Using cancer registry data, investigators have identified a subset of patients with early-stage melanoma with almost no melanoma-related deaths, potentially representing cases contributing to overdiagnosis. The research, which is published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society, may help clinicians determine which patients have a very low risk of death from melanoma after removal of the growth.

For the study, Megan M. Eguchi, MPH, of the University of California, Los Angeles; Kathleen F. Kerr, PhD, of the University of Washington; David E. Elder, MB, ChB, FRCPA, of the University of Pennsylvania; and their colleagues, analyzed information from the U.S. Surveillance, Epidemiology, and End Results (SEER) database on patients who were diagnosed in 2010 and 2011 with stage 1 melanoma that was 1.0 mm or less in thickness and had not spread to the lymph nodes. Models were developed to identify patients with a very low risk of dying from melanoma in 7 years as well as those at higher risk of death.

 Among the 11,594 patients in the analysis with follow-up data, the overall 7-year rate of mortality from melanoma was 2.5%. However, the models identified a subset of 25% of patients from the large cohort with risk below 1%. These patients tended to be younger, and their cancers exhibited minimal invasion into the skin. A very small subset of patients (less than 1%) who skewed older and had slightly more advanced tumors (although considered low risk by current criteria) had a greater than 20% risk of death, and these patients can be considered for potentially lifesaving, more complex therapy.

The findings show that a subset of melanoma patients with very low risk of death can be identified using a few standard risk factors. It is hoped that this study’s findings can be used as a starting point for future research using additional study designs and variables beyond those available in the SEER database to further improve this classification.

“Given the very low risk of death from melanoma associated with some of the cases identified in this study, and if these findings can be verified and perhaps extended in other studies, the use of a different term such as ‘Melanocytic neoplasm of low malignant potential’ may be more appropriate than that of melanoma, as has been done with some other neoplasms or tumors formerly labeled as cancers,” said Dr. Elder. “Such a term may potentially alleviate people’s concerns related to prognosis and outcomes and begin to address the problem of overdiagnosis.”

Pain after any type of surgery is expected, but up to 30% of women undergoing mastectomy as part of breast cancer treatment will experience long-term pain and discomfort known as Post-Mastectomy Pain Syndrome, or PMPS. Fortunately, several effective treatment options are available for this vexing and distressing condition.

Each year, more than 100,000 women in the United States undergo some form of mastectomy—the surgical removal of one or both breasts—which is typically performed to treat breast cancer but might also be done to prevent the disease. With more than 3.5 million women with a history of breast cancer in the U.S., that amounts to a large number who may live with PMPS, marked by nerve pain in the chest wall, armpit, and/or arm that doesn’t ease over time. Pain immediately after a mastectomy is normal, including stiffness or swelling. Discomfort and pain extending months and beyond, however, may signify more than a prolonged healing process – it could indicate PMPS. Sometimes, PMPS can be so pronounced that some women may have trouble using their arm or moving it in all directions. It can definitely take a toll on your mental wellness.

Risk factors  

The exact cause of PMPS isn’t well-understood, and the condition can happen after breast-conserving surgery such as lumpectomy as well. Often, PMPS is due to stiffness that can be alleviated with increased motion and physical therapy. Other times PMPS can be due to breast implants that are placed under the pectoralis muscle, which causes uncomfortable stretching and pressure to the muscles and nerves like a stone stuck in a shoe. Rarely, PMPS can occur due to nerve disruptions after surgery.

Who’s more likely to develop PMPS? Risk factors include the following:

• Age:Research suggests that younger women face higher odds of PMPS compared to older women, meaning someone who is 40 might have a higher risk of long-term post-mastectomy pain than a woman 20 or 30 years older.
• Treatment type:If your breast surgery removed tissue from the underarm or upper outside portion of the breast, PMPS may be more likely. This is also true if your surgery removed 10 to 14 lymph nodes around the underarm to check for cancer or if you underwent radiation therapy as part of treatment.
• Race/ethnicity:Post-mastectomy pain may be more likely to linger in women who are part of certain racial or ethnic groups, including Blacks and Latinos. This may be because these groups tend to be diagnosed when their breast cancer is at a later stage.
• Mental health challenges:Anxiety or depression may predispose you to experience persistent pain after surgery, according to research.
• Past pain:If you’ve dealt with chronic pain before, such as low back pain or headaches, you may have higher odds of experiencing lingering post-operative pain.

PMPS treatment options  

The first step for getting help for PMPS is to talk to your doctor or cancer care team if your pain is not improving over time. Several approaches can help ease the physical and mental effects of the condition. They include the following:Pain medications: Depending on how recently your breast surgery was performed, pain relief can come in the form of over-the-counter acetaminophen or NSAIDs (nonsteroidal anti-inflammatory drugs) to prescription low-dose opioids for short periods. For longer periods, you may need a referral to a pain specialist.Regional anesthesia: If oral medications don’t help, your doctor may refer you to a pain specialist for local or regional anesthesia such as nerve blocks.Steroid injections: These can help reduce nerve inflammation that contributes to pain.Implantable nerve stimulators: These devices can disrupt abnormal nerve signals leading to prolonged pain.Physical therapy: A focused course of physical therapy can target the reduced flexibility and strength that are hallmarks of PMPS. Physical therapy can also lessen scar tissue development around injured nerves that may also play a part in chronic pain development. \Surgery: Sometimes scar tissue forms around a nerve, or a divided nerve forms an overgrowth of scar tissue called a neuroma. Surgical exploration can help free up scar tissue or resect a neuroma.Constance M. Chen, MD, is a board-certified plastic surgeon with special expertise in the use of innovative natural techniques to optimize medical and cosmetic outcomes for women undergoing breast reconstruction. She is Clinical Assistant Professor of Surgery (Plastic Surgery) at Weill Cornell Medical College and Clinical Assistant Professor of Surgery (Plastic Surgery) at Tulane University School of Medicine. www.constancechenmd.com 

Additional survey findings include:

49% said they are more worried about avoiding sunburn than preventing skin cancer.

32% said they are more worried about avoiding wrinkles than preventing skin cancer.

25% said they got a sunburn in 2020.

“These findings are surprising and seem to suggest that many people do not take skin cancer seriously or perhaps believe skin cancer won’t happen to them,” says board-certified dermatologist Robert T. Brodell, MD, FAAD, professor and founding chair of the department of dermatology and professor of pathology at the University of Mississippi Medical Center. “Yet, one in five Americans will develop skin cancer in their lifetime, and nearly 20 Americans die from melanoma, the deadliest form of skin cancer, every day.”

According to the United States Centers for Disease Control and Prevention (CDC), anyone can get skin cancer. People with some characteristics, however, are at greater risk:

A lighter natural skin color

Skin that burns, freckles, reddens easily, or becomes painful in the sun

Blue or green eyes

Blonde or red hair

More than 50 moles

A family history of skin cancer

A personal history of skin cancer

“While there are many risk factors for skin cancer that people can’t control, such as having red or blond hair or blue or green eyes, there are other risk factors that we can control, like preventing sunburns and avoiding tanning, both indoors and out,” says Brodell. “Unprotected exposure to ultraviolet rays is the most preventable risk factor for skin cancer, including melanoma.”

Research shows the incidence of skin cancer among non-Hispanic white individuals is almost 30 times higher than that among non-Hispanic Black or Asian/Pacific Islander individuals. While not as common among people with skin of color, skin cancer is still a risk. Research also indicates that skin cancer in patients with skin of color is often diagnosed at a more advanced stage, when it’s more difficult to treat.

“What’s concerning is that invasive melanoma — melanoma that grows deeper into the skin or spreads to other parts of the body — is projected to be the fifth most commonly diagnosed cancer for both men and women this year,” says Brodell. “We need to make sure that everyone understands their risk for skin cancer and takes steps to prevent it as well as detect it early before it spreads.”

Keeping risk factors in mind along with practicing safe sun — such as seeking shade, wearing sun-protective clothing, and applying sunscreen — is critically important, says Brodell. He also emphasizes that skin cancer is highly treatable when caught early, so it’s important to know what to look for and encourages everyone to perform regular skin self-exams. (The AAD’s 2021 SPOT Skin Cancer survey showed that 32% of U.S. adults have never done a skin self-exam).

Skin Cancer Warning Signs

Skin cancer warning signs include changes in size, shape, or color of a mole or other skin lesion, the appearance of a new growth on the skin, or a sore that doesn’t heal. If you notice any spots on your skin that are different from the others, or anything changing, itching or bleeding, the AAD recommends that you make an appointment with a board-certified dermatologist.

To help people find a possible melanoma on their skin, dermatologists created the ABCDEs of melanoma.

A is for Asymmetry: One half of the spot is unlike the other half.

B is for Border: The spot has an irregular, scalloped, or poorly defined border.

C is for Color: The spot has varying colors from one area to the next, such as shades of tan, brown or black, or areas of white, red, or blue.

D is for Diameter: While melanomas are usually greater than 6 millimeters, or about the size of a pencil eraser, when diagnosed, they can be smaller.

E is for Evolving: The spot looks different from the rest or is changing in size, shape, or color.

To learn more from the AAD about sun protection and skin cancer prevention and test your skin cancer knowledge via a short quiz, click here. To find a board-certified dermatologist in your area, click here.

Sometimes, however, the natural look and feel of the reconstructed breast may be more apparent to others than it is to the woman herself. While pleased with the appearance of her new breasts, some women are disappointed to realize that to her reconstructed breast is numb to touch and sexual arousal.As breast reconstruction techniques have been developed, the emphasis until now has been on how the woman would look. The next frontier in reconstructive surgery is to reconnect nerves and restore sensation to the breast. New techniques show great promise and many women are now experiencing varying degrees of restored feeling.Here are my answers to questions about loss and restoration of feeling in reconstructed breasts.

“Why is feeling lost after mastectomy? Can it return?”

During a mastectomy, the nerves that provide feeling to the breast and nipple are severed, causing loss of sensation in the remaining skin. Some women experience a limited return of sensation over time, dependent in part on the type of reconstruction they have. Implants form a physical barrier that prevents nerves from growing through to the skin. Autologous reconstruction, which transfers blood vessels and nerves along with fat and skin, offers the best opportunity for nerve regeneration since nerves are more likely to grow in natural tissue.Of the four different types of nerve sensation – deep pressure, light touch, pain, and temperature – deep pressure sensation returns most quickly and temperature most slowly. But nerves grow very slowly and even when the regenerated nerves reach the skin after months or years, the quality of sensation is variable.

“How can sensation be restored?”

Because nerve regeneration is slow and results are unpredictable, reconnecting nerves has not always been a surgical priority. But new, meticulous microsurgical techniques that use neural tubes and nerve grafts have enabled surgeons to offer each woman the best possible chance for restoration of feeling.Two specific methods of autologous reconstruction offer the best opportunity for successfully reconnecting nerves via a procedure called neurorrhaphy, a microsurgical technique that attaches two nerves. In perforator flap breast reconstruction, the skin, fat, and blood vessels (the “flap”) are transferred from a donor site, often the abdomen or upper inner thighs, to create the new breast. During the flap surgery, a sensory nerve that provides feeling to the lower abdominal skin can be included and transferred with the flap to the chest. Surgeons specially trained in this technique can then connect this nerve to nerves that were severed during the mastectomy. This additional surgical step has shown great promise in restoring feeling better and faster than waiting and hoping for nerves to regenerate.

“How can I ensure that I have the best possible chance to have feeling restored?”

One of the most distressing aspects of loss of feeling is that many women were assured that their reconstructed breast would look and feel natural but weren’t told that they would lose most or all of the feeling in the breast.

The importance of the return of sensation is different for every woman and should be discussed in the initial surgical consultation so she knows what to expect and has the opportunity to ensure that her surgeon is trained in the techniques that will provide the best outcome.

What constitutes feeling “herself” again after breast cancer is an individual matter that has both physical and emotional aspects. Our responsibility to each patient is to ensure that her expectations are realistic and to offer her choices that let her decide what is the best way for her to regain her confidence and preserve her sense of self.Constance M. Chen, MD, is a board-certified plastic surgeon with special expertise in the use of innovative natural techniques to optimize medical and cosmetic outcomes for women undergoing breast reconstruction. She is Clinical Assistant Professor of Surgery (Plastic Surgery) at Weill Cornell Medical College and Clinical Assistant Professor of Surgery (Plastic Surgery) at Tulane University School of Medicine. 

According to the AAD, other survey findings include:

49% said they are more worried about avoiding sunburn than preventing skin cancer.

32% said they are more worried about avoiding wrinkles than preventing skin cancer.

25% said they got a sunburn in 2020.

“These findings are surprising and seem to suggest that many people do not take skin cancer seriously or perhaps believe skin cancer won’t happen to them,” said board-certified dermatologist Robert T. Brodell, MD, FAAD, professor and founding chair of the department of dermatology and professor of pathology at the University of Mississippi Medical Center. “Yet, one in five Americans will develop skin cancer in their lifetime, and nearly 20 Americans die from melanoma, the deadliest form of skin cancer, every day.”

According to the United States Centers for Disease Control and Prevention (CDC), anyone can get skin cancer. People with some characteristics, however, are at greater risk:

*A lighter natural skin color

*Skin that burns, freckles, reddens easily, or becomes painful in the sun

*Blue or green eyes

*Blonde or red hair

*More than 50 moles

*A family history of skin cancer

*A personal history of skin cancer

“While there are many risk factors for skin cancer that people can’t control, such as having red or blond hair or blue or green eyes, there are other risk factors that we can control, like preventing sunburns and avoiding tanning, both indoors and out,” Brodell says. “Unprotected exposure to ultraviolet rays is the most preventable risk factor for skin cancer, including melanoma.”

Research shows the incidence of skin cancer among non-Hispanic white individuals is almost 30 times higher than that among non-Hispanic Black or Asian/Pacific Islander individuals. While not as common among people with skin of color, skin cancer is still a risk. Research also indicates that skin cancer in patients with skin of color is often diagnosed at a more advanced stage, when it’s more difficult to treat.

“What’s concerning is that invasive melanoma — melanoma that grows deeper into the skin or spreads to other parts of the body — is projected to be the fifth most commonly diagnosed cancer for both men and women this year,” says Brodell. “We need to make sure that everyone understands their risk for skin cancer and takes steps to prevent it as well as detect it early before it spreads.”

Keeping risk factors in mind along with practicing safe sun — such as seeking shade, wearing sun-protective clothing, and applying sunscreen — is critically important, says Dr. Brodell. He also emphasizes that skin cancer is highly treatable when caught early, so it’s important to know what to look for and encourages everyone to perform regular skin self-exams. (The AAD’s 2021 SPOT Skin Cancer survey showed that 32% of U.S. adults have never done a skin self-exam).

Skin Cancer Warning Signs

Skin cancer warning signs include changes in size, shape, or color of a mole or other skin lesion, the appearance of a new growth on the skin, or a sore that doesn’t heal. If you notice any spots on your skin that are different from the others, or anything changing, itching or bleeding, the AAD recommends that you make an appointment with a board-certified dermatologist.

To help people find a possible melanoma on their skin, dermatologists created the ABCDEs of melanoma.

A is for Asymmetry: One half of the spot is unlike the other half.

B is for Border: The spot has an irregular, scalloped, or poorly defined border.

C is for Color: The spot has varying colors from one area to the next, such as shades of tan, brown or black, or areas of white, red, or blue.

D is for Diameter: While melanomas are usually greater than 6 millimeters, or about the size of a pencil eraser, when diagnosed, they can be smaller.

E is for Evolving: The spot looks different from the rest or is changing in size, shape, or color.

To find out more about skin health issues, click here to visit the AAD website.

Although rare, skin cancer, including melanoma — the deadliest form of skin cancer — can develop under and around the fingernails and toenails. While anyone can develop melanoma on their nails, it’s more common in older individuals and people of color. A personal or family history of melanoma or previous nail trauma may also be risk factors.

“The good news is that when found early, melanoma — even on the nails — is highly treatable,” says board-certified dermatologist Skylar Souyoul, MD, FAAD. “The best way to find skin cancer on your nails early, when it’s most treatable, is to know what to look for and regularly check your nails.”

When checking your nails for melanoma, Souyoul says to look for the following changes:

A dark streak. This may look like a brown or black band in the nail — often on the thumb or big toe of your dominant hand or foot. However, this dark streak can show up on any nail.

Dark skin next to your nail. When the skin around your nail becomes darker, it could be a sign of advanced melanoma.

Nail lifting from your fingers or toes. When this happens, your nail starts to separate from the nail bed. The white free edge at the top of your nail will start to look longer as the nail lifts.

Nail splitting, which occurs when a nail splits down the middle.

A bump or nodule under your nails. You might also see a band of color on your nail. It could be wide and irregular or dark and narrow.

“Nail melanoma is often diagnosed at a more advanced stage than melanoma on the skin, making it more dangerous for your health,” says Souyoul. “If you notice any changes to your nails, including a new dark band on your nail, make an appointment to see a board-certified dermatologist.”

 For more information on skin issues and to find a board-certified dermatologist, click here to visit the AAD website.

He also noted that colorectal cancer takes such a deadly toll because it usually has no identifiable symptoms and often goes undetected until it is too late to treat. Declaring this important month gives Americans hope in research and the fight against this cancer.

Colorectal cancer and colon cancer are often used interchangeably. To clarify, colon cancer begins in the colon, while colorectal cancer starts in the rectum. Both are considered colorectal cancer and may cause similar symptoms. They can be diagnosed using the same screening methods but differ in treatment.

According to the American Cancer Society (ACS), the estimated number of new colon cancer cases in the U.S. for 2021 will be 104,270, while the estimated number of new rectal cancer cases will be 45,320. Expected to cause 52,980 deaths in 2021, colon cancer and rectal cancer are now the third leading cause of cancer-related deaths in the U.S. Here are some tactics and tips from the experts at Gastro MD to lower your risk for colorectal cancer:

1. Separate the truth about colorectal cancer from myth

Your best defense against colon or rectal cancer starts with learning the truth behind the common misconceptions and learning more about detection. Colonoscopy is a procedure used to see inside the colon and rectum and detect inflamed tissue, ulcers, and abnormal growths. The procedure is used to look for early signs of colorectal cancer and helps doctors diagnose unexplained changes. While some people are at higher risk because of their lifestyles and genetics, colorectal cancer can be preventable. If found early, it is highly treatable.

2. Get colorectal cancer screening  

Colorectal cancer can be treated if detected early enough. You don’t have to wait until the recommended age of 45 to get tested. If you have a family history of colorectal cancer or a personal history of inflammatory bowel disease, consult your doctor, who will likely recommend screening.

3. Maintain a healthy weight

Many diseases and cancers are linked to being overweight or obese. Excess fat in the body affects your metabolism and reproductive cycles. It can cause chronic inflammation and higher insulin levels in the body, which are believed to help certain cancers develop. Eat a nutritious diet and exercise regularly to achieve an ideal weight for your height.

4. Eat foods good for your colon

Eating foods that improve the health of your colon may help prevent colon cancer. Build a diet that is high in protein, vitamin E, vitamin B, and fiber. Studies show inflammation can cause the development of cancer. So you should eat foods that reduce inflammation, such as fresh fish high in omega-3 fatty acids, leafy green vegetables, tomatoes, fruits like strawberries and almonds. Many experts would say that it’s best to avoid processed meats due to the added chemical preservatives.

5. Drink and smoke in moderation or not at all

Alcohol consumption and smoking boost your risk of severe diseases, including colon cancer. The risk for developing colorectal cancer increases as we age is due to lowered immunity. Combine that with smoking and alcohol, and healthy cells in the colon are more likely to develop mutations in their DNA, resulting in cancerous cells that multiply and form tumors.

To learn more about the different screenings performed by gastroenterologists, contact Gastro MD in Tampa. We strive to build a community of cutting-edge clinical gastroenterology practices and set the standards in digestive health care.

Research presented at the 2019 AADSummer Meeting in New York shows that between 1970 and 2009, rates of melanoma, the deadliest form of skin cancer, have increased 800% among women ages 18-39, making it the second most common cancer in young women. During a similar timeframe, basal cell and squamous cell carcinoma rates have also sharply increased by 145% and 263%, respectively.

“Because there’s a delay between UV exposure and when skin cancer appears, most women don’t think it will happen to them,” said board-certified dermatologist M. Laurin Council, MD, FAAD, FACMS, an associate professor of dermatology at Washington University in St. Louis. “This data reveals the disproportionate rise in the number of skin cancers in women and the need for further education regarding UV exposure.”

Continued use of indoor tanning devices by Caucasian girls and young women is of particular focus among dermatologists, as researchers estimate that it may cause more than 400,000 cases of skin cancer in the U.S. each year. Women are far more likely to use indoor tanning devices than men (7.8 versus 1.9 million) and of the women who began tanning before the age of 16, more than half (54%) did so with their mother.

According to experts, even one indoor tanning session can increase a user’s lifetime risk of developing melanoma by 20%, squamous cell carcinoma by 67% and basal cell carcinoma by 29%. The risk increases for younger users; indoor tanning before age 35 can increase one’s risk of melanoma by 59%. This risk increases with each use.

Even one indoor tanning session can increase a user’s lifetime risk of developing melanoma by 20%.

“It’s important that young people understand the potential impact of the habits they form when they are younger,” Council said. “There are serious, long-term consequences to activities such as sunbathing and using indoor tanning devices.”

Council recommends that parents talk with their children about limiting UV exposure, which is the easiest way to prevent skin cancer. This means practicing sun-safety habits, such as seeking shade, especially when the sun’s rays are the strongest between 10 a.m. and 2 p.m.; wearing protective clothing, including a lightweight, long-sleeved shirt, pants, a wide-brimmed hat and sunglasses; and regularly applying a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher. Parents should also discourage the use of indoor tanning devices.

“Everyone should be happy with the skin they were born with and protect it,” Council said. “Some skin cancers are treatable with surgery, but others are more advanced and may be deadly. It’s important that we modify risky behaviors such as UV exposure to prevent the occurrence of skin cancer.”

For more information, check out the AAD’s Indoor Tanning Fact Sheet, its Skin Cancer Fact Sheet and its Melanoma FAQs.

And skin cancer is on the rise in the United States. The Centers for Disease Control and Prevention (CDC) estimates there were more than 80,422 people diagnosed with melanoma of the skin—the most serious form of skin cancer—in 2015 alone. About 4.3 million people are treated for basal cell cancer and squamous cell skin cancer in the United States every year, according to a 2014 report from the Office of the Surgeon General.

The U.S. Food and Drug Administration (FDA) is continuing to evaluate sunscreen products to ensure that sunscreen active ingredients are safe and effective and that (among other things) available sunscreens help protect consumers from sunburn and, for broad spectrum products with SPF values of at least 15, from skin cancer and early skin aging caused by the sun when used as directed with other sun protection measures.

Spending time in the sun without adequate protection increases your risk of early skin aging.

Sun damage to the body is caused by invisible ultraviolet (UV) radiation. Sunburn is a type of skin damage caused by the sun. Tanning is also a sign of the skin reacting to potentially damaging UV radiation by producing additional pigmentation that provides it with some—but often not enough—protection against sunburn.

Spending time in the sun increases your risk of skin cancer and early skin aging. People of all skin colors are at risk for this damage. You can reduce your risk by:

Limiting your time in the sun, especially between 10 a.m. and 2 p.m., when the sun’s rays are most intense.

Wearing clothing to cover skin exposed to the sun—such as long-sleeve shirts, pants, sunglasses, and broad-brim hats. Sun-protective clothing is now available. (The FDA regulates these products only if they are intended to be used for medical purposes.)

Using broad spectrum sunscreens with a Sun Protection Factor (SPF) value of 15 or higher regularly and as directed. (Broad spectrum sunscreens offer protection against both UVA and UVB rays, two types of the sun’s ultraviolet radiation.)

Always read the label to ensure you use your sunscreen correctly, and ask a health care professional before applying sunscreen to infants younger than 6 months.

In general, the FDA recommends that you use broad spectrum sunscreen with an SPF of 15 or higher, even on cloudy days.

Apply sunscreen liberally to all uncovered skin, especially your nose, ears, neck, hands, feet, and lips (but avoid putting it inside your mouth and eyes).

Reapply at least every two hours. Apply more often if you’re swimming or sweating. (Read the label for your specific sunscreen. An average-size adult or child needs at least one ounce of sunscreen, about the amount it takes to fill a shot glass, to evenly cover the body.)

If you don’t have much hair, apply sunscreen to the top of your head, or wear a hat.

No sunscreen completely blocks UV radiation, and other protections are needed, such as protective clothing, sunglasses, and staying in the shade.

No sunscreen is waterproof.

Certain sunscreens have FDA-approved New Drug Applications. Others are marketed under the FDA’s Over-the-Counter (OTC) Drug Review. Sunscreens are available in forms such as lotions, creams, sticks, gels, oils, butters, pastes, and sprays.

Sunscreen products in forms including wipes, towelettes, body washes, and shampoos that are marketed without an FDA-approved application remain subject to regulatory action.

Although UVB rays are the primary cause of sunburn, both UVA and UVB rays contribute to skin cancer. All sunscreens protect against the sun’s UVB rays, but only those that are broad spectrum also have been shown to also provide sufficient protection against UVA rays to reduce the risk of skin cancer and early skin aging caused by the sun when used as directed with other sun protection measures.

Current FDA regulations that apply to sunscreens marketed without approved applications and containing certain active ingredients state:

Products that pass FDA’s broad spectrum requirements can be labeled “broad spectrum.”

Sunscreens that are not broad spectrum or that lack an SPF of at least 15 must carry a warning: “Skin Cancer/Skin Aging Alert: Spending time in the sun increases your risk of skin cancer and early skin aging. This product has been shown only to help prevent sunburn, not skin cancer or early skin aging.”

Water resistance claims, for 40 or 80 minutes, tell how much time you can expect to get the labeled SPF-level of protection while swimming or sweating.

Manufacturers may not make claims that their sunscreens are “waterproof” or “sweat proof.”

Products may not be identified as “sunblocks” or claim instant protection or protection for more than two hours without reapplying.

Remember, people of all skin colors are potentially at risk for sunburn and other harmful effects of UV radiation, so always protect yourself. Be especially careful if you have:

pale skin

blond, red, or light brown hair

been treated for skin cancer

a family member who has had skin cancer

If you take medications, ask your health care professional about sun-care precautions. Some medications may increase sun sensitivity. Even on an overcast day, up to 80 percent of the sun’s UV rays can get through the clouds. Stay in the shade as much as possible.

The FDA is committed to ensuring that safe and effective sunscreen products are available for consumer use. Because the body of scientific evidence linking UVA exposure to skin cancers and other harms has grown significantly in recent years, FDA is proposing a new requirement that all sunscreen products with SPF values of 15 and above must be broad spectrum, and that as the SPF of these products increases, broad spectrum protection increases as well. FDA is also proposing changes to the labeling of SPF values to make it easier for consumers to compare and choose sunscreen. FDA is also proposing raising the maximum proposed SPF value from SPF 50+ to SPF 60+.

Protect Your Eyes With Sunglasses

Sunlight reflecting off sand, water, or even snow, further increases exposure to UV radiation and increases your risk of developing eye problems. Certain sunglasses can help protect your eyes. When using sunglasses:

Choose sunglasses labeled with a UVA/UVB rating of 100% to get the most UV protection.

Do not mistake dark-tinted sunglasses as having more UV protection. The darkness of the lens does not indicate its ability to shield your eyes from UV rays. Many sunglasses with light-colored tints, such as green, amber, red, and gray can offer the same UV protection as very dark lenses.

Children should wear sunglasses that indicate the UV protection level. Toy sunglasses may not have UV protection, so be sure to look for the UV protection label.

Consider large, wraparound-style frames, which may provide more efficient UV protection because they cover the entire eye-socket.

This is especially important when doing activities around or on water because much of the UV comes from light reflected off the water’s surface.

Understand that pricier sunglasses don’t ensure greater UV protection.

Even if you wear contact lenses, wear sunglasses that offer UV protection.

Know that sunglasses are the most effective when worn with a wide-brim hat and sunscreen.

The report also said that cancer incidence rates, meaning the rates of new cancers, continued to decline in men, women and children from 1999 to 2016.

The annual report is a collaborative effort among the National Cancer Institute (NCI), part of the NIH; the Centers for Disease Control and Prevention (CDC); the American Cancer Society (ACS); and the North American Association of Central Cancer Registries (NAACCR). The report appeared in the Journal of the National Cancer Institute.

“We are encouraged by the fact that this year’s report continues to show declining cancer mortality for men, women, and children, as well as other indicators of progress,” said Betsy A. Kohler, executive director of NAACCR. “There are also several findings that highlight the importance of continued research and cancer prevention efforts.”

As part of the report, a special section shows a different picture for cancer incidence and mortality among men and women ages 20 to 49. When the researchers looked only at men and women ages 20 to 49, they found that both incidence and death rates were higher among women.

The authors reported that, in the 20–49 age group from 2011 to 2015, the average annual incidence rate for all invasive cancers was 115.3 (per 100,000 people) among men, compared with 203.3 among women, with cancer incidence rates decreasing an average of 0.7% per year among men and increasing an average of 1.3% per year among women. During the period from 2012 to 2016, the average annual cancer death rate was 22.8 (per 100,000 people) among men and 27.1 among women in this age group.

The most common cancers and their incidence rates among women ages 20 to 49 were breast (73.2 per 100,000 people), thyroid (28.4), and melanoma of the skin (14.1). Breast cancer incidence far exceeded the incidence of any other cancer. The most common cancers among men ages 20 to 49 were colon and rectum (13.1), testis (10.7), and melanoma of the skin (9.8).

“The greater cancer burden among women than men ages 20 to 49 was a striking finding of this study,” said Elizabeth Ward, Ph.D., lead author of the study and a consultant at NAACCR. “The high burden of breast cancer relative to other cancers in this age group reinforces the importance of research on prevention, early detection, and treatment of breast cancer in younger women.”

“Significant differences remain in cancer cases and deaths based on gender, ethnicity and race.”

In studying this age group, the authors also found that, from 2012 to 2016, death rates decreased 2.3% per year among men and 1.7% per year among women.

“It is important to recognize that cancer mortality rates are declining in the 20-to-49-year-old age group, and that the rates of decline among women in this age group are faster than those in older women,” said Douglas R. Lowy, M.D., acting director of NCI.

The authors also wrote that some of the most frequent malignant and nonmalignant tumors that occur in this age group may be associated with considerable long-term and late effects related to the disease or its treatment. The authors conclude that access to timely and high-quality treatment and survivorship care is important to improve health outcomes and quality of life for younger adults diagnosed with cancer.

This year’s report found that, among all ages combined, existing incidence and mortality trends for most types of cancer continue. Rates of new cases and deaths from lung, bladder, and larynx cancers continue to decrease as a result of long-term declines in tobacco smoking. In contrast, rates of new cases of cancers related to excess weight and physical inactivity—including uterine, post-menopausal breast, and colorectal (only in young adults)—have been increasing in recent decades.

Several notable changes in trends were observed in the report. After decades of increasing incidence, thyroid cancer incidence rates in women stabilized from 2013 to 2015. The authors wrote that this could be due to changes in diagnostic processes related to revisions in American Thyroid Association management guidelines for small thyroid nodules.

The report also shows rapid declines in death rates for melanoma of the skin in recent years. Death rates, which had been stable in men and decreasing slightly in women, showed an 8.5% decline per year from 2014 to 2016 in men and a 6.3% decline per year from 2013 to 2016 in women.

“The declines seen in mortality for melanoma of the skin are likely the result of the introduction of new therapies, including immune checkpoint inhibitors, that have improved survival for patients diagnosed with advanced melanoma,” said J. Leonard Lichtenfeld, M.D., M.A.C.P., interim chief medical officer of ACS. “This rapid change shows us how important it is to continue working to find effective treatments for all kinds of cancer.”

The report also shows continuing racial and ethnic disparities in cancer mortality and incidence. When data for people of all ages were combined and compared by sex, across racial and ethnic groups, black men and black women had the highest cancer death rates, both for all cancer sites combined and for about half of the most common cancers in men and women. Black men and white women had the highest overall cancer incidence rates, and Asian/Pacific Islander men and women had the lowest overall rates. Non-Hispanic men and women had higher overall incidence rates than Hispanic men and women.

“Major declines overall in cancer mortality point in the right direction, yet significant differences remain in cancer cases and deaths based on gender, ethnicity, and race,” said CDC Director Robert R. Redfield, M.D. “A better understanding of these discrepancies improves cancer diagnosis and recovery for all patients and is vital to our public health mission.”

For more about the report, click here.