Canadian Cancer Society “UV Index“, Web)

Referencing the UV Index so you know how to prepare for the day is simple, as there are several UV Index apps and websites! Life has a great list of UV Index apps which you can check out here. If you want to look for the UV Index online, The Weather Network has a UV Index in its weather forecast, as does AccuWeather, and the Government of Canada website has a daily UV Index Forecast for many Canadian cities.

Now that you have the UV Index at your fingertips, there’s no excuse for not being exercising precautions when the UV Index is higher than 2! Thanks for reading, and stay sun safe out there!

Save Your Skin Weekly Flashback! [July 16th-22nd]

Welcome to the Save Your Skin Foundation media flashback- your weekly guide to the melanoma landscape, and the activities of the Save Your Skin Foundation! We’ve got a lot of links to share with you this week, but we’d first like to call your attention to our partnership with Innovicares, Canada’s only free manufacturer and patient benefit plan! You can learn more here. We are also running a sunburn survey, and would love for you to take it! You can fill it out here. If you’re looking to brush up on your melanoma knowledge, we’ve been sharing this Aim at Melanoma list of statistics. We also shared with you that Aim at Melanoma is running a free nurse on call service that can be reached at nurseoncall@AIMatmelanoma.org or 1-877-246-2635! Cool, huh?

(WorkSafe BC, “Sun Safety at Work: Employers”)

Here are some links we shared with you this week:

–This Sydney Morning Herald piece criticizing health advice from celebrities

–This Centers for Disease Control and Prevention guide to protecting children from the sun

– This article in Melanoma News Today announcing that researchers have identified ways melanoma tumours can bypass immune checkpoints, leading to new research opportunities

–This article on 680 CJOB citing Manitoba as one of Canada’s leaders in cancer diagnosis and treatment. Way to go, Manitoba!

–This National Institutes of Health article about keeping elderly people safe from heatstroke, and some general tips to stay safe on hot days

–This OncLive peer exchange video about incorporating prognostic factors into melanoma (with more videos below!)

–This patient testimonial from Leo Pharma Global about living with actinic keratosis

–This article in Australia’s ABC News about Keytruda’s success in almost 50% of patients!

–This OncLive article reporting that long-term follow up has shown that Sonidegib can be beneficial for basal cell carcinoma

–This Leo Pharma Global informational video about actinic keratosis

–This article in Science Daily reporting that, despite the 2013 ban, indoor tanning rates of persons under 17 in New Jersey have not declined

–This OncLive article reporting the benefit of Vismodegib in basal cell carcinoma patients

–This Science Daily article announcing that Spanish researchers have uncovered some genetic reasons why men are more susceptible to skin cancer than women!

Cameron Institute’s Dr. John A. Bachynsky Offers Angle on Drug Pricing in Canada

In a recent post by the Cameron Institute, Dr. John A. Bachynsky suggests that “there are a growing number of gaps in coverage that calls for some form of universal, comprehensive, national drug coverage to fill these gaps” (Bachynsky 5). These ‘gaps,’ Bachynsky maintains, are caused by the provincial health ministries’ focus on price reduction while not considering the need for specific drugs; he opens the piece with an example wherein a drug priced at $600,000 for only two patients is considered ‘unaffordable’ while a ‘cheaper’ drug can have greater overall costs while being distributed to more patients. Instead, “Canadian government drug plans use the comparison with older, generic drugs ‘which do the same thing’ at a lower price” (4), as opposed to introducing more specific, improved drugs into the market. According to Bachynsky, the government does so by supporting multiple groups that restrict access to drugs and none that improve access, and labelling the prices of new drugs as ‘cost increases’ while there is no prior price to compare it to (3,4).

Naturally, blanket marketing drugs to a population with varied medical needs is problematic, especially for Canadians that are being medicated for long-term chronic illnesses. As Bachynsky points out, the problem with even reasonable drug prices is that they are utilized most often by only a segment of the population, but in high amounts. As Canadians have to pay for medical prescriptions out of pocket, with or without medical insurance, these ongoing costs can be financially draining; Bachynsky states that 25% of the chronically ill patients in Canada attempt to lower costs by stretching or skipping their medication (5), which is inadvisable even if they are using the ideal drug. The “universal, comprehensive, national […] coverage” that Bachynsky calls for is to aid this percentage (5), whom he suggests national assistance programs were initially created to protect.

While medication costs are legitimately high for the average Canadian citizen, they are not as troublesome for the government as provincial bodies would have you believe; Bachynsky cites drug expenditures as only 8% of government health care costs (6). Health care costs for the government have increased via the technological advancement and increase in litigation that comes with the unique and improved drugs the pharmaceutical industry is developing. While this is ‘too costly’ for the government, Bachynsky points out that “use of new technology has increased physician and hospital expense to an even greater degree but there is no outcry over excessive costs or sustainability” (7). The alternative treatments for a patient with no appropriate drugs for their condition utilize the latter technologies in a manner that is expensive, inefficient, and distressing for the patient, with measures such as hospital care, tests, referrals and surgeries. This realization begs the question: “why can we fund a lot of less effective procedures without complaint but not afford to pay for medication that does a better job and is preferred by the patient” (7).

The problem with reducing medication costs, while this would be to the benefit of both the government and the patient, is that pharmaceuticals are less likely to market drugs at a lower price point. Thus, the government’s solution to cut costs directly affects the patient; Bachynsky cites the example of “proposed therapeutic substitution” (10), in which the government will only cover the lowest-cost medical therapy for a variety of related illnesses. If a patient wants the more expensive treatment that is specific to their illness, they have to cover the cost.

As the burden of medication costs is something not experienced by the entire Canadian populace, the relationship between pharmaceuticals and government can go unconsidered by many in a nation that boasts free health care. Thanks to Doctor Bachynsky for writing an angle on that relationship! You can read the original post here.

Works Cited

Bachynsky, John A. “Opinion: Drug Prices are Too High!?” Cameron Institute. Cameron Institute (2016).

Save Your Skin Weekly Flashback! [July 9th-15th]

Welcome to the Save Your Skin Foundation media flashback- your weekly guide to the melanoma landscape, and the activities of the Save Your Skin Foundation! We’ve been very prolific on social media this week, as you’ll see by the links below, and we posted a blog about regional melanoma statistics in Canada, which you can check out here. If you’re just discovering Save Your Skin, or you haven’t looked recently, be sure to drop in on our survivorship initiative I’m Living Proof– we’re working on translating all survivor stories into French!

Our Dr. Halpern shows @PIX11News how we're using 3D photography to change the way we treat #melanoma. #UVSafetyMonth https://t.co/CQmScTd8nn

— Memorial Sloan Kettering Cancer Center (@sloan_kettering) July 11, 2016

Here are some links we shared with you this week:

–This Medivizor article about the effects of stereotactic radiosurgery on brain metastasized melanoma

–This article in The Brownsville Herald about Super Ray and the Sunbeatables- a sun safety curriculum being rolled out in six Texas primary school districts!

–This article in EurekAlert about a study by the Melanoma Research Alliance and Brown University which found that pre-screening of patients for melanoma did not see an increase in dermatologist visits or surgical treatments

–This article in High Times about the University of Canberra and Cann Pharmaceutical Australia’s efforts to develop medical-grade cannabis therapy to melanoma patients

–The OHSU Dermatology War on Melanoma registration page

–This article in The Skin Cancer Foundation Journal about keeping toddlers and babies sun safe

–This piece from ABC 6 Action News in Philadelphia about melanoma development in adolescents

–This eyelid melanoma case study in The New England Journal of Medicine

–This Jama Dermatology review in which the partners of melanoma patients were trained in skin-examination and identifying potential new melanoma

–This CBC News article about a gene variant that may cause redheads to have increased skin cancer risk

–This New York Post guide to vetting the sunscreens you buy

–pERC’s final recommendation for Cotellic and Zelboraf

–This article in The Sydney Morning Herald about the increasing incidence of melanoma in Australia

–This North Shore News piece about the Save Your Skin Foundation’s ten year anniversary and other achievements!

Thanks for reading, have a sun safe week!

The Gender and Geography Statistics of Melanoma in Canada

Last week, we posted a broad overview of the past ten years in melanoma statistics, drawn from the Canadian Cancer Society’s documents Canadian Cancer Statistics 2014, Special Topic: Skin Cancers and 2015, Special Topic: Predictions of the Future Burden of Cancer in Canada. This week, we’re going to focus on more geographically specific statistics; what is the melanoma landscape in your province like?

If you read last week’s post, you’ll know that in Canada, males are generally more likely to be diagnosed with melanoma than females. Over the past 25 years, the age standardized incidence rate (ASIR) of melanoma in Canadian males increased on average 2% yearly, while the ASIR of females increased but 1.5%; however, this percentage has jumped to 2.5% over the past eight years for females, likely due to the advent of tanning salons (2014 79). Between 1993 and 2009, men have seen a lifetime risk increase of 0.8%, while the lifetime risk increase rose 0.7% for women (79). Mortality statistics indicate that the melanoma death rates among Canadian males and females are consistent with diagnosis rates; the age standardized mortality rates (ASMR) have risen 1.2% yearly for males, 0.4% for females.

The higher melanoma incidence rates among men are also generally consistent from province to province, with the exception of Saskatchewan, in which the ASIR in 2010 saw 9.5 melanoma cases in every 100,000 males and 11.3 in every 100,000 females (2014 93, “Table 7.1”).

(2014 93, “Table 7.1 Annual Percent Change in Age-Standardized Incidence Rates (ASIR) for Melanoma of the Skin by Province and Sex, 1986-2010”)

The comparative incidence rate of melanoma in men is consistently higher in every province (except Saskatchewan), though, as indicated by the annual percent change being greater for Canadian females by 0.6% overall, melanoma rates among women are catching up. The greatest discrepancy between males and females is on Prince Edward Island, which has the highest provincial rate of melanoma in Canada for males (93, “Table 7.1”). The demographic with the lowest melanoma rate in Canada, as of 2010, was women in Newfoundland and Labrador (93, “Table 7.1”).

(2014 93, “Table 7.2 Annual Percent Change in Age-Standardized Mortality Rates (ASMR) for Melanoma of the Skin by Province and Sex, 1986-2009”)

Thankfully, the age-standardized mortality rates (ASMR) for Canadians are considerably lower than the ASIR. “Table 7.2” indicates that while Nova Scotia has the highest melanoma mortality rate among both males and females, the mortality rates for both men and women on Prince Edward Island in 2009 were too low to be recorded, though “Table 7.1” cites PEI as having the highest incidence rate among Canadian provinces for men, and the second highest for women (the highest being Ontario). The mortality rate among women in Newfoundland and Labrador is also too low to be recorded; the lowest recorded mortality rates for both men and women are in Manitoba. It is notable that Quebec, while having one of the lower incidence rates among the provinces for both men and women, has similar mortality rates.

The Canadian Cancer Society states that “variations of melanoma prevalence by province […] largely reflect population size differences and but also differences in rates of melanoma diagnosis and survival” (2014 85), which are important factors to keep in mind when considering the above data. Thank you for reading, and thank you to the Canadian Cancer Society and their document Canadian Cancer Statistics 2014, Special Topic: Skin Cancers for the statistics!

Works Cited:
Canadian Cancer Society’s Advisory Committee on Cancer Statistics (2014). Canadian Cancer Statistics 2014. Web.

Save Your Skin Weekly Flashback [July 2nd-8th]

Welcome to the Save Your Skin Foundation media flashback- your weekly guide to the melanoma landscape, and the activities of the Save Your Skin Foundation! We hope you had a fabulous and sun safe Canada Day long weekend. Thanks to the Toronto Blue Jays, Save Your Skin was able to donate tickets to the Peer Project and to the melanoma survivors featured in our campaign with the Melanoma Network of Canada, #notjustskincancer to a game, at which they also ran the #notjustskincancer campaign! A blog post by Natalie Richardson of The Impatient Patient about the day can be found here. Thanks Blue Jays!

Also this week, Save Your Skin Founder Kathy Barnard was on Roundhouse Radio’s Impact with Don Shafer segment alongside Mary-Jo Dionne and Dr. Joel Claveau, discussing the importance of using sunscreen! Give it a listen here.

If you’re looking to catch up on some reading, check out our recent blog posts “Understanding the Pan-Canadian Pharmaceutical Alliance (PCPA) and How it Affects Those Fighting Skin Cancer” and “Melanoma in Canada: A Short Review of the Past Ten Years”.

Here are some links we shared with you this week:

–This CTV News Atlantic interview with Dr. Ira Mellman about immunotherapy

–This article in Metro Vancouver (featuring Save Your Skin Founder Kathy Barnard!) about checking your loved ones’ moles for possible melanoma

–This response by the Urban Public Health Network to Environmental and Radiation Health Services Directorate’s document Consultation- Tanning Guidelines (warning: graphic images from page three onwards)

–This Medpage Today video featuring Dr. Omid Hamid on the promising trial treatment T-VEC

–This blog post by Save Your Skin’s pal Natalie Richardson over at The Impatient Patient about her sponsorship of the Meaford Soap Box Derby

–This Pacific Dermaesthetics piece about EltaMD suncare products

–This Huffington Post article about natural sunscreens

–This Science Explorer piece about the effects of chemotherapy on the body and mind

Melanoma in Canada: A Short Review of the Past Ten Years

In the decade since the Save Your Skin Foundation began, the Canadian melanoma landscape has seen both positive and negative changes. Advances in treatment methods and greater availability of trial drugs has increased survivorship rates, yet melanoma remains one of the only preventable cancers that has not seen a decline in diagnosis’. Review of the data found in the Canadian Cancer Society’s Canadian Cancer Statistics 2014, Special Topic: Skin Cancers and 2015, Special Topic: Predictions of the Future Burden of Cancer in Canada reveals that more Canadians are being diagnosed with melanoma than ever before.
Melanoma diagnosis rates have risen considerably in the past decade; in 2006, it was estimated that melanoma accounted for 13.6 of every 100,000 male cancer diagnosis’, and 11 of every 100,000 female cancer diagnosis’. This number has climbed to 16.1/100,000 cases for males and 13.2/100,000 for females in 2015 (2015 26-27). Given that the largest risk factor for melanoma is UV exposure, it is possible that this rise is due to the increasing popularity of tanning beds; this suggestion is supported by the yearly increase of 2.9% of melanoma cases among women between 2001-2010, versus 2.3% per year for men between in the same time period (21). However, melanoma is still more prevalent in males than in females; the Canadian Cancer Society estimated that in 2014, 1 in 59 Canadian men would develop melanoma with a 1 in 290 mortality rate, while 1 in 73 Canadian women would develop melanoma with a 1 in 395 mortality rate (2014 78).
While these numbers are growing, so are the survival rates of melanoma in Canada. Based on their follow-up data from between 2004 and 2008, the Canadian Cancer Society found “the one-, five-, and [ten]-year predicted relative survival ratios (RSRs) [to be] 97%, 89% and 86% respectively” (83). The CCS also found that the five-year predicted relative survival ratio has risen “from 85% in 1992-1996 to 89% in 2004-2008” (83), likely due to the rise of new treatment opportunities for melanoma patients.
While the incidence and mortality rates are higher in adult than adolescent Canadians (2014 77), statistics demonstrate that childhood sun safety is critical. Skin cancer is the second most diagnosed among Canadian youth 15-35 years old (Canadian Skin Cancer Foundation, “About Skin Cancer”), and the Canadian Cancer Society has found links between intermittent and intense sun exposure (resulting in burns) in adolescence and the development of skin cancers later in life (2014 87). It is imperative that parents ensure their children are protected during their outdoor activities, not only during their summer activities but also while partaking in winter sports, as snow can reflect UV rays. Preventing sunburns in adolescence, and teaching children about sun safety, can reduce their chances of developing melanoma as an adult.
Maintaining a sun safe attitude is not just important as an adolescent; no tan is a safe tan, and exposure to UV rays at any stage in life can contribute to the development of melanoma! If you are interested in reading more about sun safety, Save Your Skin’s recent blog post on the topic can be found here. For more information about cancers in Canada, we recommend a read of the Canadian Cancer Society’s Canadian Cancer Statistics 2014, Special Topic: Skin Cancers and 2015, Special Topic: Predictions of the Future Burden of Cancer in Canada. Thank you for reading, and remember sun safety during your outdoor activities!

Works Cited:

Canadian Cancer Society’s Advisory Committee on Cancer Statistics (2014). Canadian Cancer Statistics 2014. Web.

Canadian Cancer Society’s Advisory Committee on Cancer Statistics (2015). Canadian Cancer Statistics 2015. Web.

Canadian Skin Cancer Foundation. “About Skin Cancer”. Web.

Save Your Skin Weekly Flashback [June 25th-July 1st, 2016]

Welcome to the Save Your Skin Foundation media flashback- your weekly guide to the melanoma landscape, and the activities of the Save Your Skin Foundation! It’s an exciting week for the skin cancer community, with the Post-ASCO 2016 Conference in Munich, Germany and the Summit for Cancer Immunotherapy (Canadian Cancer Immunotherapy Consortium and BioCanRx) in Halifax, Nova Scotia, which Save Your Skin Founder Kathy Barnard opened with a discussion of life “beyond the curve” of melanoma. Keep an eye on our facebook page and twitter for updates on both conferences!

We are also excited to announce that we have been featured in the Summer 2016 issue of Canadian Skin, which includes a profile on the Save Your Skin Foundation and a testimonial from one of our board members, Christian Mosley!

Finally, we are still running our survey on sun safety behaviour, which you can fill out here. We appreciate it!

Here are some links and images we shared with you this week:

– This image from Post-ASCO in Munich, which suggests an alteration to the ABCDE (now the ABCD!) rules of clinical mole recognition:

–This article from Modern Medicine Network outlining the S3 international guidelines for actinic keratosis

–This article from Dermatology News reporting the findings of a study done by the US National Cancer Institute’s Surveillance, Epidemiology, and End Results program (SEER), which “highlight[s] the heavy death toll of thin melanomas”

–This article from Ecancernews reporting the suggested links between immunotherapy drugs, such as ipilimumab and nivolumab, and arthritis

–This News Wire article announcing that Merck has approved Keytruda for the treatment of patients with unresectable or metastatic melanoma that have not been treated with ipilimumab

–This article in Bel Marra Health suggesting that the development of vitiligo may be indicative of immunotherapy response

–This article in Trib Live about awesome Mohs histologist Danielle Deroy Pirain, who had a sunscreen dispenser installed in Mt Lebanon Park, Pennsylvania!

–This link to the Aim at Melanoma Foundation’s Memorial Wall. If you would like to include a loved one’s name on the Memorial Wall, you can do so here.

-And this Fierce Medical Devices article about the partnership between Australia’s IBM Research and Melanoma Institute Australia to build on IBM’s MoleMap, which seeks to identify patterns in early stage melanoma

Thank you for reading, be sun safe out there!

Save Your Skin Weekly Flashback [June 18-24, 2016]

Welcome to the Save Your Skin Foundation media flashback- your weekly guide to the melanoma landscape, and the activities of the Save Your Skin Foundation! It’s the first week of summer in the Western world, which means it’s definitely time to start thinking about sun safety! Check out our recent blog about sun safety here. We’re also running a summer sun safety behaviour survey, which we would love for you to fill out! You can find it here.

If you missed the flashback last week, it is our pleasure to inform you that Save Your Skin Founder Kathy Barnard was awarded a BC Community Achievement Award in May! Shaw TV will be airing the event for the rest of June and into July; a broadcasting schedule can be found here.
Here are some images and links we shared with you this week:

This cute video from Leo Pharmaceuticals about sun safety
This article from Sundicators about protecting your skin from the sun
The American Academy of Dermatology’s new Melanoma PSA, “‘Arms’”
This link to the draft of the Government of Canada’s Guidelines for Tanning Equipment Owners, Operators, and Users, with a feedback opportunity
This article in Targeted Oncology announcing that the Melanoma Institute Australia and the University of Sydney have deemed the combination of pembrolizumab and ipilimumab as a safe treatment for advanced melanoma
This article in Fierce Pharma that the National Institute for Health and Care Excellence has approved Bristol-Meyer’s combination of Opdivo and Yervoy for advanced melanoma patients
This Today piece about the “Mr. Sun” campaign, which aims to warn families about the possibly severe consequences of childhood burns
This HelloGiggles article debunking 13 myths about sunscreen and skin cancer
This piece from Cure Today about the 2014 Cancer Experience Registry Report, “Elevating the Patient Voice”

A Sun Safety Reminder from The Save Your Skin Foundation!

Summer has officially begun, and while it’s off to a cloudy start here at Save Your Skin in Vancouver, it’s important to remember sun safety during your outdoor activities! Though it is tempting to get a tan during the summer, keep in mind that the Canadian Cancer Society cites exposure to ultraviolet radiation as the greatest risk factor for the development of skin cancer. Melanoma is often a preventable disease, yet it is estimated that in 2017, 7, 200 Canadians were diagnosed with melanoma skin cancer and 74, 000 with non-melanoma skin cancer. That is why it’s essential to keep sun safety in mind if you’re working or playing outside this summer!

If you choose to wear sunscreen, it should have at least SPF 30, with UVA and UVB protection. The high SPF ensures that you will be well protected if you apply every two hours, while UVA and UVB protection shields you from both longer and shorter UV rays, respectively. It is a good idea to reapply more frequently if you are sweating or swimming, as moisture can rinse away sunscreen, and if you are at the beach, as sand can reflect ultraviolet rays. Remember to apply sunscreen to areas which are often forgotten, such as the back of your neck, your ears, the backs of your hands and the tops of your feet. If you are concerned about the chemical compositions of sunscreen, you can stay sun safe with organic sunscreens, which contain zinc oxide as their only active ingredient. They are available at most drug stores. Whatever sunscreen you use, remember to apply it fifteen minutes before leaving the house, so the ingredients have time to be absorbed into your skin!

There are ways to protect yourself from UV rays as an alternative, or in addition, to wearing sunscreen. These include wearing sunglasses to protect your eyes and prevent ocular melanoma, and a hat to shield the top of your head and neck and long sleeved shirts and pants. It is wise to seek shade whenever possible, especially when you don’t have the protection of sunscreen or clothing.

Sun safety is especially important for children. There are links between intermittent and intense sun exposure (resulting in burns) in adolescence and the development of skin cancers later in life, and skin cancer is the second most commonly diagnosed cancer in Canadian youth from 15-35 years old. While it is a good idea to introduce your children to sun safety early, keep in mind that the developing skin of babies is sensitive to both UV damage and the chemicals found in sunscreen. It is therefore best practice to keep babies out of the sun as much as possible.

If you live in a city with inconsistent weather, it is important to be protected even when the sun isn’t shining. The Skin Cancer Foundation estimates that up to 40% of the sun’s ultraviolet radiation can still reach the earth through clouds, so it is important to consider sun safety even when the sky is grey. While we recommend wearing sunscreen every day, check a UV index app if you need convincing; if the UV index is higher than 3, the US Environmental Protection Agency recommends taking full sun safety measures. While we may take it for granted, the skin is our largest organ, and it deserves to be taken care of!

Thanks for reading! On behalf of the The Save Your Skin Foundation, have a great and sun safe summer!

The UV Index and You

Save Your Skin Weekly Flashback! [July 16th-22nd]

Cameron Institute’s Dr. John A. Bachynsky Offers Angle on Drug Pricing in Canada

Save Your Skin Weekly Flashback! [July 9th-15th]

The Gender and Geography Statistics of Melanoma in Canada

Save Your Skin Weekly Flashback [July 2nd-8th]

Melanoma in Canada: A Short Review of the Past Ten Years

Save Your Skin Weekly Flashback [June 18-24, 2016]

A Sun Safety Reminder from The Save Your Skin Foundation!

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