TANNING BEDS. INDEX RESEARCH PARTNERS Tanning beds...1 Is my skin aging?...5. our MISSION. Breast Cancer. June 2013 Issue 31

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1 Breast Cancer FACTs, MYTHs, and CHOICEs INDEX RESEARCH PARTNERS Tanning beds...1 Is my skin aging?...5 COMMUNITY PARTNERS Coffee Talks...6 Crossword puzzle...7 UV rays and Skin...9 Butterfly pasta and kale recipe...10 Nutrient Density...11 SunGuard Man...12 Yoga Pose...13 Ribbon stained glass pattern...15 Just 4 fun...17 Contacts hosm@uc.edu askdrmeiho@gmail.com Breast cancer: Windows of Susceptibility. NIH grant 1U01ES tracie@pinkribbongirls.org PINK RIBBON GIRLS our MISSION TO PREVENT the occurrence of BCa through RESEARCH and EDUCATION TO ENCOURAGE and SUPPORT BCa survivors, friends and families. June 2013 Issue 31 TANNING BEDS When reading any editorial opinions or contemplating change in lifestyle, like moving toward healthful living, always consider that what we know today will be changed in due time. The surface has only been scratched and what we think is true today, won't be for very long. Case in point: The current view of UV, sunshine in general, vitamin D, optimal health, and benefits of outdoor living, is hugely different than it was even a few years ago. The readily available information on tans and tanning beds, risks of UV exposure changes frequently. Some reasonably up-to-date data follow: Ultraviolet Radiation (UV) UV (all forms) is electromagnetic radiation from stars, which is either visible to humans, or invisible, depending upon wavelength (measured in nm of the spectrum), Radiation from "our" star which reaches earth and is not absorbed by our atmosphere is vitally important for life and also deleterious. The longest wavelength UV (UVA) is not visible to humans; the former currently divided into two componenets, UVA1 and UVA2. There is also, UVC, far UV and vacuum UV. As long as the ozone layer is intact, only small amounts of UVC penetrate our atmosphere, and far UV and vaccum UV do not penetrate to earth at this time. UVA does penetrate our atmosphere and reaches skin, (and also the cornea of the eye), where it penetrates to the level of the dermis (Figure pg 9 ). penetrates the atmosphere, reaches the skin but penetrates to about the basal layer of cells in the epidermis. (Figure pg 9 ). UVA and play an important role in premature aging of the skin, and formation of cataracts in the eye, and three or more types of skin cancers. These facts are largely recognized, but less well understood is that UV can suppress the immune system. There are many immune cell types in the epidermis, especially near the basal layer where both UVA and can reach pass) and in demis where UVA passes. Lowering immune capability makes fighting off maladies more difficult. 1

2 UVA, and and Skin Cancer UV causes damage to cellular DNA (UVA causes DNA strand breaks; causes DNA dimer formation). Excessive UV radiation produces genetic mutations that can lead to skin cancer. The U.S. Department of Health and Human Services and the World Health Organization consider UV radiation to be carcinogenic to humans and the main cause of basal cell carcinoma and squamous cell carcinoma affecting more than a million Americans each year. UV, particularly artificial UV from a tanning bed, plays a key role in melanoma for more than 8,000 Americans each year. UVA About 95% of the UV which reaches earth and to which we are exposed to is UVA. UVA is less intense radiation (longer wavelength) but more abundant and more penetrating thus we are exposed to large amounts of UVA. UVA rays are present with relatively equal intensity during all daylight hours throughout the year, and can penetrate clouds and glass. UVA penetrates the skin deeper than and has been known since prehistory tolong been known to contribute to aging and wrinkling of skin (i.e. the protective middle-eastern clothing tells this story). Only recently have data surfaced that UVA also causes significant damage in areas of the epidermis, right along with. Basal and squamous cells are types of keratinocytes which after UV damage may initiate the development of skin cancers. UVA is also the dominant tanning ray, with the stimulation of melanocytes to make more protective melanin granules which gives skin its darker appearance. Tanning, whether outdoors with natural UVA or in a tanning salon, causes damage to acccumulative over time. Tanning is basically the skins acknowlegment that it has been injured, an attempt to prevent further DNA damage to the resident cells. During repair of DNA damage, errors may occur (mutations) which can lead to skin cancer. In addition to DNA damage, there is also damage to the elastin, collagen, and the dermal and epidermal immune cells. RESEARCH PARTNERS Basal cell carcinoma: An estimated 2.8 million cases of basal cell carcinoma (not usually a metastasizing cancer)(can be flatand shinny) every year. Squamous cell carcinoma: 700,000 new cases of squamous cell carcinoma each year, 2,500 deaths (these cancers are lumpy and crusty and elevated) Melanoma: Melanomas can be pink, purple, black, brown, blue and can be amelanotic as well and are responsible for 120,000 new cases each year and 8,700 deaths. Tanning booths primarily emit UVA using high-pressure sunlamps emitting times more UVA to your skin than the sun. (ed. google, "tanning without burning in a tanning bed" and you will find that indeed, skin types differ in their response to the tanning lamps, and even a short exposure to a tanning lamp can give some individuals a burn. The community responses to google posts exposes a low level of knowledge about UV radiation in general. Not surprisingly, people who use tanning salons are 2.5 times more likely to develop squamous cell carcinoma, and 1.5 times more likely to develop basal cell carcinoma. 2

3 RESEARCH PARTNERS Age at first exposure to tanning beds in youth increases melanoma risk by 75 percent. Risk of melanoma is double with 5 or more sunburns., causes reddening and sunburn damage the superficial layers of skin, and risk for skin cancer as well as tanning and premature aging of the skin. The atmosphere, tilt of the earth and time of day change the amount of that reaches us. is highest in the northern hemisphere: 10 AM and 4 PM; April to October; at high altitudes, and off reflective surfaces (water snow ice). 80 percent of the reflected rays hit the skin more than once. Glass is fairly protective for. Measures for UV protection Work and play in shaded outdoor sites, especially between 10 AM and 4 PM. Add window tinting your car's side and rear windows and to house and business. Dress to limit UV exposure: (A shirt with an UPF of 30, for example, means that just 1/30th of the sun's UV radiation can reach the skin). For instance, bright- or dark-colored, lustrous clothes reflect more UV radiation than light colors; and tightly woven, loose-fitting clothes provide more of a barrier between your skin and the sun. Wear broad-brimmed hats and UV-blocking sunglasses. Sun Protection Factor (SPF) and UV Radiation SPF indicates how long it will take for rays to redden skin when using a product vs to how long it would take for skin redden skin without the product. E.g. SPF 15 application allows one to stay 15 times longer in the sun without reddening than without the product SPF 15 sunscreen screens 93 percent of the sun's rays; SPF 30 screens 97 percent; SPF 50, screens 98 percent. Sunscreen Ingredients Adequate protection must reduce both UVA and, requiring broad UV protection and an SPF of 15 or higher. Because there is no scientific consensus on how much protection is necessary these terms may not be entirely meaningful. The USDA has approved 17 active ingredients for use in sunscreens. Sun screens are chemicals which absorb UV before it gets to epidermis or dermis; most sun blocks act to physically reflect UV rays. In all, they form a thin, protective film on the surface of the skin and absorb or reflect the UV radiation before it penetrates the skin. Most sunscreens contain chemical and physical agents. 3

4 FDA-Approved sunscreens Active ingredient 4-Aminobenzoic acid a (PABA) Avobenzone Cinoxate Dioxybenzone Ecamsule (Mexoryl SX) Ensulizole (PSA) Homosalate Merdimate (Menthyl anthranailate) Octocrylene Octinoxate Octisalate (octyl salicylate) Sulisbenzone Trolamine salicylate RESEARCH PARTNERS Absorbers and reflectors* UV nm-range blocked UVA1 UVA2 UVA2 UVA2 UVA2 Physical barriers TItanium dioxide, UVA2 Zinc oxide, UVA1, UVA2 wear a hat and sunglasses and dark clothes to protect your skin and eyes * There are possible reactions to all these chemicals, though overall hazards appear to be low Portions excerpted from The fashion industry propelled us into the unhealthy practice of wanting to be tan. In the 1920 s Coco Channel's models had tanned skin (a sign of affluence and leisure on the Riviera?) affirmed subsequently by Hollywood's (our US Riviera on the Pacific) affirmation in movies. Tanning is a protective response to a harmful environment. The pigment-producing melanocytes in the basal epidermis increase their production of melanin granules (pigment) darkening the skin. UVA,, and UVC all cause different repair reactions in skin. Both the sun's rays and artificial UV (tanning bed) cause this damage (darkening, loss of elasticity, wrinkling, freckling, burning, squamous cell and basal cell carcinomas, and melanomas) in skin. The amount of UV radiation from tanning beds (both UV-A and UV-B) can be 15 times stronger than from the sun. View your tan as a warning. Naturally occuring high melanin content in skin provides some natural protection from UV, as would have been beneficial in near equatorial zones. Damage to skin from UV is more apt to increase cancer risk and damage when exposure occurs in childhood. * The World Health Organization recommends that no person under the age of 18 should use a tanning bed. * The International Agency for Research on Cancer has concluded that there is a clear increase in melanoma risk associated with the use of tanning beds during the teens and twenties. 4

5 RESEARCH PARTNERS ANSWER QUESTION: How do I know whether my skin is aging? It is an easy test to conduct. Find an area of your skin which never "sees" the sun. Look at the texture and color, number of smallrough areas (which can be hyperkeratosis or small papillomas) and also the light and dark areas of pigmentation. Then compare with areas of the forehead or the backs of the hands, which "see" UV all day long. SOLUTION: If you don't mind using sunblock, which is seemingly the least toxic and does the best job of blocking all UV (broad spectrum), then this solution is probably best. Combine this with covering your body with lightweight cloths (dark colors absorb UV bettern than light colors (which do more reflecting) to gain more protection. Sunscreens (with the benz-compounds need to be researched carefully as some have ill-effects, while others are less apt to cause other consequences. In addition to absorbing and reflecting UV rays, these differ in their ability to avoid breakdown, some last longer than an hour, others need to be frequently re-applied. WIKIPEDIA: "Some sunscreens only protect against radiation, and not against the more dangerous UVA component of the spectrum. Incomplete protection against the full ultraviolet spectrum combined with spending a lot of time in the sun can lead to an increase in the risks of developing malignant melanoma, a rarer but more deadly form of skin cancer. Some sunscreen ingredients (such as oxybenzone, benzophenone, octocrylene, or octyl methoxycinnamate) may be potentially carcinogenic or have other health risks. Reduced exposure to ultraviolet light in sunlight can contribute to Vitamin D deficiency. 5

6 RESEARCH PARTNERS These issues have precipitated various levels of disagreement within the academic community over the benefits and risks of sunscreen use and sun exposure". SOLUTION...(cont) On the whole, suncscreen use is deemed beneficial but some products are better than others at lessening all types of UV expusre, and others may be less apt to cause allergic responses or leave harmful chemical residues and breakdown products (ed) some refs below.. COMMUNITY PARTNERS Coffee Talk Pink Ribbon Girls Coffee Talk for June. Meet up with other Pink Ribbon Girls for coffee and conversation at Aroma's Java & Gelato on Saturday, June 22 at 10am. Don't be shy... we want to meet you! Location: 6407 Bridgetown Road; Cincinnati, OH Saturday, 22 June :00 AM - 12:00 PM And a quote from the toxnet data network... Sunscreens should not be used as a substitute for clothing (ROFLOL) tion/uva-and-uvb/understanding-uva-and-uvb 6

7 Across Down RESEARCH PARTNERS CROSSWORD PUZZLES for better health Tanning beds increase risk for three types of skin cancer, and photoaging of the skin, damage collagen and elastin, cause DNA dimers and mutations, and depress the immune system. Young people are at increased risk for this damage. Crossword puzzles for better health 1. The skin carcinoma least apt to metastasize is the cell carcinoma 2. There are major complications from UV exposure to the eyes called - 3. Tanning in tanning beds can suppress the system 4. The skin carcinoma that kills 2500 people per year cell 5. Most convenient way to avoid exposure to eyes is to wear 1. Failing to cover eyes in a tanning bed can cause - 2. Three types of this disease may result from UV exposure 3. Most convenient way to avoid exposure to body is to wear 4. Most convenient way to avoid exposure to face is to wear a 5. The most dangerous form of skin cancer,, is increased by UVA exposure 6. There are high pressure tanning beds that generate primarily UVA with some by using highly specialized quartz lamps and 7. British name for our tanning beds is 8. What gives 10 to 15 times more UV radiation than the sun? percent of the radiation from a tanning bed is 10. An acronym for remembering which UV spectrum causes skin aging is 11. An acronym for remembering which UV burns the skin is 12. Acronym for an international health organization that does NOT recommend the use of tanning beds for cosmetic reasons 7

8 RESEARCH PARTNERS Answers to this the crossword puzzle on sunscreens and UV damage. Links to more puzzles 8

9 290-40nm UVC Far UV Vacuum UV nm UVA nm UVA nm b lo cked b y atmosphere keratin SKIN epidermis: basal cells melanocytes and immune cells dermis: collagen, elastin, and immune cells absorbed by atmosphere Vacuum UV Far UV UVC UVA1, nm Cataracts Skin damage Skin cancer Sun burn Immunosuppressive DNA strand breaks DNA dimers UV weather hazard index scale Effects of UV radiation can be worsened chemical agents including birth control pills, tetracycline, sulphathizole, cyclamates, antidepressants, coal tar distillates found in antidandruff shampoos, lime oil, and some cosmetics. Protection from UV is provided by clothing, polycarbonate, glass, acrylics, and plastic diffusers used in office lighting. Sun-blocking lotions offer limited protection against UV exposure. The amount of UV light reaching the ground in any given place depends on a number of factors, including the time of day, time of year, elevation, and cloud cover. An online weather channel can give you the UV index each day. UV radiation can breakdown some fluoro and chlorocarbons in the air, if present, to toxic chemicals. 9

10 Butterfly Pasta with Kale By: Laurie David and Kirstin Uhrenholdt The Family Dinner: Great Ways to Connect with Your Kids, One Meal at a Time You need: 2 large bunches of kale 1 pound farfalle pasta 3 tablespoons olive oil 6 cloves garlic, slivered 1 1/2 cups sun-dried tomatotes from a jar, drained, rinsed and coarsely chopped 1/2 cup pine nuts, toasted Salt and pepper or red pepper flakes Freshly graed Parmesan cheese To make six servings: Fill a large pot with water. Bring it to a boil, then salt it so it tastes like the sea. Remove the stems from the kale. Stack all the kale leaves on the top of one another, roll them into a fat cigar, and slice it into thin slices. Or just chop, chop, chop it all - that works, too. Throw the kale into the pot for 4 minutes, then remove with a slotted spoon or tongs and drain well. Put the pasta into the same pot of water and cook according to the package directions. While the pasta is boiling, drizzle a large pan with olive oil, heated over medium flame until shimmering, add the garlic, and gently saute'it until golden and fragrant. Toss in the kale and the sun-dried tomatoes, cooking until the kale is tender and the sun-dried tomatoes are soft and bright. When the pasta is done, drain it, reserving a few teaspoons of the cooking water. In a large bowl, combine the pasta with the kale and the remaining ingredients. If you want to moisten a bit, you can use the reserved cooking water. Serve with a lovely mixed green salad. 10

11 1: 28 nu t i r ents highly anti-inflammatory great anti-cancer food 2% dietary fiber vit A, C, E, K, B1, B2, B3. B6, B9 choline, low glycemic. low fat lutein, zeaxanthin calcium, magnesium, manganese, potassium, zinc nutrient dense d f c l oar i S so low in calories 1: 306 nu t i r ents 25% fat, Vit A,B1, B2, B5, B12, choline 25% RDI of fat, 34% RDI of saturated fat, 5% RDI cholesterol c a l or S i 100 grams:@73 calories Kale, low glycemic index, significant amounts of many vitamins and minerals, highly anti-inflammatory, easy to prepare, great phytochemicals, extremely low in calories. Nachos, are a popular food based on nixtamalized corn, of Mexican origin associated with Tex-Mex cuisine (wikipedia), the amount of fat in this food makes it high in calories relative to the amount of nutrients. 100 calories 11

12 SunGuardMan Site for games and education focus is on protection from UV K PA GE I D S simple online games for kids (probably ages 3-8) education about UV rays and sun protection in a gaming format. 12

13 REDUCE CANCER RISK GAIN STRENGTH RELEASE STRESS YOGA AT YOUR DESK Basic alignment is important in yoga poses as it will maximise the benefits of the pose. It will increase the strength & flexibility without causing any pain, discomfort or injury. Every pose has an optimal alighment Reduce stress Calm your mind Feel better Relax and stretch Inspired by Kali Ray s TriYoga, the art and science of Yogaflow PRACTICE #1 YOGIG BREATHING PRACTICE #2: NATURAL ALIGNMENT PRACTICE #3: HEALTHY SPINE Side stretch, seated or standing Clasp hands and lift arms overhead Pull tummy in, stretch side to side Spinal twist (seated Sit tall. Bring left hand to right outer thigh and twist. Repeat on other side. Seated cat roll PRACTICE #3: HEALTHY SPINE Inhale, hands on thighs, genetly arch back and look up Exhale, round back tuck chin to chest 13

14 REDUCING CANCER RISK GAINING STRENGTH RELEASING STRESS verification Yoga Associated With Gene Expression In Immune Cells, Study Finds (excerpted from )The Huffington Post By Carolyn Gregoire Posted: 04/24/ :41 pm EDT Updated: 04/30/2013 5:56 pm EDT Studies show yoga is beneficial for physical and mental health in new research (University of Oslo) Yoga practices impact gene expression, particularly in immune function almost immediately.. Yoga previously was linked to lower stress levels, back pain, depression, lower risk factors for heart disease, and greater bone health. The mechanisms are still being researched. In the journal PLoS ONE, evidence of yoga's impact on the immune system of 10 participants who engaged in a one week yoga retreat, showed a beneficial change in 111 immune - related genes in blood just before and a few hours after the sessions. As a control, music and walking exercises changed 38 genes. The surprising results are the immediacy of the effect and this points out the benefit of long term yoga practices. Other research has shown that regular participation in a type of chanting yogic meditation daily for eight weeks lowered stress levels by reducing biological mechanisms responsible for increasing the immune system's inflammatory response. Windows of Susceptibility Facebook You Tube

15 thanks to for this stained glass pattern see pattern to enlarge at any quick print shop on the next page. Thank you to Barbara Hudson, breast cancer survivor, who sent a photo of her stained glass panel made from one of our patterns (here). It is awesome and she is making several others for a charity fundraiser. 15

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17 UVA ageing, cancer burns, cancer UVC hopefully stopped by ozone, cancer D vitamin deficiency without UV Exposure to UV for 10 min makes vit D in light skin Five times longer exposure is required in dark skin to make vit D Generation of reactive oxygen species occurs with sunscreen High childhood exposure to UV does increase skin cancer risk Degredation of sunscreens releases DNA damaging agents Deficiency in vit D can increase cancer risk High childhood exposure to UV does increase skin cancer risk I lotion for suntanning maximizes UV (avoid this) Malignant melanoma increased in sunscreen users in one study N Oxygen (singlet) is produced by UV with some sunscreens Penetration of the deeper skin occurs with many suncreens Q (free) Radicals are generated as sunscreens absorb UV Sunscreen chemicals are degraded by UV Titanium micronized nanoparticle risk has not been studied Usually skin cancer deaths are from malignant melanoma Vit D production is 95% inhibited by sunscreens What-next X Y Zinc oxide micronized nanoparticle risk is unknown thanks wikipedia "miscellaneous but interesting quotes" 17