Category Archives: The Mole

New Anti-Inflammatory Drugs Will End Anti-TNF Dominance

Tumor necrosis factor inhibitor drugs began to dominate treatment of inflammatory diseases like rheumatoid arthritis, psoriasis, and the inflammatory bowel diseases ulcerative colitis and Crohn’s disease a little over a decade again. Now, the time when the importance of the anti-TNFs will wane and newer drugs will take their place is clearly visible on the horizon. It hasn’t happened yet, but the era of anti-TNF dominance for treating inflammatory diseases that persisted throughout the 2000s will end in the next 5 years.

The anti-TNF era began in 1998 with the approval of etanercept (Enbrel) for rheumatoid arthritis and infliximab (Remicade) to treat Crohn’s disease. In subsequent years, the list of approved anti-TNFs expanded to include adalimumab (Humira), golimumab (Simponi), and certolizumab (Cimzia), and the approved indications grew to include many inflammatory disease of joints, the GI tract, and skin. The anti-TNFs revolutionized inflammatory disease treatment and made treatment to remission possible for many patients.

tumor necrosis factor (green, purple, black) and TNF receptors (blue)/courtesy Bassil Dahiyat; Science

But reports from just the past month show that new agents are overtaking the anti-TNFs.

In May, I reported from Digestive Disease Week on phase III trial results with vedolizumab, which was compared against placebo for patients with ulcerative colitis. One of the study investigators noted that vedolizumab beat the placebo arm for steroid-free clinical remission by 30 percentage points. “Nothing else is that good,” Dr. William Sandborn, professor of medicine and chief of gastroenterology at the University of California, San Diego, told me, and the benchmark he had in mind was the performance of the anti-TNFs in similar patients.

More recently, at the European Congress of Rheumatology earlier this month I heard a report on a head-to-head comparison of the anti-IL-6 drug tocilizumab (Actemra) and the anti-TNF adalimumab in patients with rheumatoid arthritis. After 24 weeks of monotherapy, patients on tocilizumab had nearly a fourfold higher remission rate than patients on adalimumab. Though the monotherapy trial design did not mimic the way most rheumatoid arthritis patients get treated, the new drug tocilizumab absolutely blew adalimumab out of the water in a rare head-to-head comparison among different classes of anti-inflammatory drugs.

And at the same meeting several talks highlighted another new anti-inflammatory class of agents coming soon to the U.S. market, the Janus kinase (JAK) inhibitors, such as tofacitinib, which is expected to received FDA approval later this summer. Phase III results show that tofacitinib has safety and efficacy that seems at least comparable to anti-TNF drugs, with the advantage of oral dosing.

Vedolizumab, tocilizumab, and tofacitinib are just the tip of new waves of anti-inflammatory drugs that will soon substantially alter a landscape that the anti-TNFs have mostly had to themselves for the past 14 years. For the moment, the anti-TNFs have the advantage of a longer track record for safety, but changing that is only a matter of time.

—Mitchel Zoler (on Twitter “mitchelzoler)

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Update on the Earth’s Natural Sunscreen

It’s a good news/bad news story.

Most ozone is found in a layer that starts 6 -10 miles above earth and ends at about 30 miles up. (Photos by D. McNamara)

First, the good news: The ozone layer is recovering. The once-ominous news about depletion of the protective ozone surrounding the earth is now much sunnier, Drusilla Hufford of the U.S. Environmental Protection Agency said.

“It is likely we will have an ozone layer that recovers to what it was before human intervention by 2050 or 2065,” Ms. Hufford said at the Florida Society of Dermatology & Dermatologic Surgery (FSDDS) annual meeting.

The bad news is that is still at least 38 years away. “This is ultimately a self-righting system, but it will not happen

Drusilla Hufford

immediately,” said Ms. Hufford, director of the EPA’s Stratospheric Protection Division. Chlorofluorocarbons (CFCs) and other ozone-depleting substances last a long time. So even though levels are decreasing, we are still at risk of increased UV exposure in the meantime.

In fact, 2011 featured one of the largest holes in the ozone layer in the Southern hemisphere. NASA compiled a great video of daily satellite images from July to December 2011 that shows the ozone hole forming and dissipating as part of its normal seasonal fluctuation.

Despite the 2011 event, Ms. Hufford remains optimistic. “Global ozone was likely to get a lot worse in absence of the Montreal Protocol, and it has not.”

The EPA is going beyond the science to help physicians and others deliver effective sun protection messages. For example, if you are looking for a new angle on your sun protection message, consider pointing your patients to the EPA SunWise site. They can find a daily UV index forecast by city or zip code. Want help convincing patients to move outdoor activities earlier or later in the day to avoid peak sun exposure? The EPA service, provided in conjunction with the National Weather Service, also breaks down UV levels by hour of the day.

Courtesy Drusilla Hufford/EPA

If you have a patient who likes technology, they can get even more precise information. Have them scan this QR code from the SunWise program with their smartphone. It provides real-time UV exposure data for their precise location using the phone’s GPS technology.

The question remains: How bad would the future have been if we’d done nothing? NASA scientist Paul Newman and colleagues at NASA’s Goddard Space Flight Center developed ‘The World We Avoided’ simulation to answer that question. It shows what earth could have been like if 193 countries had not signed the Montreal Protocol and agreed to curtail production of ozone depleting chemicals starting about 25 years ago

Here is an excerpt: “The year is 2065. Nearly two-thirds of Earth’s ozone is gone — not just over the poles, but everywhere. The infamous ozone hole over Antarctica, first discovered in the 1980s, is a year-round fixture, with a twin over the North Pole. The ultraviolet (UV) radiation falling on mid-latitude cities like Washington, D.C., is strong enough to cause sunburn in just 5 minutes. DNA-mutating UV radiation is up 650%, with likely harmful effects on plants, animals, and human skin cancer rates.”

Ms. Hufford added, “Not only has the Montreal Protocol been enormously successful worldwide in preventing massive destructive of ozone layer, it is also likely helping with climate change.”

–Damian McNamara

@MedReporter on twitter

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‘Skinvestigator’ Author Describes His Dermatology Detective Series

A 22-year-old model with a distinct tattoo is murdered in Miami Beach. A dermatologist learns of the mysterious case while taking a skin cancer biopsy from a friend, a red-headed, fair-skinned policeman. “Doc, you know a lot about tattoos, don’t you?”

So starts “The Skinvestigator: Tramp Stamp,” the first in the Sunshine State Trilogy series of hard-boiled detective fiction written by Florida dermatologist Dr. Terry Cronin, Jr.

“It takes a lot of the knowledge I have about tattoos and feeds it into the mystery,” Dr. Cronin said in an interview. “But it also talks a lot about ‘scalpel tourism,’ where people go to foreign nations to get plastic surgery and cosmetic surgery at cut-rate prices, and a lot of times they get mutilated. That plays a big part in the murder mystery.”

Dr. Terry Cronin, Jr. (photo by D. McNamara)

Miami dermatologist Dr. Harry Poe delivers some important messages in the book as well. “He’s out there trying to promote prevention of skin cancer.” Like most dermatologists, he faces the challenge of warning people about the dangers of sun exposure in a culture that values tanning and looks above safety. When Dr. Poe goes to the beach, for example, everyone is lying out in the sun while he’s wearing long sleeves, a hat, sunglasses, and sunscreen. “And people make fun of him,” Dr. Cronin said.

A dermatologist as detective makes sense – because they use the same type of skills to diagnose skin conditions in their patients every day, explained Dr. Cronin, who is in private practice in Melbourne, Florida.

“I’ve always had a creative flair. I was involved in film making ‑ short films, going to independent film festivals. I ended up writing for comic books. Then I got the idea that I really wanted to tell a story that was pro-dermatologists.” Although Dr. Cronin had always kept his professional and creative sides separate, that was about to change.

The first book in the Sunshine State Trilogy (photo by D. McNamara)

“I wanted to tell a story in which the dermatologist was the hero. I love mysteries, like the Travis McGee series from John D. MacDonald and books byEd McBain and Ken Bruen. I thought ‘maybe I can make this hard-boiled dermatologist detective story, in which the dermatologist is pulled into an investigation. By using his expertise in diseases of the skin, he is able to help police solve a murder.”

Even though Dr. Cronin went through a “big process” of writing draft after draft, honing the story through multiple editors (including Michael Garrett, an editor for Stephen King), and encountering some challenges along the way, he encourages other physicians to pursue their outside passions as well.

“If a physician wants to be a writer, they should let their creative juices flow and do it. Don’t take ‘no’ for an answer,” Dr. Cronin said. “All doctors are pretty smart people, pretty motivated people, who have lots of talents. Some have those talents, but they tamp them down because of their professional needs. I think you have to have an outlet.”

Dr. Cronin initially self-published and sold copies of “Tramp Stamp” at Comic-Con and through Amazon.com. Then a friend at Barnes & Noble encouraged him to sell the bookstore management on ‘The Skinvestigator” series. They liked it and helped him find a publisher. (The store does not inventory self-published titles.) “Now it’s on the shelf in Barnes & Noble. That’s a thrill.”

Dermatologist colleagues have been very supportive, Dr. Cronin said. “That’s the thing I like the most. A lot of dermatologists have been reading it and giving me feedback that is good. I appreciate that.”

“The lay person will enjoy the book, but a dermatologist will get a kick out of it.  They know the language and they will laugh because so much of it is authentic.”

The second book in the series “The Skinvestigator: Rash Guard” is about surfers, syphilis, and the state department. The third installment, yet to be published, will be called “The Skinvestigator: Sun Burn.”

–Damian McNamara @MedReporter on twitter

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A Few Pills a Day to Keep Wrinkles Away?

Unilever, the international conglomerate that makes Dove soap, Axe body spray, Lipton tea and Ben & Jerry’s ice cream, is poised to bring the world a nutraceutical that it says can activate genes that will essentially repair the damage that leads to wrinkles.

Courtesy Wikimedia Commons user Bastet78/Creative Commons

According to an extensive article in the NewScientist, the nutraceutical will be launched in October in 44 spas that Unilever co-owns in the United Kingdom, Spain, and Canada.  Unilever is not seeking regulatory approval because the capsules contain ingredients already in use, and the company will not make any health claims, according to the article.

If Unilever is hoping to ever introduce the pill in the United States — which we can safely assume it will — it will likely take the same approach. Dietary supplements don’t require formal approval from the Food and Drug Administration, unless they claim to treat or cure a condition. (For more on how FDA regulates functional foods and supplements, see its web page here.)

The vast majority of supplements push as close to the legal requirements as they can, and some skirt past them, in the hopes that the FDA won’t notice. But the agency has been noticing more often and cracking down on products that make health claims.

The Unilever pill apparently has some scientific evidence to support its mechanism of action.

Again, according to the NewScientist, it will contain soy isoflavones, vitamin E, vitamin C, lycopene, and omega-3 polyunsaturated fatty acids extracted from fish oil. The omega-3s reportedly activate a PPAR gene (peroxisome proliferator-activated receptor). PPARs are involved in cellular differentiation, development, metabolism, and tumorigenesis.

The company could spend the money and time to seek formal FDA approval for wrinkle improvement — following in the footsteps of say, a Quaker Oats getting a cholesterol-lowering claim for its oatmeal. Competitors have basically ridden on Quaker’s coattails — if one oatmeal lowers cholesterol, they probably all do.

But I can’t see Allergan (which makes Botox) or Medicis (which makes Restylane) sitting idly by while Unilever mass markets an over-the-counter dietary supplement with a claim to erase wrinkles. A pill could be seen as an attractive alternative to the currently available injections, fillers, and surgical options.

And everyone’s always looking for the next best anti-aging product.

The NewScientist story caused an eruption in the blogosphere, with citations appearing everywhere from the beauty site Jezebel to the Yahoo health and beauty page, Shine. A quick Google search shows that it even ran on the Ecuador Times, which bills itself as a bilingual site for all things Ecuadorian.

The world is waiting, Unilever.

—Alicia Ault (on Twitter @aliciaault)

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Is Your Phone Smart Enough to Cure Acne?

The Federal Trade Commission (FTC) says no, definitely not.  On Sept. 8, the agency announced that it had reached settlements with two companies that were claiming that their apps could cure acne. It is the first time the FTC has pursued any company making a health claim for an app.

“AcneApp” and “Acne Pwner” both claimed to be able to treat acne with colored lights that come out of the phone when the app is activated. Purchasers were told to hold the screen next to the affected area of skin for few minutes daily.

The agency was having none of it. “Smartphones make our lives easier in countless ways, but unfortunately when it comes to curing acne, there’s no app for that,” said FTC Chairman Jon Leibowitz, in a statement.

Acne Clear app. Photo by Alicia Ault

According to the FTC, there were 3,300 downloads of AcnePwner, for sale in the Android Marketplace for 99 cents. AcneApp was downloaded 11,600 times from the iTunes store at a cost of $1.99 each. 

The AcneApp makers claimed that the app was developed by a dermatologist and that its technology was backed up by a study in the British Journal of Dermatology. Nope, not true, said the FTC.

The settlements bar the app makers from making acne-treatment claims and they were ordered to pay nominal fines. Koby Brown and Gregory W. Pearson, doing business as DermApps, have to pay $14,294, and Andrew N. Finkle, doing business as Acne Pwner, was ordered to pay $1,700.

The trade journal mobihealthnews reported that both apps had been removed from retail earlier this year or late last year.  Mobihealthnews also noted that the New York Times gave the AcneApp some press in late 2009. Gregory Pearson is identified in that story as a Houston-area dermatologist.

Apps that claim to offer curative powers were the subject of a two-day workshop that the Food and Drug Administration just wrapped up.  The agency has been mulling over how and when to regulate mobile apps.  It looks like the FTC may have beaten it to the punch.

But there are likely to be plenty more apps to scrutinize in the future.

A quick check of the Android marketplace today from my smartphone found, “Acne Clear,” from United Holdings Group, being sold at 99 cents.  It supposedly “uses a specific sound frequency and a blue color wavelength from the Lapis Lazuli gemstone to help clear and detox the skin.”  United also markets a “Skin Cleanser” app that supposedly uses a sound frequency and “a yellow color wavelength from the Imperial Topaz gemstone to help clean the skin of dark spots, sun spots, and acne scars.”  It’s 99 cents.

There’s also “SkinApp” from M&R Selected, which is free. and advises that it allows you to do “color light therapy on the go.” It is listed as having 10,000 to 50,000 downloads. The reviews are full of testimonials that it works, but also that it is just plain “bad.”

What kind of review would you give these apps? Should patients download them, or are they better off keeping their 99 cents?

— Alicia Ault (on Twitter @aliciaault)

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Breakfast in Bed, Anyone?

What do beds and pancakes have in common?

Nothin' says lovin' like dust mites from from the... frying pan? Photo by Flickr Creative Commons user Kalavinka

A: Romantic interlude

B: Snuggly Sunday treat

C: Wonderfully considerate partner

D: Potentially lethal mites

Answer:  All of the above

If you’re lucky in love, you get some romance along with your hot pancakes, propped up on your comfy mattress and fluffy pillows.

If you’re not so lucky, you suck in a lungful of Dermatophagoides pteronyssinus from your comforter and slug down a syrup-coated helping of its wheat-loving cousin, Dermatophagoides farina. And if your immune system is easily triggered, this relaxed repast can turn into a choking, wheezing trip to the hospital.

The tiny (300 micron), translucent house dust mite frequently haunts human beds, thoughtfully cleaning up mold, fungi, bacteria, pollen, your dead skin cells, and maybe that other white sock you lost a couple months ago.

Dermatophagoides pteronyssinus - a species of house dust mite. Photo by Flickr Creative Commons user Giles San Martin

Because of their tiny size and adaptive nature, these guys traveled with us from our damp, dark caveman homes to our modern hang outs and creature comforts:  beds, blankets, sofas, rugs, and cuddly stuffed animals.

For most of us, house dust mites cause no problem. They’re so tiny we can’t see them. They don’t sting or bite. And even if 100 were creeping up your leg – which they will probably do tonight – you would never know.

But unfortunately, they can seriously bug people with atopy. It’s not the mite per se, but its numerous droppings that cause issues among the allergic.  Inside those tiny poo balls are bits of undigested food and the digestive enzymes meant to break them down. All it takes is a breath of air – or a dip in pancake batter – for the “stuff” to melt away,  activating these enzymes.

Inhalation reactions start when the molecules come into contact with lung epithelium. Scavenger cells get the inflammatory process up and running, aggravating asthma and other allergic reactions, like atopic dermatitis, allergic rhinitis, conjunctivitis, and otitis media.

Pancake syndrome is a variation of the inhalation reaction. Whenever cooks use mite-infested flour, there is potential for danger. The medical literature contains case reports and series of both children and adults who experienced an anaphylactic reaction after eating mite-infested wheat-flour based foods. The reactions varied from mild to lethal.

In all cases, the flour used was replete with dust mites of several species – and full of the cell-destroying Der enzyme, cysteine protease. Among its many talents: direct damage to airway epithelium; destruction of the body’s epithelial tissue damage defense system; disruption of intercellular junctions; and of course, stimulating those pesky proinflammatory mediators.

Infested flour is more likely to be found in temperate, humid areas, and in poorly stored wheat flour or flour-based mixes – or products that have been opened for a long period and never used. In 2009, the World Allergy Organization published a dust mite oral anaphylaxis paper, suggesting that all grain flours be stored in airtight containers in the refrigerator or freezer.

So the next time a half-empty box of pancake mix gets you in the mood for some snuggly breakfast in bed – try switching to eggs. – Michele G. Sullivan

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Melanoma Heads Down the Genetic Pathway

The molecular profilization of melanoma is nigh. Assessment of advanced-stage, metastatic melanoma to determine whether it carries a mutation in the BRAF oncogene will turn routine soon, once physicians have the option to treat these patients with the new BRAF inhibitor drug, vemurafenib.

That might happen any day now. Reuters said on August 9  that the FDA’s approval of vemurafenib could get announced soon. Roche/Genentech submitted their NDA for vemurafenib to the FDA in May, and in June came impressive efficacy results in a phase III study that got reported at both ASCO and in a New England Journal of Medicine article.

malignant melanoma; courtesy Nephron/Wikimedia Commons

Last week, I covered the American Academy of Dermatology’s summer meeting in New York, and melanoma specialist Dr. Richard D. Carvajal from Memorial Sloan-Kettering, New York, told me that once vemurafenib was on the market, genetic analysis of advanced melanomas to find BRAF mutations would suddenly become standard of care. Once testing for one mutation starts, several more genes can easily piggyback onto the assay, which will help to further flesh out the range of genetic mutations that can exist in metastatic melanoma and provide potential targets for new drugs.

It’s becoming a well-trodden path that’s rapidly driving the treatment of advanced cancers of all kinds into the molecular-profiling era. Just a couple of weeks ago, I blogged here on how it had already transformed advanced lung cancer management. Breast cancer and colorectal cancer have an even longer history of genetic assessment, and more cancers will likely follow this route soon.

When I wrote my blog post about lung cancer in late July, I focused on the challenge to successfully treating late-stage cancer, and I said that better alternatives were lung cancer prevention, by not smoking, and earlier diagnosis, with CT screening.

Melanoma does not pose the same screening issues as lung cancer. It’s much easier to survey the skin than to peer into a person’s lungs. And the idea of melanoma prevention by sunlight avoidance and protection has transformed the way many Americans approach outdoor activity. Over the last generation or so, SPF has become a cultural touchstone.

Despite that,  cases of advanced melanoma are inevitable. Last week at the AAD meeting, Dr. Darrell S. Rigel from New York University showed evidence of a troubling, new wrinkle in melanoma epidemiology: an appreciable blip in cases that first appeared about 10 years ago in American women aged  30-34 years, a shift that Dr. Rigel attributed to an increased use of tanning salons among teenage girls that started in the 1980s.

Even if advanced-stage tumors, melanoma, or lung cancers are unstable and unlikely to respond to even the best targeted of drugs for more than a few years, those extra years of cancer control with good quality of life can make a big difference to each patient who responds to a genetically targeted treatment, Dr. Carvajal told me.

—Mitchel Zoler (on Twitter @mitchelzoler)

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The Little Ant With the Big Bite

Just speaking with Dr. Ronald Rapini during the summer meeting of the American Academy of Dermatology  is enough to make you itch. That’s how good he is at describing the vicious attack of the fire ant – as it bites and stings its way northward from its Southern roots.

A native of South America, this aggressive invader established the first Fire Ant Town around Mobile, Ala., in the early 1900s. Rumor has it that the little buggers were stowaways on steamers. Apparently they found American soil so friable (and American flesh so tender) that they have engaged in a relentless northern march, traveling first throughout the southeast and now up both the Eastern and Western seaboards.

Fire Ant

Fire ants belong to the same species as wasps and bees. (Photo courtesy Agricultural Research Service, USDA)

Fire ants sport a chillingly descriptive Greek name – Solenopsis invecta, “Unvanquished Channel-Faced.” I leave it to you to decide if the imported red fire ant is “channel-faced,”  but I defy you to deny that it is unvanquished.

These are a species of the Hymenoptera, the insect order that includes wasps and bees, and they share some basic characteristics. Unlike their cousins, fire ants are only winged during the spring, when the await Eros’ call to fly from their nests in a mating frenzy – after which their diaphanous wings drop away and they build ever-more-complicated colonies that can spread throughout entire fields.

They also adhere to their order’s inclination to live in large, hierarchical societies arranged around a queen, with armies of workers bent on aggressive nest defense — much to the dismay of bumbling human feet.

If you invade their space, the ants swarm out with a
double-ended defense, Dr. Rapini, chair of dermatology at the University of Texas Medical School, Houston, said in a video interview.

“Unlike most ants, which just bite you, these guys bite with their huge jaws and then pivot around and sting you,” with a venom filled dagger.

The resulting wounds are painful, itchy, and full of pus.  Although familiar to Southern physicians, who have seen the problem for years, Northerners are just coming to grips with these tiny purveyors of pustular pain.

“Sometimes doctors will even get a biopsy on this because they’ve never seen it before,” Dr. Rapini said.

Because a fire ant bite/sting feels pretty much like someone burning you with a lit cigarette, most  humans are cognizant enough to run hysterically away from a fire ant encounter, doing the “fire ant dance” to shake the critters off their legs and shoes and out of their trousers. But like drinking and driving, drinking and fire ant hills are not a good mix, Dr. Rapini said.

An inebriated man fell asleep on a fire ant hill with dire consequences. (Photo courtesy of Dr. Ronald Rapini)

“My worst case was a guy who got drunk and passed out on a fire ant hill and came in with hundreds of stings,” he said. The patient wound up in the hospital, desperately ill with a bacterial superinfection; treating him required both antibiotics and high-potency corticosteroids.

There have even been reports of fire-ant deaths.

For most folks, though, the bites are painful, but few. A prescription-strength corticosteroid cream will at least help get patients through the worst stages. “It basically is a self-limiting issue; the bites just go away over a week or two,” Dr. Rapini said. “You really have to try not to scratch, though. That’ll make a scab. And pickers get scars.”

And by the way, humans aren’t the only creatures to suffer at the jaws and stingers of fire ants. They can cause terrible injuries in reclining baby animals.

Pets can also be at risk.

As are, apparently  cute little caterpillars and tweeting birdies.

— By Michele G. Sullivan (on Twitter @MGSullivan)

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Radiation Is Radiation

Wikimedia Commons

The sun tan … deliberately darkening one’s skin — naturally or via man-made pods — in some aesthetic pursuit (we’ll leave the sociological discussion of skin color to other blogs).  I don’t get it.  I don’t get why a dark tan somehow conveys youth and beauty and health.

But what I really don’t get though is that tanners don’t seem to get that tans are caused by radiation! Egads! We don’t want nuclear power plants built near our homes, we don’t want radioactive waste from said power plants ending up for all eternity near our homes.  And meltdowns — as with the recent Fukushima Daiichi catastrophic engineering failures — make for hours how news coverage and punditry and protests, which we enjoy from a distance.

Image courtesy of Flickr user keith011764 (CC)

But everyone knows that radiation is radiation, right?  Yes, there is a big difference between ionizing radiation (think nuclear p0wer plants and x-ray machines) and non-ionizing radiation (think visible light, microwaves and radio waves). Sure, radiation energy is a sliding scale. But the radiation that we’re talking about with tanning — ultraviolet light — is just barely on the “safe” side of the divide between ionizing energy like x-ray and gamma rays.

We know that radiation has the ability to damage biologic systems — the degree of damage depends on the type of and exposure to radiation.  The type of radiation that is typical in and around nuclear power plants has the power to break DNA bonds. UV radiation from tanning beds or a nice long day at the beach have the power to speed the aging process of skin and can even lead to cancer with enough exposure.

So I just don’t get how people can freak out about nuclear power plants or cyclotrons in one moment and then head off to catch a little radiation at the local tanning parlor.  Somebody’s missing an important point and I’m pretty sure that it’s not me.

Kerri Wachter

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Video of the Week: Good News for Melanoma Finally

For a while, melanoma has been a bit of a red-headed stepchild of oncology. While advances have improved survival in a number of cancers in recent years, little progress had been made in melanoma. At this year’s ASCO annual meeting, new melnoma treatments generated a lot of buzz.

These new drugs are exciting and important because of their activity — meaning that they have an impact and clinical benefit in patients with advanced melanoma.      

Dr. Lynn Schuchter  

Overall survival was 11.2 months in melanoma patients who received  ipilimumab plus dacarbazine group and 9.1 months in the placebo plus dacarbazine group. The study was simultaneously published in the New England Journal of Medicine (2011 June 5 ;doi:10.1056/NEJMoa1104621). Ipilimumab was approved earlier this year as a first-line monotherapy treatment at a dosage of 3 mg/kg.

In another plenary presentation at ASCO, there was a 63% reduction in risk of death with vemurafenib, compared with dacarbazine alone, in metastatic melanoma patients with BRAF mutations. Vemurafenib is an investigational oral drug that inhibits BRAF kinase.

The read more about the results of these drug trials, check out the story in Skin & Allergy News

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