US Cancer Drug Approvals Ensure Access but Not Value

US Cancer Drug Approvals Ensure Access but Not Value

Cancer drugs that have been approved in the United States are often not immediately approved in the United Kingdom and Canada, owing to uncertainty over benefits and harms as well as extremely high prices, two new studies in JAMA Internal Medicine indicate.

 

The oncology drug approval process of the US Food and Drug Administration (FDA) is “broken,” concludes an accompanying editorial.

 

“Many cancer drugs come to market in the United States and, eventually, globally at unaffordable prices with massive uncertainty about their benefits and harms,” say the editorialists, Vinay Prasad, MD, MPH, University of California, San Francisco, and Myung Kim, MD, Oregon Health and Science University, Portland, Oregon.

 

“The US system of approval of drugs with uncertain clinical benefit followed by mandated coverage by Medicare without any ability to negotiate on prices ensures access,” they observe.

 

“It is less clear that the US system benefits patients with cancer,” they conclude.

 

In addition, the uptake of these cancer drugs “is often delayed in high-income Western nations because of justified and persistent doubts about value,” they continue.

 

“We should consider the possibility that our drug policy has negative repercussions for patients with cancer worldwide,” they write.

 

Negative Repercussions

The negative repercussions of the FDA drug approval process were most evident in the study from Canada. As analyzed by Daniel Meyers, MD, University of Calgary, Alberta, Canada, and colleagues, between 2011 and 2020, the pan-Canadian Oncology Drug Review (pCODR) issued 104 reimbursement recommendations for cancer drugs that were indicated for solid tumours.

 

“Three-quarters of all submissions received a positive recommendation,” the investigators report. However, more than 92% of those approvals were conditional, most commonly because of serious reservations about the cost-effectiveness of the drug, they note.

 

Moreover, only half of the cancer drugs recommended by pCODR improved overall survival (OS), and survival gains were usually modest. The median OS was only 3.7 months, and the median progression-free survival (PFS) was only 4.7 months; these rates are not substantially different from those of drugs that received a negative recommendation, Meyers and colleagues point out.

 

Importantly, almost 40% of cancer drugs that received a positive recommendation from pCODR did not achieve the threshold for substantial clinical benefit, as assessed by the European Society for Medical Oncology–Magnitude of Clinical Benefit Scale.

 

These results suggest that despite the pCODR framework, which provides reimbursement recommendations based on clinical benefit, cost-effectiveness, and patient-based values, “cancer drugs without meaningful patient benefit continue to be reimbursed in the Canadian market,” the authors conclude.

 

In the UK study, Avi Cherla, MSc, London School of Economics and Political Science, London, the United Kingdom, and colleagues compared cancer drug indications that received FDA accelerated approval from December 1992 to May 2017 with the same indications in England through August 2019.

 

Of 93 cancer drug indications that received FDA accelerated approval over the past 25 years, they found that 30 drug indications were not reviewed for coverage by the UK’s National Health Service (NHS). In addition, 12 drug indications were denied authorization or coverage by either European regulators or the National Institute for Health and Care Excellence (NICE) because of insufficient safety, clinical efficacy, or cost-effectiveness data.

 

Furthermore, NHS coverage of cancer drugs that did receive FDA accelerated approval frequently required additional price concessions, restriction of drug indications to specific patient subgroups, and the collection of additional data. As has been reported, most drug approvals by the FDA are based on surrogate markers, such as tumour shrinkage or delayed tumour growth (PFS), a point that editorialists Prasad and Kim emphasize.

 

“Surrogate endpoints result in substantial uncertainty regarding the magnitude of clinical benefit (if any exists), which is a key input to a cost-effectiveness calculation,” they point out.

 

Perhaps most importantly, “the cancer drugs available in England, Canada, and the US are not as good as physicians would hope for patients,” the editorialists write. For example, only 34 of 52 cancer drugs evaluated by NICE showed any survival benefit, and that benefit was at best very modest.

 

JAMA Intern Med. Published online February 22, 2021. A Canadian study, Abstract; UK study, Full text; Editorial

 

The study authors have disclosed no relevant financial relationships. Prasad has received grants from Arnold Ventures Research and personal fees from Johns Hopkins Press, Medscape, UnitedHealthcare, New Century Health, and Evercore. He has also received honoraria from medical centres, nonprofit organizations, and professional societies and hosts a podcast called Plenary Session that has Patreon backers.

US Cancer Drug Approvals Ensure Access but Not Value

US Cancer Drug Approvals Ensure Access but Not Value

Cancer drugs that have been approved in the United States are often not immediately approved in the United Kingdom and Canada, owing to uncertainty over benefits and harms as well as extremely high prices, two new studies in JAMA Internal Medicine indicate.

 

The oncology drug approval process of the US Food and Drug Administration (FDA) is “broken,” concludes an accompanying editorial.

 

“Many cancer drugs come to market in the United States and, eventually, globally at unaffordable prices with massive uncertainty about their benefits and harms,” say the editorialists, Vinay Prasad, MD, MPH, University of California, San Francisco, and Myung Kim, MD, Oregon Health and Science University, Portland, Oregon.

 

“The US system of approval of drugs with uncertain clinical benefit followed by mandated coverage by Medicare without any ability to negotiate on prices ensures access,” they observe.

 

“It is less clear that the US system benefits patients with cancer,” they conclude.

 

In addition, the uptake of these cancer drugs “is often delayed in high-income Western nations because of justified and persistent doubts about value,” they continue.

 

“We should consider the possibility that our drug policy has negative repercussions for patients with cancer worldwide,” they write.

 

Negative Repercussions

The negative repercussions of the FDA drug approval process were most evident in the study from Canada. As analyzed by Daniel Meyers, MD, University of Calgary, Alberta, Canada, and colleagues, between 2011 and 2020, the pan-Canadian Oncology Drug Review (pCODR) issued 104 reimbursement recommendations for cancer drugs that were indicated for solid tumours.

 

“Three-quarters of all submissions received a positive recommendation,” the investigators report. However, more than 92% of those approvals were conditional, most commonly because of serious reservations about the cost-effectiveness of the drug, they note.

 

Moreover, only half of the cancer drugs recommended by pCODR improved overall survival (OS), and survival gains were usually modest. The median OS was only 3.7 months, and the median progression-free survival (PFS) was only 4.7 months; these rates are not substantially different from those of drugs that received a negative recommendation, Meyers and colleagues point out.

 

Importantly, almost 40% of cancer drugs that received a positive recommendation from pCODR did not achieve the threshold for substantial clinical benefit, as assessed by the European Society for Medical Oncology–Magnitude of Clinical Benefit Scale.

 

These results suggest that despite the pCODR framework, which provides reimbursement recommendations based on clinical benefit, cost-effectiveness, and patient-based values, “cancer drugs without meaningful patient benefit continue to be reimbursed in the Canadian market,” the authors conclude.

 

In the UK study, Avi Cherla, MSc, London School of Economics and Political Science, London, the United Kingdom, and colleagues compared cancer drug indications that received FDA accelerated approval from December 1992 to May 2017 with the same indications in England through August 2019.

 

Of 93 cancer drug indications that received FDA accelerated approval over the past 25 years, they found that 30 drug indications were not reviewed for coverage by the UK’s National Health Service (NHS). In addition, 12 drug indications were denied authorization or coverage by either European regulators or the National Institute for Health and Care Excellence (NICE) because of insufficient safety, clinical efficacy, or cost-effectiveness data.

 

Furthermore, NHS coverage of cancer drugs that did receive FDA accelerated approval frequently required additional price concessions, restriction of drug indications to specific patient subgroups, and the collection of additional data. As has been reported, most drug approvals by the FDA are based on surrogate markers, such as tumour shrinkage or delayed tumour growth (PFS), a point that editorialists Prasad and Kim emphasize.

 

“Surrogate endpoints result in substantial uncertainty regarding the magnitude of clinical benefit (if any exists), which is a key input to a cost-effectiveness calculation,” they point out.

 

Perhaps most importantly, “the cancer drugs available in England, Canada, and the US are not as good as physicians would hope for patients,” the editorialists write. For example, only 34 of 52 cancer drugs evaluated by NICE showed any survival benefit, and that benefit was at best very modest.

 

JAMA Intern Med. Published online February 22, 2021. A Canadian study, Abstract; UK study, Full text; Editorial

 

The study authors have disclosed no relevant financial relationships. Prasad has received grants from Arnold Ventures Research and personal fees from Johns Hopkins Press, Medscape, UnitedHealthcare, New Century Health, and Evercore. He has also received honoraria from medical centres, nonprofit organizations, and professional societies and hosts a podcast called Plenary Session that has Patreon backers.

Mortality Gap Between Cancer

Heart Disease Narrowing for Women Younger Than 65

THURSDAY, Feb. 25, 2021 (HealthDay News) — For women aged younger than 65 years, the mortality gap between cancer and heart disease is narrowing, according to a study published online Feb. 8 in the European Heart Journal: Quality of Care & Clinical Outcomes.

 

Safi U. Khan, M.B.B.S., from West Virginia University in Morgantown, and colleagues compared premature heart disease- and cancer-related deaths in women aged younger than 65 years in the United States. The annual percentage changes (APCs) in age-adjusted mortality rates (AAMRs) and years of potential life lost per 100,000 persons were compared.

 

The researchers found that cancer was a more prevalent cause of premature death than heart disease overall. Between 1999 and 2018, there were decreases in the AAMRs for both cancer (61.9 to 45.6 per 100,000) and heart disease (29.2 to 22.6 per 100,000). The APC in AAMR for cancer decreased consistently over time, while for heart disease, the APC in AAMR declined initially but increased between 2010 and 2018 (0.53), with significant increases in the Midwest, medium/small metros, and rural areas after 2008. The APC in AAMR for heart disease increased in women aged 25 to 34 years (2.24) and 55 to 64 years (0.46) compared with cancer. There was a narrowing in the mortality gap observed between cancer and heart disease, from 32.7 to 23.0 per 100,000.

 

“If extreme public health measures are not taken to mitigate cardiovascular risk factors, focusing on high-risk groups, heart disease mortality may supersede cancer to become the leading cause of death in young women,” the authors write

Long-term face mask use will not cause lung cancer

The claim: Long-term mask-wearing may cause advanced-stage lung cancer, one study shows

It is well-known by now masks can help prevent the spread of the novel coronavirus. New data from the U.S. Centers for Disease Control and Prevention recommends even better prevention with double masking. But one social media post claims wearing a mask may cause serious harm in the long run.

 

“Long-Term Mask Use May Contribute to Advanced Stage Lung Cancer, Study Finds,” asserts a Jan. 29 article from BlackListed News, an independent news platform known to publish pseudoscience and conspiracy-related content.

 

How exactly this alarming condition arises is through the “inhalation of harmful microbes” into the lung that has been “cultivated through prolonged mask-wearing,” writer Phillip Schneider claims.

 

He also provides quotes from lead author Dr Leopoldo Segal, director of New York University Langone’s Lung Microbiome Program, explaining the scientific basis for these microbes’ destructive effect, and ties the study’s discovery to the larger trend of purported evidence against mask-wearing.

 

BlackListed News did not return USA TODAY’s request for comment.

 

Fact check: Masks encouraged on federal lands if distancing isn’t possible

 

Oral bacteria can lead to poor lung cancer prognosis and progression

The human body is a host to millions of different kinds of microorganisms inhabiting both the skin surface and deep within various organs, such as the gastrointestinal tract. These bacteria, viruses, fungi and other life forms – the microbiome – play a key role in maintaining health and preventing disease. Shifts in the microbiome because of ageing, long-term dieting, stress or pharmaceutical drugs have been linked to conditions like obesity, depression and autoimmune diseases, among many others.

 

They can even contribute to cancer, as some emerging research has found. Segal’s study particularly looked at how the microbiome within the lungs – previously believed a sterile, microorganism-free environment – plays into the development of lung cancer, a disease afflicting over 2 million people worldwide and responsible for nearly 1.8 million deaths in 2018, according to the World Health Organization.

 

Story continues

 

The study analyzed the lung microbiomes of 83 untreated adult patients with lung cancer and found that patients with advanced-stage lung cancer (stage III to IV) “had greater enrichment of oral commensals in the lung than those who had the early-stage disease (stages 1-3a),” stated a November news release on the study from the American Association for Cancer Research. Oral commensals are simply oral bacteria.

 

Some of those bacteria are the same ones typically found in the respiratory tract’s lower airways, such as Prevotella and Veillonella, both of which can cause oral infections and mingle with Streptococcus to form dental plaque (in the case of Veillonella).

 

These oral bacteria were found to be associated with “decreased survival, even after adjusting for tumour stage.” Veillonella, Prevotella and Streptococcus, in particular, were associated with poor prognosis. All three, plus another bacteria making up the mouth’s normal flora, Rothia, were associated with tumour progression.

 

The study did report that one limitation to its findings – aside from the study size being too small to allow for patient stratification into subgroups – was that since lung microbiomes were sampled before patients undergoing their respective cancer treatments, “changes resulting from treatment could not be assessed.”

 

Fact check: Posts use 2012 photo of Magic Johnson to falsely claim he donated blood

 

No correlation of long-term mask-wearing with lung cancer

USA TODAY reviewed the study’s paper published online this month: Nowhere is long-term mask-wearing mentioned or even alluded to.

 

Segal and another author, Dr James Tsay of NYU’s Grossman School of Medicine, told Reuters their study did not involve long-term mask-wearing, and that, “currently there is no scientific evidence to this misinterpretation of our result.”

 

The study’s participants were individuals recruited from NYU’s Lung Cancer Biomarker Center between March 2013 and October 2018, before the pandemic. Tsay stated that “since mask-wearing was not common during our study period, it is highly unlikely it is one of the reasons that contribute to our findings.”

 

“The main source of these bacteria to the lung is the mouth and oropharynx (the part of the pharynx that is behind the mouth) itself,” said Segal, explaining these oral bacteria are in “pretty much every individual” and how much is present depends on oral hygiene and food intake.

 

In an email to USA TODAY, Schneider, the author of the BlackListed News article, acknowledged it was his personal view “this study suggests that prolonged mask-wearing may breed microbes which contribute to advanced-stage lung cancer.” Schneider did not say whether he verified his inference with the study’s authors but did add a clarification to the article on his website. This revision has not been made to the original BlackListed News article.

 

Fact check: Masks encouraged on federal lands if distancing isn’t possible

 

No evidence mask-wearing poses danger to health

Claims regarding whether face masks work against COVID-19, are detrimental to health (causing oxygen reduction or excessive blood carbon dioxide levels) or violate constitutional amendments have been debunked numerous times.

 

The claim in November alleging people were arriving in intensive care units sick with pneumonia from mask-wearing has also been debunked.

 

While bacteria and other microorganisms can collect on the inside of a mask, microbiologist Patrick Grant of Florida Atlantic University told CBS Florida affiliate CBS12 that whatever collects does not have the potential to harm unless it is allowed to build up; borrowing someone else’s mask is also ill-advised.

 

The CDC recommends storing cloth masks properly – either in plastic bags for damp masks, paper bags for dry or clean ones – and washing regularly, making sure to dry thoroughly. Disposable masks should be thrown away after one use.

 

Fact check: Post distorts WHO’s COVID-19 PCR testing guidelines

 

Our rating: False

The claim that long-term mask-wearing was found by one study to contribute to advanced-stage lung cancer is FALSE, based on our research. The study, headed by Dr Leopoldo Segal, director of NYU’s Lung Microbiome Program, found patients with advanced-stage lung cancer had greater amounts of oral bacteria in the lungs compared to early-stage patients. The presence of these bacteria was associated with decreased survival, poor prognosis and tumour progression. Nowhere is the impact of long-term mask-wearing or the relationship with lung cancer mentioned or alluded to. The writer of the article making the claim stated that the relationship was his personal view. There is no evidence to suggest masks, the only effective means to prevent COVID-19 transmission, instead cause disease.

 

Our fact-check sources:

Centres for Disease Control and Prevention, Feb. 10, “Maximizing Fit for Cloth and Medical Procedure Masks to Improve Performance and Reduce SARS-CoV-2 Transmission and Exposure, 2021”

 

Media Bias/Fact Check, accessed Feb. 16, “Blacklisted News”

 

Nature, Jan. 29, 2020, “The complex relationship between drugs and the microbiome”

 

The New York Times, Sept. 10, 2019, “Seeking an Obesity Cure, Researchers Turn to the Gut Microbiome”

 

Science Magazine, May 7, 2020, “Meet the ‘psychobiotic: the gut bacteria that may alter how you think, feel, and act”

 

Nature, Jan. 29, 2020, “Could a bacteria-stuffed pill cure autoimmune diseases?”

 

Nature, Jan. 29, 2020, “Fighting cancer with microbes”

 

The Journal of Immunology, June 15, 2016, “The Lung Microbiome, Immunity, and the Pathogenesis of Chronic Lung Disease”

 

The World Health Organization, Sept. 12, 2018, “Cancer”

 

American Association for Cancer Research, Nov. 11, 2020, “The Lung Microbiome May Affect Lung Cancer Pathogenesis and Prognosis”

 

American Journal of Respiratory and Critical Care Medicine, June 2, 2011, “Topographical continuity of bacterial populations in the healthy human respiratory tract”

 

Journal of Bacteriology, June 3, 2015, “Interaction between Streptococcus spp. and Veillonella tobetsu ensis in the Early Stages of Oral Biofilm Formation”

 

Journal of Microbiological Methods, Jan. 10, 2017, “Isolation and identification methods of Rothia species in oral cavities”

 

Cancer Discovery, Feb. 1, “Lower Airway Dysbiosis Affects Lung Cancer Progression”

 

Reuters, Feb. 4, “Fact check: No evidence linking masks to oral bacteria and to lung cancer; article refers to the study that did not involve masks”

 

USA TODAY, Jul. 27, 2020, “Fact check: What’s true and what’s false about face masks?”

 

CBS12, Nov. 20, 2020, “Bacteria is growing on your mask”

 

U.S. Centers for Disease Control and Prevention, Oct. 28, 2020, “How to Store and Wash Masks”

 

Thank you for supporting our journalism. You can subscribe to our print edition, ad-free app or electronic newspaper replica here.

 

Our fact check work is supported in part by a grant from Facebook.

 

This article originally appeared on USA TODAY: Fact check: Long-term face mask-wearing does not cause lung cancer

What is Thyroid Cancer

What is Thyroid Cancer?

Thyroid cancer is a disease in which the cells of cancer are found in thyroid glands. The thyroid glands are the lower part of the throat. This is a rare type of cancer. People in their 30s and those over the age of 60 may be infected by this disease. Women are 2 to 3 times more likely to develop it than men.

Types of Thyroid Cancer:

Generally, there are mainly four main types of thyroid cancer which are based on how the cancer cells look under a microscope. They are:

  • Papillary
  • Follicular 
  • Medullary
  • Anaplastic

Symptoms of Thyroid Cancer:

If you have the symptoms which are given below please talk to your doctor right away. The symptoms are:

  • Pain in the front of the neck and sometimes it travels upward to the ears.
  • A lump in the neck, sometimes growing quickly.
  • Swelling in the neck.
  • Hoarseness or other voice changes that do not go away.
  • A constant cough that does not contain due to cold
  • Trouble swallowing.
  • Trouble breathing.

Many of these symptoms can also be caused by non-cancerous conditions or even other cancer of the neck area. 

Remedy of Thyroid Cancer:

Different tests and procedures are used to diagnose thyroid cancer. Which is as follows:

  • Physical exam
  • Blood tests
  • Ultrasound imaging 
  • Removing a sample of thyroid tissue
  • Other imaging tests
  • Genetic testing

Most of thyroid cancer can be cured by treatment. Very small thyroid cancer that has a low risk of spreading in the body might not need treatment right away. If the risk risks of thyroid cancer grow then treatment should be initiated. Those are:

  • Surgery
  • Removing a portion of the thyroid (thyroid lobectomy)
  • Removing all or most of the thyroid (thyroidectomy)
  • Removing lymph nodes in the neck (lymph node dissection)
  • Thyroid hormone therapy
  • Radioactive iodine
  • External radiation therapy
  • Chemotherapy
  • Targeted drug therapy
  • Injecting alcohol into cancer
  • Supportive care

7 Rarest Cancers in the World

Type of 7 rarest cancer 

 

1. Head And Neck Cancer

Cancers are known as head and neck cancers usually begin in the squamous cells that line the mucosal surfaces inside the head and neck (e.g. mouth, nose and throat). Cancers of the head and neck can be categorised by the area where they begin, e.g. the oral cavity, pharynx, larynx, paranasal sinuses and nasal cavity and salivary glands. 

 

2. Sarcoma

Sarcoma arises in the connective tissue of the body, i.e. fat, blood vessels, nerves, bones, muscles, deep skin tissues and cartilage. This type of cancer is divided into either bone sarcomas or soft tissue sarcomas – all share certain microscopic characteristics and have similar symptoms. 

 

3. Thyroid Cancer

Thyroid cancer is a rare type of cancer that affects the thyroid gland, a small gland at the base of the neck that produces hormones. Symptoms include a painless lump or swelling in the front of the neck, swollen glands in the neck, unexplained hoarseness, a lingering sore throat and difficulty swallowing. 

 

4.Neuroendocrine Cancer

A neuroendocrine tumour begins in the hormone-producing cells of the body’s neuroendocrine system. Neuroendocrine cells are found in organs like the lungs and gastrointestinal tract, including the stomach and intestines. 

 

5. Brain Tumours

Cancerous brain tumours are high-grade tumours that either start in the brain (primary tumours) or spread into the brain from elsewhere (secondary tumours). Symptoms include severe, persistent headaches, seizures, persistent nausea, vomiting and drowsiness, mental or behavioural changes, vision or speech problems, progressive weakness or paralysis on one side of the body. 

 

6. Lymphoma

Lymphoma occurs when lymphocytes (white blood cells) get out of control. They divide abnormally or don’t die when they should. Abnormal lymphocytes can collect in your lymph nodes, often in your armpits, neck or groin, but they can collect in almost any part of your body. Symptoms will depend on where the lymphoma starts and what parts of your body are affected. 

 

7. Paediatric (Childhood) Cancer

The most common cancers in children include leukaemia, lymphoma and brain cancer. Things that cause cancer in adults (e.g. smoking or exposure to environmental toxins) are usually not the same as in children. In most cases, childhood cancers come from random mutations in the genes of growing cells, which means that there’s often no effective way to prevent them.

Eight Skin Cancer Myths You Need To Stop Believing Skin cancer is the most common type of cancer in the U.S.—with current estimates suggesting that one in five Americans develop skin cancer by the time they hit 70. But with so much contradictory information out there on the subject, skin cancer is often misunderstood and sometimes, not taken seriously enough. In order to help you better protect yourself against the potentially fatal disease, I spoke with a board-certified dermatologist to get the facts behind some of the biggest misconceptions about skin cancer: MYTH #1 I'm not at risk of developing skin cancer in the winter months or when it’s cloudy because the sun isn’t as strong. One of the most prevalent myths when it comes to sun protection is that you don't need to apply sunscreen or sunblock on cold or cloudy days. "The harmful UV rays emitted by the sun—that are largely responsible for all of the major types of skin cancer, including melanoma—are present year-round. Also, they can penetrate through clouds and even glass windows," tells Dr. Julie Karen, a board-certified dermatologist who specializes in Mohs micrographic surgery, laser surgery and skin cancer. Bottom line: No matter what the forecast is, don't skip sunscreen. MYTH #2 The damage is already done. I was careless in my youth, it's too late now to make any significant impact on my skin cancer risk. "While we used to estimate that the vast majority of a person's sun damage in a lifetime occurred during childhood, we now know that by age 22, only about 20% of your lifetime damage has been accrued," says Dr. Karen. "Each decade thereafter, you acquire an additional 10% of your lifetime damage. So, it's not too late to make a difference at any age. Introducing sun-smart behaviors, even after years of carelessness, will help to reduce additional UV damage from occurring and thus reduce your cumulative risk of developing all forms of skin cancer," she notes. MYTH #3 I used SPF 50 this morning, so I can safely sunbathe now. "Often patients will present to my office with tan lines or worse yet, sunburns and declare that they 'wore SPF 50.' So, I spend a ton of time educating them about what true 'sun smart behavior' is," says Dr. Karen. "First of all, there is no such thing as a safe tan. Your skin thickens and darkens (i.e. tans) to protect itself from further damage caused by UV exposure. So even though a tan is less harmful than a blistering sunburn, once you see a tan, the damage is done," tells the dermatologist. Secondly, "most people apply far less than 50% of the recommended amount of sunscreen required for adequate protection. So, the SPF on the label of your bottle is rarely achieved in daily practice," Dr. Karen points out. "You should apply at least one ounce (a shot glass full or golf ball-sized) of sunscreen from head to toe, twenty minutes before going into the sun. And reapply an equally generous amount every two hours or sooner after swimming or perspiring," she suggests. Though wearing sunscreen is a critical component of skin protection, it's by no means a license to lie in the sun. Rather, sunscreen should be used in conjunction with a hat, sunglasses and sun-protective clothing, adds the skin specialist. MYTH #4 I shouldn't wear sunscreen because sun exposure on my bare skin is essential to boost my Vitamin D levels. "Indeed, exposure of the skin to ultraviolet B (UVB) radiation is responsible for cutaneous production of vitamin D precursors," says Dr. Karen. However, it's important to note that the beneficial effects of exposure to UVB radiation cannot be separated from its harmful effects. "UV radiation from the sun is a known carcinogen that is responsible for DNA damage that results in skin cancer," tells the dermatologist. Besides, photodamage also contributes to other skin concerns such as wrinkles, dark spots and redness. This is why intentional UV exposure to increase Vitamin D levels is ill-advised, says the skincare expert. The safest way to prevent Vitamin D deficiency is to eat a balanced diet that includes whole foods rich in Vitamin D (such as fatty fish, egg yolks, mushrooms, spinach, etc.) and take a daily oral supplement, suggests Dr. Karen. MYTH #5 Dark-skinned people aren't at risk of developing skin cancer. "Although fair skin, light eyes, light hair, the tendency to freckle or burn are risk factors for developing melanoma (one of the most aggressive forms of skin cancer), no ethnicity is completely immune," says Dr. Karen. Therefore, people of all colors, including those who have black or brown skin, need to integrate safe-sun practices into their daily routine. MYTH #6 Tanning beds are safer than sunbathing. Tanning booths and beds expose you to ultraviolet rays that can cause serious DNA damage, increasing your risk of developing skin cancer. "The amount of UV radiation emitted by these indoor lamps exceeds ten times that emitted by the sun during peak hours," says Dr. Karen. According to the American Academy of Dermatology (AAD), just one indoor tanning session can increase the risk of developing melanoma by 20%, squamous cell carcinoma by 67% and basal cell carcinoma by 29%. MYTH #7 Makeup with sunscreen provides suitable protection against skin cancer. "No. A dedicated sunscreen should be applied before putting on makeup, even if there is SPF within a makeup product—this is because often it's not applied in adequate amounts to achieve the stated SPF on the product and therefore, won't offer sufficient protection," Dr. Karen explains. MYTH #8 If I want to get a mole checked out, I have to get surgery. Having a suspicious mole or skin lesion observed by a dermatologist can be a scary thought. "While the traditional method of melanoma diagnosis involves a scalpel, that’s not the only option available. Dermatologists can use genomic assays like DermTech, which uses a smart sticker to painlessly and noninvasively diagnose atypical moles at an earlier stage. This option obviates a biopsy for every mole and can even be administered at home, once prescribed by your dermatologist," notes Dr. Karen. "Research what your dermatologist can provide and know that you’re not solely bound to surgical cutting and consequent scarring in order to have peace of mind," adds the skin specialist. Besides slathering on sunscreen before stepping outdoors, it is also important to follow other critical measures including seeking the shade—especially when the sun is at its strongest (between 10 a.m. and 4 a.m.) and wearing sunglasses and sun-protective clothing—which, unlike sunscreen, don't lose their efficacy over the course of a day, says Dr. Karen. It's also important to examine your skin (and that of your partner/loved ones) for lesions that may be new or changing or appear to be distinct from all others. And lastly, get your skin examined by a dermatologist annually, suggests Dr. Karen. "When caught in the earliest stage, skin cancer is completely curable. If however, it is not caught early, it can be deadly," adds the skincare expert.

Eight Skin Cancer Myths You Need To Stop Believing

Eight Skin Cancer Myths You Need To Stop Believing

Skin cancer is the most common type of cancer in the U.S.—with current estimates suggesting that one in five Americans develop skin cancer by the time they hit 70. But with so much contradictory information out there on the subject, skin cancer is often misunderstood and sometimes, not taken seriously enough. 

 

To help you better protect yourself against the potentially fatal disease, I spoke with a board-certified dermatologist to get the facts behind some of the biggest misconceptions about skin cancer:

 

MYTH #1 I’m not at risk of developing skin cancer in the winter months or when it’s cloudy because the sun isn’t as strong.

 

One of the most prevalent myths when it comes to sun protection is that you don’t need to apply sunscreen or sunblock on cold or cloudy days. “The harmful UV rays emitted by the sun—that are largely responsible for all of the major types of skin cancer, including melanoma—are present year-round. Also, they can penetrate through clouds and even glass windows,” tells Dr Julie Karen, a board-certified dermatologist who specializes in Mohs micrographic surgery, laser surgery and skin cancer. Bottom line: No matter what the forecast is, don’t skip sunscreen.

 

MYTH #2 The damage is already done. I was careless in my youth, it’s too late now to make any significant impact on my skin cancer risk.

 

“While we used to estimate that the vast majority of a person’s sun damage in a lifetime occurred during childhood, we now know that by age 22, only about 20% of your lifetime damage has been accrued,” says Dr Karen. “Each decade thereafter, you acquire an additional 10% of your lifetime damage. So, it’s not too late to make a difference at any age. Introducing sun-smart behaviours, even after years of carelessness, will help to reduce additional UV damage from occurring and thus reduce your cumulative risk of developing all forms of skin cancer,” she notes.

 

MYTH #3 I used SPF 50 this morning, so I can safely sunbathe now.

 

“Often patients will present to my office with tan lines or worse yet, sunburns and declare that they ‘wore SPF 50.’ So, I spend a ton of time educating them about what true ‘sun smart behaviour’ is,” says Dr Karen. “First of all, there is no such thing as a safe tan. Your skin thickens and darkens (i.e. tans) to protect itself from further damage caused by UV exposure. So even though a tan is less harmful than a blistering sunburn, once you see a tan, the damage is done,” tells the dermatologist. Secondly, “most people apply far less than 50% of the recommended amount of sunscreen required for adequate protection. So, the SPF on the label of your bottle is rarely achieved in daily practice,” Dr Karen points out. “You should apply at least one ounce (a shot glass full or golf ball-sized) of sunscreen from head to toe, twenty minutes before going into the sun. And reapply an equally generous amount every two hours or sooner after swimming or perspiring,” she suggests. Though wearing sunscreen is a critical component of skin protection, it’s by no means a license to lie in the sun. Rather, sunscreen should be used in conjunction with a hat, sunglasses and sun-protective clothing, adds the skin specialist.  

 

MYTH #4 I shouldn’t wear sunscreen because sun exposure on my bare skin is essential to boost my Vitamin D levels.

 

“Indeed, exposure of the skin to ultraviolet B (UVB) radiation is responsible for cutaneous production of vitamin D precursors,” says Dr Karen. However, it’s important to note that the beneficial effects of exposure to UVB radiation cannot be separated from its harmful effects. “UV radiation from the sun is a known carcinogen that is responsible for DNA damage that results in skin cancer,” tells the dermatologist. Besides, photodamage also contributes to other skin concerns such as wrinkles, dark spots and redness. This is why intentional UV exposure to increase Vitamin D levels is ill-advised, says the skincare expert. The safest way to prevent Vitamin D deficiency is to eat a balanced diet that includes whole foods rich in Vitamin D (such as fatty fish, egg yolks, mushrooms, spinach, etc.) and takes a daily oral supplement, suggests Dr Karen. 

 

MYTH #5 Dark-skinned people aren’t at risk of developing skin cancer.

 

“Although fair skin, light eyes, light hair, the tendency to freckle or burn are risk factors for developing melanoma (one of the most aggressive forms of skin cancer), no ethnicity is completely immune,” says Dr Karen. Therefore, people of all colours, including those who have black or brown skin, need to integrate safe-sun practices into their daily routine. 

 

MYTH #6 Tanning beds are safer than sunbathing.

 

Tanning booths and beds expose you to ultraviolet rays that can cause serious DNA damage, increasing your risk of developing skin cancer. “The amount of UV radiation emitted by these indoor lamps exceeds ten times that emitted by the sun during peak hours,” says Dr Karen. According to the American Academy of Dermatology (AAD), just one indoor tanning session can increase the risk of developing melanoma by 20%, squamous cell carcinoma by 67% and basal cell carcinoma by 29%. 

 

MYTH #7 Makeup with sunscreen provides suitable protection against skin cancer.

 

“No. A dedicated sunscreen should be applied before putting on makeup, even if there is SPF within a makeup product—this is because often it’s not applied in adequate amounts to achieve the stated SPF on the product and therefore, won’t offer sufficient protection,” Dr Karen explains. 

 

MYTH #8 If I want to get a mole checked out, I have to get surgery.

 

 Having a suspicious mole or skin lesion observed by a dermatologist can be a scary thought. “While the traditional method of melanoma diagnosis involves a scalpel, that’s not the only option available. Dermatologists can use genomic assays like DermTech, which uses a smart sticker to painlessly and noninvasively diagnose atypical moles at an earlier stage. This option obviates a biopsy for every mole and can even be administered at home, once prescribed by your dermatologist,” notes Dr Karen. “Research what your dermatologist can provide and know that you’re not solely bound to surgical cutting and consequent scarring to have peace of mind,” adds the skin specialist. 

 

Besides slathering on sunscreen before stepping outdoors, it is also important to follow other critical measures including seeking the shade—especially when the sun is at its strongest (between 10 a.m. and 4 a.m.) and wearing sunglasses and sun-protective clothing—which, unlike sunscreen, don’t lose their efficacy for a day, says Dr Karen.

 

It’s also important to examine your skin (and that of your partner/loved ones) for lesions that may be new or changing or appear to be distinct from all others. And lastly, get your skin examined by a dermatologist annually, suggests Dr Karen. “When caught in the earliest stage, skin cancer is completely curable. If however, it is not caught early, it can be deadly,” adds the skincare expert.