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Preventing Skin Cancers

Any direct exposure of the skin to sunlight increases risk for skin cancer. The sun emits ultraviolet rays that are classified mostly into UVA and UVB. Most sun screens protect against only UVB rays, which are the primary cause of sunburn and skin cancer, but UVA rays penetrate deeper into your skin, to cause wrinkling, thinning, aging, and brown spots. Any exposure to the sun's rays can cause sunburns and skin damage. Long-term exposure to either UVB or UVA, or both, can cause skin cancer.

Vitamin D: People cannot meet their needs for vitamin D unless they expose their skin to sunlight or take vitamin D supplements. Food sources are inadequate and vitamin D pills may not supply all the benefits of sunlight. If you do not allow the sun's rays to reach your skin, you will not be able to gain all the benefits of sunlight. You can meet your vitamin D requirements by exposing a small area of skin for about half an hour.

Body parts that should always be covered: Since cumulative exposure to sunlight over a lifetime is what causes skin cancers, always cover the areas that have had the most sun exposure: face, hands, arms and tops of the ears, Most basal and squamous skin cancers occur on the face, ears, neck, forearms, and hands, but melanoma occurs most commonly on the upper back for men and the lower legs and upper back for women. Expose your legs or other areas of your body that have received little cumulative sun exposure over your lifetime. However, any sunlight exposure increases risk for skin cancer and aging. Take care to avoid sunburn, as a single sunburn increases risk for melanoma.

Clothes are far more protective than sun screens: In one study, participants completed questionnaires on the frequency with which they used sun screens, wore a hat or long sleeves, or stayed in the shade, in comparison to their number of sunburns in the past year. Although using sun screens is the most common sun protective behavior, use of sun screens does not reduce risk for sunburns. Those who avoid the sun by seeking shade or wearing long sleeves are far less likely to suffer sunburns (Cancer Causes and Control, June 2011). Wear a hat that covers your ears, a shirt, and arm coolers on your arms when you exercise outdoors.

Arm coolers: Arm coolers are made of special materials that evaporate water quickly so that your arms will feel cool when sweat evaporates. You can even make your arms feel cold on hot days just by pouring water on them. You can buy arm coolers in sports stores or online.

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Clouds don't protect you: Up to 80 percent of the sun's UV rays can pass through clouds to damage your skin.

Glass does not protect you: Glass blocks UVB rays that are the primary causes of skin cancer and sunburns, but they do not block UVA that can also cause skin cancer and aging.

Beach umbrellas do not protect you: UV rays are reflected towards you from sand and water. Studies show that you get up to 84 percent of the exposure to UV radiation under an umbrella that you receive in the open sun.

Dark colored fabrics block UV rays better than light colors: The colors that block the most UV include black, deep blue, orange and red.

Tightly woven fabrics block more uv than looser weaves: Hold the material up to a light source. The more light that passes through a fabric, the more UV will also pass.

Sunglasses help to prevent skin cancer: Skin cancers around the eyes, mouth, ears and nose are among the most difficult to treat and cure and are also the ones most likely to recur after treatment. Cancers in these areas can tunnel underneath the skin and not be obvious to the naked eye. Sunglasses block UV light and therefore help to prevent cancer in skin around your eyes.

People with dark skin still need to follow sun protection precautions: Skin pigment reduces the amount of UV rays that pass into skin, but it does not prevent sunburns or skin cancer.

Safety of sun screens? We do not know how safe sun screens are because they have never been tested systematically. For example, oxybenzone in sun screens has been shown to be absorbed into the bloodstream in humans, and to disrupt hormones in animals. A critique of 1700 sun screens was conducted by the Environmental Working Group. Brand name listings and sunscreen recommendations for 2011

SPF: Sun Protection Factor (SPF) on sun screen labels tells you how long it takes to burn your skin underneath that sun screen. It does not tell you how much protection you are getting. A SPF 30 sun screen blocks 97 percent of UVB rays, compared to an SPF 15 sun screen that blocks 93 percent. No sun screen blocks all UV rays.

Broad-spectrum sun screens provide some protection against UVA and UVB rays, but the SPF (sun-protection factor) rating refers only to the level of protection from UVB rays. The FDA just ruled that as of the summer of 2012, sun screen labels that claim to be "broad spectrum" must protect against UVA as well as UVB. The new rules also prohibit any sun screen from claiming that it prevents skin cancer or aging because no sun screen blocks all UV rays. Sun screens cannot claim that they last for more than two hours, unless proof of longer protection is submitted to the FDA.

Zinc and titanium are safest: The safest and most effective sun screens contain zinc or titanium. These sunscreens are generally thicker and whiter. You do not need to reapply these as long as there is a visible white paste on your skin.

Re-apply sun screens often: Many sun screens contain the filters octylmethoxycinnamate, benzophenone-3 or octocrylene, which reflect ultra violet rays away from your skin to protect it only when they are on the surface of the skin. When these sun screens are absorbed and the skin is not re-coated, they increase skin production of harmful oxidants that can cause skin aging and cancer (Free Radical Biology & Medicine, September 2009).

Most sun screens burn your eyes: To avoid getting sun screens in your eyes, wash your hands after each application and do not apply sun screen above your eyes. Use a hat whenever you can, covering your forehead and the top of your ears.

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Dear Dr. Mirkin: Why do cholesterol-lowering statin drugs cause muscle pain and muscle damage? We don't know. Only a small percentage of those who take statin drugs suffer muscle pain and damage, those most likely to have muscle pain from statins are the ones who exercise. The more vigorously you exercise, the more likely you are to suffer muscle pain and damage from statins.

A recent study from Texas A&M shows that among older men who start a muscle strengthening program, those who have the highest rise in blood levels of the bad LDL cholesterol are the ones who gain the most muscle strength and size (Journal of Gerontology, May 6, 2011). Every cell membrane is made up of millions of cholesterol molecules. This study implies that the so-called "bad" LDL cholesterol can be good because it brings cholesterol to the damaged muscle to hasten healing and promote muscle growth.

All training for strength involves taking a workout so intense that it damages the muscles and causes soreness on the next day. Then you are supposed to take easy workouts for as many days as it takes for muscles to heal and the soreness to diminish. When your muscles feel better, you take another hard workout that damages your muscles again. Statin drugs block the bad LDL cholesterol and delay healing, so it can take longer for athletes to recover from their hard days and they are not able to be as competitive as they would be if they were not taking these drugs.

If you take statins, you should realize that most people can lower their bad LDL cholesterol without taking drugs. However, many people are not willing to make the necessary lifestyle changes:

• lose excess weight
• avoid sugared drinks and foods with added sugar
• eat large amounts of fruits and vegetables
• avoid red meat
• get blood levels of vitamin D3 above 75 nmol/L (30 ng/L)
• check with your doctor and start an exercise program or increase the intensity of your current exercise. People with blocked arteries leading to the heart can suffer heart attacks when they exercise intensely.

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Dear Dr. Mirkin: Can obesity cause impotence and loss of interest in lovemaking?

Yes! Obesity lowers testosterone to cause loss of sexual interest and function in men. Surgery that causes weight loss in these men raises testosterone markedly and improves their sexual interest and function (presented at The Endocrine Society's 93rd Annual Meeting in Boston, June 4, 2011). Seventeen men who had weight-loss surgery lost an average of 90.2 pounds. One year after surgery, their testosterone levels increased significantly to a normal range.

Furthermore, the higher the level of physical fitness in young men, the less likely they are to suffer from impotence and loss of interest in making love (International Journal of Impotence Research. May 12, 2011).

A man's endocrine glands produce both male and female hormones. The liver removes the female hormone, estrogen, from the bloodstream. However, obesity causes the liver to fill with fat. This prevents the liver from removing estrogen from the bloodstream. Estrogen levels rise to shut off the brain from producing FSH, the hormone that stimulate the testicles to make the male hormone, testosterone. Since the testicles are not stimulated by FSH, they make very little testosterone, which is necessary for sexual interest and function. Loss of sexual interest and function is often caused by a fatty liver.

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Recipe of the Week:

Two-Bean Cabbage Slaw

You'll find lots of recipes and helpful tips in The Good Food Book - it's FREE

June 19th, 2011
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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