The weather doesn't look much like spring yet. The sun peeks out from behind the clouds much less often than we would like. But everything is ahead. A few weeks maximum - and the bright and warm spring sun will shine again.
Then the May “barbecue and dacha” holidays will come, and only then will most citizens think about spending a summer vacation. Naturally, outdoor recreation without exposure to the sun is not really vacation. Unless we become like folklore “vampires” - who go out only at night, due to intolerance to daylight.
But it’s now scary to bask in the sun’s rays - just how many “horror stories” have there been in the media about how you are at greater risk of getting skin cancer this way?
Fortunately, the other day scientists presented more joyful news to sun and tan lovers - it turns out that these factors greatly contribute to life expectancy! The study was conducted by employees of the Karolinska Institute in Stockholm - on a very large “sample” of 30 thousand women, over a period of 20 years.
Sun lovers live longer
And it turned out that those of them who loved to be in the sun were twice as likely to be alive after 20 years as those who avoided the sun. The common reasons for such longevity were a significant decrease in “sun-loving” cardiovascular and other diseases, except cancer, presumably, skin.
At the same time, scientists point out that body production of vitaminDunder influence sunlight counteracts osteoporosis and diabetes, and, in general, the rays of our luminary increase the overall mood, stimulating the production of our own “happiness hormones” - endorphins. The high level of which, in particular, is responsible for maintaining long-term relationships between lovers. They, unlike “amphetamines”, which give intense “love at first sight”, contribute to feelings of “quiet joy”, security, comfort, which can last in truly loving couples for years and decades.
How big is the risk of skin cancer?
But what about the notorious “cancer danger” of tanning? Have the Swedes really crossed out with their work the favorite “trend” of the modern near-medical press - “tanning is harmful, does it cause cancer?” But, in general, scientists from Stockholm do not encroach on this fact. Yes, there is such an increased risk for those who like to soak up the sun.
But here it is also important general statistics look! Here are just a few, particularly illustrative statistics from the World Health Organization on this matter. In 2012, a total of 56 million people died worldwide. Of these, 8.2 million are from cancer, which is just under 15%. At the same time, the types of tumors themselves, according to the number of deaths they caused, were distributed as follows.
lung cancer - 1.59 million deaths;
liver cancer - 745,000 deaths;
stomach cancer - 723,000 deaths;
colon cancer - 694,000 deaths;
breast cancer - 521,000 deaths;
Esophageal cancer – 400,000 deaths (1).
As you can see, skin cancer is not included in this list at all, due to its relatively low frequency. But even if we assume that it did not enter this gloomy “top”, only slightly behind esophageal cancer with its 400 thousand deaths per year, then this figure would be only 0.71%. While from cardiovascular diseases During the same period, 17.5 million people died—30%. And then, this is data from all over the world. In developed countries, where it is difficult to die from diarrhea or, say, during childbirth, a much larger percentage of the population dies from heart attacks and strokes.
The sun protects against cardiovascular diseases
In general, the situation is quite obvious. Sun exposure can cause skin cancer, with a mortality rate of less than one percent in general list, but they save from diseases that occupy the “lion’s share” of the main causes of mortality. Accordingly, avoiding the sun to prevent skin tumors, thereby depriving yourself of protection from more probable causes going to the next world is something like the parable of a greedy merchant who, in order to find a nickel that had fallen into the grass at night, set fire to a hundred-ruble note as a torch.
Tanning is good for you, but not for everyone
In fairness, it should be noted that the slogan “if you give a tan, it’s good for everyone!” will also not be entirely appropriate. Unfortunately, there are people for whom this procedure is indeed contraindicated.
Doctors identify six “phototypes” of skin.
The first is people with snow-white skin, blond or slightly reddish hair, blue or green eyes.
The second is light-skinned people with light brown or “sandy”, “wheat” colored hair, and eyes ranging from green to light brown.
Third - olive skin or color Ivory, dark brown or brown hair, brown, less often black or blue eyes.
Fourth - "southerners", dark skin without freckles, dark eyes and dark hair.
Fifth - “Asians”, very dark skin without freckles, hair - dark brown or black, the color of a raven's wing, slanting oriental eyes.
The sixth type is people of the Negroid race.
So, in short, people of the first type should not sunbathe at all - and an attempt may end, even if not with cancer, but only with a sunburn, which is also an unpleasant thing.
The second type can sunbathe - but with caution, not exceeding the “permissible doses”, which at noon in the summer are no more than 15 minutes.
The third type in this sense is a little more resilient, will not get burns, but with many hours of tanning, his skin will simply age faster.
And only the last three types can bask in the sun without much fear - but, nevertheless, preferably also without fanaticism.
Although, by and large, this classification should not be perceived as an absolute dogma, because scientists at the Carolingian Institute conducted observations specifically on Swedes, “descendants of the Vikings,” who had predominantly light skin. And tanning not only did not harm them, but even significantly extended their life.
Questionable cases
We should not forget about those people who have skin diseases, some of which are defined as “precancer”. If there is any suspicion, you should consult a dermatologist. Moreover, an experienced doctor can suspect skin cancer only during an external examination, without any ultrasound or MRI. Maximum - you will need to do a biopsy, tissue scraping for the presence of atypical cells.
Such an examination can be done without any complaints, simply in terms of prevention. But if any complaints appear in the form of itching, pain, peeling, previously unobserved warts, spots on the skin, it is advisable not to delay contacting a doctor. Especially before planning to sunbathe.
- and not small cell carcinoma lung These types are diagnosed based on how the cells look under a microscope. Based on the established type, treatment options are selected. To understand the prognosis of the disease and survival rate, I present statistics from open US sources for 2014 on both types of lung cancer together: New cases of the disease (prognosis: 224210 Number of projected deaths: 159260 Let us consider in detail both types, specifics and treatment options.">Lung cancer 4
- in the United States in 2014: New cases: 232,670 Deaths: 40,000 Breast cancer is the most common non-skin cancer among women in the United States (open sources, an estimated 62,570 cases of pre-invasive disease (in situ, With 232,670 new cases of invasive disease and 40,000 deaths, fewer than one in six women diagnosed with breast cancer will die from the disease, compared with an estimated 72,330 American women who will die from lung cancer in 2014. Breast Cancer glands in men (yes, yes, there is such a thing) accounts for 1% of all cases of breast cancer and mortality from this disease. Widespread screening has increased the incidence of breast cancer and changed the characteristics of detected cancer. Why has it increased? Yes, because the use modern methods has made it possible to detect the incidence of low-risk cancers, premalignant lesions and ductal carcinoma in situ (DCIS). Population-based studies in the US and UK show an increase in DCIS and the incidence of invasive breast cancer since 1970, this is associated with widespread hormone therapy in postmenopause and mammography. In the last decade, postmenopausal women have refrained from using hormones and the incidence of breast cancer has decreased, but not to the level that can be achieved with the widespread use of mammography. Risk and protective factors Increasing age is the most important risk factor for breast cancer. Other risk factors for breast cancer include the following: Family medical history o Underlying genetic susceptibility Sex mutations in the BRCA1 and BRCA2 genes, and other breast cancer susceptibility genes Alcohol consumption Breast tissue density (mammographic) Estrogen (endogenous: o Menstrual history (onset of menstruation / late menopause o No history of childbirth o Older age at first birth History of hormonal therapy: o Estrogen and progestin combination (HRT) Oral contraception Obesity Absence physical exercise Personal History of Breast Cancer Personal History of Proliferative Forms of Benign Breast Diseases Radiation Exposure to the Breast Of all women with breast cancer, 5% to 10% may have germline mutations in the BRCA1 and BRCA2 genes. Research has shown that specific BRCA1 and BRCA2 mutations are more common among women of Jewish descent. Men who carry a BRCA2 mutation also have an increased risk of developing breast cancer. Mutations in both the BRCA1 and BRCA2 genes also create an increased risk of developing ovarian cancer or other primary cancers. Once BRCA1 or BRCA2 mutations have been identified, it is advisable for other family members to be tested. genetic counseling and testing. Protective factors and measures to reduce the risk of developing breast cancer include: Using estrogen (especially after a hysterectomy Establishing an exercise habit Early pregnancy Breast-feeding Selective estrogen receptor modulators (SERMs) Aromatase inhibitors or inactivators Reducing the risks of mastectomy Reducing the risk of oophorectomy or spaying Screening Clinical trials have found that screening asymptomatic women by mammography, with or without clinical examination breast, reduces mortality from breast cancer. Diagnosis If breast cancer is suspected, the patient usually must go through the following steps: Confirmation of the diagnosis. Assessment of the stage of the disease. Choice of therapy. Next tests and procedures used to diagnose breast cancer: Mammography. Ultrasound. Magnetic resonance imaging of the breast (MRI, if available) clinical indications. Biopsy. Contralateral breast cancer Pathologically, breast cancer can be multicentric and bilateral. Bilateral disease is somewhat more common in patients with invading focal carcinoma. Over 10 years after diagnosis, the risk of primary breast cancer in the contralateral breast ranges from 3% to 10%, although endocrine therapy may reduce this risk. Development of second breast cancer is associated with an increased risk of distant recurrence. If the BRCA1/BRCA2 gene mutation was diagnosed before the age of 40, the risk of cancer of the second breast in the next 25 years reaches almost 50%. Patients diagnosed with breast cancer should undergo bilateral mammography at the time of diagnosis to rule out synchronous disease. The role of MRI in screening for contralateral breast cancer and monitoring women treated with breast conservation therapy continues to evolve. Because the increased level detection of possible disease on mammography has been demonstrated, selective use of MRI for additional screening is occurring more frequently, despite the lack of randomized controlled data. Because only 25% of MRI-positive findings represent malignancy, pathological confirmation is recommended before treatment. Whether this increased rate of disease detection will lead to improved treatment outcomes is unknown. Prognostic Factors Breast cancer is usually treated with various combinations of surgery, radiation therapy, chemotherapy and hormonal therapy. Conclusions and selection of therapy may be influenced by the following clinical and pathological features (based on conventional histology and immunohistochemistry: Menopausal status of the patient. Stage of disease. Grade of primary tumor. Tumor status depending on the status of estrogen receptors (ER and progesterone receptors (PR). Histological types Breast cancer is classified into different histological types, some of which have prognostic significance. For example, favorable histological types include colloid, medullary and tubular cancer. Uses of molecular profiling in breast cancer include the following: ER and PR status testing. Receptor testing HER2/Neu status. Based on these results, breast cancer is classified as: Hormone receptor positive. HER2 positive. Triple negative (ER, PR, and HER2/Neu negative. Although some rare inherited mutations, such as BRCA1 and BRCA2, predispose to the development of breast cancer in carriers of the mutation, however, prognostic data on carriers of the BRCA1 / BRCA2 mutation are contradictory; these women are simply at greater risk of developing second breast cancer. But it is not a fact that this can happen. Hormone replacement therapy After careful consideration, patients with severe symptoms may be treated with hormone replacement therapy. Follow-up Frequency of follow-up and appropriateness of screening after completion of primary treatment for stage I, stage II, or stage III breast cancer remain controversial. Data from randomized trials show that periodic follow-up with bone scans, liver ultrasound, chest x-rays and blood tests for liver function does not improve survival or quality of life at all compared with routine health checks. Even when these tests allow early detection relapse of the disease, this does not affect the survival of patients. Based on these data, limited screening and annual mammography may be an acceptable continuation for asymptomatic patients who have been treated for stage I to III breast cancer. More detailed information in articles: "> Mammary cancer5
- , ureters, and proximal urethra are lined by a specialized mucosa called transitional epithelium (also called urothelium. Most cancers that form in the bladder, renal pelvis, ureters, and proximal urethra are transitional cell carcinomas (also called urothelial carcinomas, derived from transitional epithelium Transitional cell bladder cancer can be low-grade or full-grade: Low-grade bladder cancer often recurs in the bladder after treatment, but rarely invades the muscle walls of the bladder or spreads to other parts of the body.Patients rarely die from bladder cancer low-grade. Full-blown bladder cancer usually recurs in the bladder and also has a strong tendency to invade the muscular walls of the bladder and spread to other parts of the body. Bladder cancer with high malignancy is considered to be more aggressive than low-grade bladder cancer and is much more likely to cause death. Almost all deaths from bladder cancer are due to high-grade cancer. Bladder cancer is also divided into muscle-invasive and non-muscle-invasive disease, based on invasion of the muscle lining (also referred to as the detrusor muscle, which is located deep in the muscle wall of the bladder. Muscle-invasive disease is much more likely to spread to other parts of the body and is typically treated by either removing the bladder or treating the bladder with radiation and chemotherapy.As noted above, high-grade cancers are much more likely to be muscle-invasive cancers than low-grade cancers.Thus, Muscle-invasive cancer is generally considered to be more aggressive than non-muscle-invasive cancer.Non-muscle-invasive disease can often be treated by removing the tumor using a transurethral approach and sometimes chemotherapy or other procedures in which medicine inserted into the bladder through a catheter to help fight cancer. Cancer can occur in the bladder in the setting of chronic inflammation, such as a bladder infection caused by the parasite haematobium Schistosoma, or as a result of squamous metaplasia; Frequency squamous cell carcinoma bladder function is higher in conditions of chronic inflammation than otherwise. In addition to transitional carcinoma and squamous cell carcinoma, adenocarcinoma, small cell carcinoma, and sarcoma can form in the bladder. In the United States, transitional cell carcinomas account for the vast majority (more than 90% of bladder cancers. However, a significant number of transitional cell carcinomas have areas of squamous cell or other differentiation. Carcinogenesis and Risk Factors There is compelling evidence of the influence of carcinogens on the occurrence and development of bladder cancer. The most common risk factor for developing bladder cancer is cigarette smoking. It is estimated that up to half of all bladder cancer cases are caused by smoking and that smoking increases the risk of developing bladder cancer at two to four times the baseline risk. Smokers with less functional polymorphisms N-acetyltransferase-2 (known as a slow acetylator) has a higher risk of developing bladder cancer compared to other smokers, apparently due to a decreased ability to detoxify carcinogens. Certain occupational hazards have also been linked to bladder cancer, and higher rates of bladder cancer have been reported due to textile dyes and rubber in the tire industry; among artists; leather processing industry workers; from shoemakers; and aluminum, iron and steel workers. Specific chemicals associated with bladder carcinogenesis include beta-naphthylamine, 4-aminobiphenyl, and benzidine. Although these chemicals are now generally banned in Western countries, many other chemicals that are still used today are also suspected of causing bladder cancer. Exposure to the chemotherapy agent cyclophosphamide has also been associated with an increased risk of bladder cancer. Chronic infections urinary tract infections and infections caused by the parasite S. haematobium are also associated with an increased risk of developing bladder cancer, and often squamous cell carcinoma. Chronic inflammation is believed to play a key role in the process of carcinogenesis in these conditions. Clinical signs Bladder cancer usually presents with simple or microscopic hematuria. Less commonly, patients may complain of frequent urination, nocturia, and dysuria, symptoms that are more common in patients with carcinoma. Patients with urothelial cancer of the upper urinary tract may experience pain due to obstruction by the tumor. It is important to note that urothelial carcinoma is often multifocal, necessitating examination of the entire urothelium if a tumor is detected. In patients with bladder cancer, imaging of the upper urinary tract is essential for diagnosis and follow-up. This can be achieved using urethroscopy, retrograde pyelogram in cystoscopy, intravenous pyelogram, or computed tomography (CT urogram). In addition, patients with transitional cell carcinoma of the upper urinary tract have a high risk of developing bladder cancer; these patients require periodic cystoscopy and observation of the contralateral upper urinary tract.Diagnosis When bladder cancer is suspected, the most useful diagnostic test is cystoscopy.Radiological examination, such as CT scan or Ultrasounds are not sensitive enough to be useful for detecting bladder cancer. Cystoscopy can be performed in urological clinic. If cancer is detected during cystoscopy, the patient is typically scheduled for a bimanual examination under anesthesia and a repeat cystoscopy in the operating room so that transurethral tumor resection and/or biopsy can be performed. Survival Patients who die from bladder cancer almost always have metastases from the bladder to other organs. Low-grade bladder cancer rarely grows into the muscle wall of the bladder and rarely metastasizes, so low-grade (stage I) bladder cancer patients very rarely die from the cancer. However, they may experience multiple recurrences that should be treated resection. Almost all deaths from bladder cancer occur among patients with disease with high level malignancy, which has a much greater potential to invade deep into the muscular walls of the bladder and spread to other organs. Approximately 70% to 80% of patients with newly diagnosed bladder cancer have superficial bladder tumors (ie, stage Ta, TIS, or T1. The prognosis of these patients depends largely on the grade of the tumor. Patients with Tumors high degree malignancies have a significant risk of dying from cancer, even if it is not muscle-invasive cancer. Those patients with high-grade tumors who are diagnosed with superficial, non-muscle-invasive bladder cancer in most cases have a high chance of cure, and even in the presence of muscle-invasive disease, sometimes the patient can be cured. Studies have shown that in some patients with distant metastases, oncologists achieved long-term complete responses after treatment with a combination chemotherapy regimen, although most of these patients have metastases limited to their lymph nodes. Secondary Bladder Cancer Bladder cancer tends to recur, even if it is non-invasive at the time of diagnosis. Therefore, standard practice is to monitor urinary tract after a diagnosis of bladder cancer. However, no studies have yet been conducted to evaluate whether surveillance affects progression rates, survival, or quality of life; although there is clinical trials to determine the optimal observation schedule. Urothelial carcinoma is thought to reflect a so-called field defect, in which the cancer arises due to genetic mutations that are widely present in the patient's bladder or throughout the urothelium. Thus, people who have had a resected bladder tumor often subsequently have ongoing tumors in the bladder, often in other locations than the primary tumor. Similarly, but less frequently, they may develop tumors in the upper urinary tract (i.e., renal pelvis or ureter). An alternative explanation for these patterns of recurrence is that cancer cells that are destroyed when the tumor is excised may reimplant in another site in the urothelium. Support for this second theory is that tumors are more likely to recur lower than in the opposite direction from the initial cancer.Upper tract cancer is more likely to recur in the bladder than bladder cancer is to reproduce in the upper urinary tract. The rest is in the following articles: "> Bladder cancer4
- , as well as an increased risk of metastatic disease. The degree of differentiation (staging) of a tumor has an important influence on the natural history of the disease and on the choice of treatment. An increase in the incidence of endometrial cancer has been found in association with long-term, unopposed estrogen exposure (increased levels. In contrast, combination therapy (estrogen + progesterone prevents an increase in the risk of developing endometrial cancer associated with a lack of resistance to the effects of estrogen specifically. Receiving a diagnosis is not the best time. However, you should know - endometrial cancer is a treatable disease. Monitor the symptoms and everything will be fine! In some patients, it may play a role "activator" of endometrial cancer is a prior history of complex hyperplasia with atypia. An increase in the incidence of endometrial cancer has also been found in association with treatment of breast cancer with tamoxifen. According to researchers, this is due to the estrogenic effect of tamoxifen on the endometrium. Because of this increase, patients who therapy with tamoxifen is prescribed should be mandatory undergo regular pelvic examinations and should be attentive to any abnormal uterine bleeding. Histopathology The distribution pattern of malignant endometrial cancer cells depends in part on the degree of cellular differentiation. Well differentiated tumors, as a rule, limit their spread to the surface of the uterine mucosa; myometrial expansion occurs less frequently. In patients with poorly differentiated tumors, invasion of the myometrium is much more common. Invasion of the myometrium is often a precursor to lymph node involvement and distant metastases, and often depends on the grade of differentiation. Metastasis occurs in the usual way. Spread to the pelvic and para-aortic nodes is common. When distant metastases occur, it most often occurs in: Lungs. Inguinal and supraclavicular nodes. Liver. Bones. Brain. Vagina. Prognostic factors Another factor that is associated with ectopic and nodal spread of the tumor is the participation of the capillary-lymphatic space in histological examination. Three prognostic groups clinical stage I became possible thanks to careful operational planning. Patients with stage 1 tumors involving only the endometrium and no evidence of intraperitoneal disease (i.e., adnexal extension) are at low risk (">Endometrial Cancer 4
Questions from AiF-Chelyabinsk readers were answered during the direct line by Mr. Chief oncologist of the Ministry of Health of the Chelyabinsk region Andrey Vazhenin.
How to check?
My husband's parents died of cancer. Today he is 60 years old, he has a polyp in his colon, and I worry about his bad heredity. Maybe he should have a PET scan?
Raisa Tikhonovna, Chelyabinsk
In no case! PET is positron emission therapy. During a PET study, a total computer diagnostic of the entire body is performed, and this means a significant radiation exposure. We get the opportunity to see not only the anatomy, but also the functions of many organs according to the degree of metabolic intensity. Any malignant tumor is accompanied by an increase in metabolism. With the help of PET, we see areas of increased metabolism and can tell where the tumor is, where the metastasis is, and where it is just inflammation. So PET is not a primary diagnostic method, it is used only when all other resources have been exhausted.
In addition, it is incorrect to talk about cancer heredity. Lifestyle matters more. The polyp, of course, needs to be removed, and then it is enough to be observed by an oncologist and periodically do a colonoscopy.
- But what about those who worry about heredity?
There is no universal way to “get tested for cancer.” But if there was, for example, uterine cancer or breast cancer in the female line, then you should regularly visit a gynecologist or mammologist. If there are several generations of smokers in the family, then the chances of lung cancer increase accordingly. But this is not heredity, but everyday life... If we are talking about cancer of the rectum or stomach, then there are probably some peculiarities of family nutrition. Perhaps the basis of the traditional menu should be reconsidered.
Beetroot, carrots, cucumbers and their juices and mixtures help normalize metabolism. This should be on our table every day. It is very important to supply the body with enzymes, minerals, amino acids and vitamins contained in natural products. To do this, include in your diet daily bran, oatmeal, rice, sunflower and pumpkin seeds, dates, nuts, almonds, cucumbers, peppers, radishes, broccoli, sprouted wheat, seaweed, soybeans.
About claws and cartilage
Do cat's claw and shark's whiskers help with cancer?
T. Davydova, Magnitogorsk
Shark cartilage, cat's claw, as well as sublimate, fly agaric, kerosene, Shevchenko's method using sunflower oil, and also mothballs, which need to be wrapped in crumb white bread, - all this is a relationship to treatment oncological diseases does not have. Alas, the level of education of the population is falling, and the degree of ignorance is increasing; people are beginning to aggressively deny scientific medicine. First, they rush into all seriousness and only then turn to doctors. Meanwhile, precious time is lost. Remember: the sooner you contact a specialist, the higher the chances of cure.
I am disabled heart disease. In April I was diagnosed with stage 3 inoperable prostate cancer. Treatment began immediately. When I was admitted to the hospital, my PSA was about 30, and upon discharge it became 9.8. This is fine? Maybe it was necessary to operate?
L. Kaplunov, Ozersk
Your current indicators indicate good effect therapeutic tactics. But surgery for prostate cancer is not always necessary. He is being treated well and conservative ways- tablets and injections.
- I'm planning a trip to the Sea of Azov. Do you think healing volcanic mud will benefit me?
No! Mud, paraffins and physiotherapy are not recommended for your diagnosis. Also remember that you should not get carried away with tanning and stay in the active sun for a long time.
About moles and warts
I have a mole on my face. It didn't bother me before, but recently it started to grow in size and hair is growing out of it.
- Is it true that appearing warts foreshadow cancer?
No it is not true.
- Is it necessary to see an oncologist before removing moles and warts?
Certainly. There are moles that are removed without prior morphological examination. But what is removed surgically must be examined afterwards.
- Is it possible to determine for yourself when a formation on the skin poses a danger?
It is not good if moles change after 20-30 years of existence. It is even more dangerous if you are over 40-50 years old. If a pigmented formation appears on the skin (especially after summer or a trip to the south) and it begins to grow, swell, crust over or bleed, do not ignore this fact. Remember: this is not a diagnosis of a “tumor”; this is a reason to consult a doctor, and not to panic.
- Is it true that skin cancer is caused by environmental conditions?
Living in general is unhealthy. Sooner or later it always ends the same way. Skin cancer, lung cancer, stomach cancer - all this is connected with the environment, with the quality of food, water and inhaled air, and our bad habits. The more urbanized a country is, the higher the cancer incidence rate.
I'm going on a seaside holiday to Turkey, I want to get a bronze tan. But then I heard: ultraviolet rays can provoke the growth of a malignant tumor - melanoma.
Yulia, Kopeisk
It is far from certain that a trip to Turkey will provoke melanoma in you. If you have few moles, they behave calmly, do not enlarge, and you are not blonde, then there is no risk. Blondes are more likely to get melanoma because they have lighter skin.
- Is it true that a person who has many moles should not go to a solarium?
Solariums, of course, are more harmful than natural tanning: they contain harsh ultraviolet radiation. Be vigilant: if you see that any of your moles begin to increase in size, rise above the surface, crack or bleed, consult a doctor.
“There is nothing worse than aspirin-colored skin,” said Coco Chanel and introduced the fashion for tanning. In summer, tanned skin is considered the main attribute of beauty and a sign of health. But what is a tan? And is it safe for our body? The head physician of the regional oncology clinic, candidate of medicine, talks about this and much more. medical sciences Konstantin Vladimirovich Yarynich.
“You and I live on planet Earth, and it is clear that all biological processes on it take place under the influence of the sun. The sun's rays give us warmth and health, and at the same time, if solar energy is not absorbed correctly, negative consequences can occur.
Now there are such scientific works who claim that you can’t even go out into the sun. This is overkill. Without the sun, human life is impossible. Therefore, you should not give up the sun.
The sun emits ultraviolet and infrared rays. Tanning depends on ultraviolet rays, otherwise 
the heat we feel is infrared radiation. Ultraviolet radiation emitted by the sun passes through several degrees of protection of the Earth. The main one is the ozone layer, in which it is retained most of ultraviolet radiation and only a small percentage reaches us,” explains Konstantin Vladimirovich.
In the Kirovograd region, about 600 people get skin cancer per year, melanoma - 50-60 people
- Is tanning useful from the point of view of an oncologist?
By forming a tan, nature is not trying to make us beautiful. In fact, it is primarily protection against ultraviolet rays. In our tissues and organs, hair, skin, as well as in the blood vessels and retina of the eye, there is a dark brown or black pigment called melanin, which prevents ultraviolet radiation from penetrating deeply into the tissues of the body. Melanin synthesis occurs in special cells - melanocytes. Under the influence of UV, calciferol is produced, it helps deliver calcium throughout our body, in particular to bone tissue. Without calciferol, this mechanism does not work. This substance works both as a vitamin and as a hormone. 90% of calciferol is formed under the influence of sunlight. That is, without exposure to sunlight, people would not have normal bone tissue, as a result - fractures, bone diseases, rickets. Solar energy is prophylactic, which reduces the risk of developing breast cancer, pancreatic cancer, prostate cancer, esophageal cancer - that is, those main localizations that are related to this hormone.
Thermal energy has great value for the prevention of other diseases - tuberculosis, colds.
How true is the statement that solar radiation provokes skin cancer and the risk of developing melanoma?
Now many researchers are saying that it is not the sun that causes skin cancer. They consider the proof of this to be the fact that at the equator the sun shines intensely all year round, although the incidence in this region of the Earth is not the highest, and the incidence of skin cancer and melanoma increases in direct proportion to the distance from the equator. The farther you are from the equator, the higher the percentage of cancer. In addition, skin cancer and melanoma often appear in areas that are not exposed to sunlight.
When we talk about the risk of getting sick, a lot depends on skin phototypes (from 1 to 6). 1 - these are people who tan very badly, they immediately get a burn. The Slavs belong to types 2 and 3, type 6 is the Negroid race.
I would like to note that it is not solar energy itself that causes diseases, but burns. If a person received for his life sunburn 2-3 times, then the risk of disease increases by 1.5 times.
One cannot help but mention the increasing number of skin cancer cases. Over the past 10 years in Europe and the USA, the number of cases has increased 10 times. In Ukraine, the figure has doubled.
In the Kirovograd region, about 600 people a year get skin cancer, and 50-60 people get melanoma.
Melanoma and cancer are absolutely various diseases. Tumors that arise from melanocytes are very aggressive and spread quickly. Skin cancer usually develops slowly, so the disease has a favorable prognosis. With a timely diagnosis, the number of people cured approaches 100%.
Melanomas occur at the site of moles. When there is prolonged mechanical, chemical, ultraviolet exposure, cells begin to divide incorrectly. And in those places where moles are constantly macerated, they need to be removed. Depending on the mole and the depth of its spread, the surgeon will choose a treatment method. You should also constantly pay attention to your moles in order to notice them in time. alarms. There is a rule "ABCDE":
A is the asymmetry of the mole;
B (border) - edges;
C (color) - color;
D - diameter;
E - changes.
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When is it time to see a doctor?
- What are the first “bells” indicating that it’s time to see a doctor?
If you discover even 1 of the 5 signs of changes in a mole, you need to contact a specialist.
Skin cancer manifests itself in the form of ulcers that do not heal for a long time. In case of prolonged non-healing erosion, you should definitely consult a doctor, who, after conducting tests, will prescribe treatment.
Konstantin Vladimirovich, what do statistical data say about the percentage of recovery and fatal cases of cancer patients in the Kirovograd region?
Last year, 59 people were diagnosed with melanoma. 26 people died from this disease. That’s why we say that melanoma is serious illness. 576 people fell ill with skin cancer, 5 died. These were advanced cases.
What does a dispensary need to diagnose cancer?
The Kirovograd Oncology Center has everything to diagnose this pathology. This is, first of all, qualified doctors. After all, any equipment in inept hands is ineffective. We have a powerful cytology laboratory. To confirm or remove a diagnosis, the subjective opinion of a doctor is not enough. All pathologies that can be seen with the eye are checked using tests.
Sunscreens are not a panacea
- Is it possible to reduce the risk of skin cancer?
Not everything depends on the sun, but, nevertheless, a lot depends on the sun. And today there are studies that say that protecting yourself with sunscreen ointments and creams is not entirely correct. There are time periods (from early morning to 10-11 o'clock in the afternoon and after 16) during which sunbathing is safe and healthy. At other times, it is advisable to protect yourself from sunlight. Wear a hat with large brims. As for sunscreens, products with an SPF level of 15, 30 do not completely protect the skin. Only clothing fully protects the skin. If used, sunscreen should be applied after each swim. But this does not exclude the rule that you cannot sunbathe from 11 a.m. to 4 p.m. Otherwise, depression will occur. immune system against the background of ultraviolet re-emission. Children are especially sensitive to such radiation, so you need to take special care of them and try to keep them in the shade. Solarium is a separate topic for discussion; it is absolutely harmful.
But the sun's rays bring much more benefits than harm.
Where is it safer to sunbathe - on Kirovograd beaches or at sea? Is there a difference in how the sun affects human skin in water and on land?
Interesting information: the highest incidence of skin cancer is in Australia and New Zealand. Above these areas of the Earth there are large ozone holes that allow ultraviolet light to pass through. Considering that the distance from Kirovograd to the sea is small, there is no difference in where to sunbathe, if we are talking about the time periods in which sunbathing is allowed. The tan will be the same. But indeed, there is an influence sea water- it promotes faster tanning. IN fresh water the refraction of rays is different. Both “sea” and “river” tans fade equally. Everything in moderation is useful. This also applies to sun tanning. You should not chase a “chocolate” skin color. By tanning gradually and at the right time, you will receive all the benefits of sunlight. The main thing is not to overdo it.
Zhanna Friske's illness became the most discussed event in in social networks. The singer fell ill with brain cancer and is now undergoing treatment abroad. We talked to an oncologist, a therapist, a doctor highest category, the head of the EMC Clinic of Oncology and Hematology, Yulia Mandelblat, on how to protect yourself from cancer, what types of cancer are the most common and aggressive and why you need to be afraid of the sun
- How to diagnose yourself early cancer? What is needed for this?
You won't be able to diagnose it yourself. Moreover, just because you don't have any pain doesn't mean you don't have early colorectal cancer, breast cancer, or skin cancer. Most often from my patients I hear the phrase “It can’t be, I feel great, I don’t have cancer.” And they really feel
they feel good: they have no symptoms, they feel amazing, they play sports. Because it is early cancer that does not manifest itself. It can only be detected through initial screening. In general, most tumors can be detected relatively early, which accordingly increases the chances of cure. Unfortunately, the same cannot be said about Zhanna Friske. I read that she has brain cancer, although without specifying what kind of cancer (there are many different types), but the main thing is that there is no screening for brain cancer.
- What other screenings are missing?
Let's start with what we have for the most commonly diagnosed cancers. There are screenings for lung cancer, breast cancer, cervical cancer, stomach cancer, prostate cancer, testicular cancer, bowel cancer and skin cancer. For other types of tumors, if there is no family risk factor, there is no point in screening.
As for brain cancer, that's enough rare view cancer, despite the fact that we sometimes hear that some celebrities have it. Just one high-profile incident gives a good resonance.
- Does it make sense to do, for example, an MRI to find out that you do not have brain cancer?
Even if you decide to have an MRI once a year, this does not mean that a month after the MRI you will not suddenly develop stage 4 cancer. Brain cancer (or rather, some types of brain cancer) is one of the most aggressive: it forms and grows very quickly.
But colon cancer screening, which is done at age 50, provides a guarantee for 7–10 years (if, of course, the colonoscopy was done well), because bowel cancer, as a rule, grows very slowly.
- How often should screening for cancer of other organs be done?
For women over 35–40, breast cancer screening is done once a year, skin cancer screening by a dermatologist is also done once a year. I mean only those people who do not have a risk factor.
It is often said that it is impossible to insure against cancer. They say you may never smoke at all and still get lung cancer. Is it so?
We cannot influence our genetics, but we can influence our health and attitude towards it: whether we smoke or not, whether we are obese, whether we eat right, whether we play sports, whether we drink alcohol, and so on. Preventive measures for cancer development are quite simple. Physical activity is needed, which helps prevent both the development and recurrence of tumors. Physical activity strengthens the immune system. In addition, physical education helps fight cardiovascular diseases, which are main reason mortality in the world. There must be a reasonable relationship with the sun. Patients often ask me whether it is necessary to prepare the body for the sun - for example, before leaving for warm countries, go to the solarium so that the skin gets used to it. I answer that the sun is harmful in any quantity: often a little, and rarely a lot. Or they say that they need vitamin D. I answer that it is quite possible to get vitamin D from a capsule, and it will be as effective as from the sun. The sun is harmful, just remember this. We are detecting skin cancer more and more often: it is clear that tanning and solarium are in fashion, and people abuse it.
Besides brain cancer, which is very difficult to diagnose early and develops so quickly, what other types of cancer behave as aggressively?
Any cancer can develop quickly and quietly up to stage 3-4. Ovarian cancer, for example, develops without symptoms until stage 3-4, when it is still possible to cure, but there is a risk of relapse. Pancreatic cancer behaves the same way. Although pancreatic screening exists, it is most often prescribed for people with diabetes, since they are at particular risk.
And what forms of cancer do you, as a specialist, consider the mildest? For example, a patient comes to you, and you tell him: oh, how easy it is, don’t worry, we’ll quickly operate and you’ll be jumping like new?
Early types of cancer of almost any etiology including breast cancer, colorectal cancer, cervical cancer, lymphomas, leukemia, prostate cancer, lung cancer- and this is not a complete list.
It is also important for patients who have recovered from cancer to remember about secondary screening and not to forget to see an oncologist. This program is now called Survivorship Care, where the oncologist establishes a surveillance program possible complications problems that may occur years after the end of treatment, as well as a program to monitor possible relapses.
- Recently, material was published in which it is said that there are a number of viruses that provoke the development of cancer, including the human papillomavirus, hepatitis B and HIV. Which of this is true and which is false?
It's all true.
- Is it possible to predict when a cure for cancer will be presented?
Most types of cancer have different and very complex causes and mechanisms of occurrence. Cancer is not one disease, but many.
This is not just an infection that can be cured by taking a targeted antibiotic. In addition, cancer is constantly changing, mutating, developing different kinds resistance. Therefore, there is no need to wait for a single magic cure, and, given the difficulties described above, we are unlikely to quickly - at least in my lifetime - cure cancer by taking a magic pill.
Therefore, one can only rely on the prevention of risk factors for cancer and timely screening. Much depends solely on the patient.
How much do you personally believe in the conspiracy theory that a cure has already been invented, but it is either not well tested or is being hidden by large pharmaceutical corporations?
I do not believe. This information is most often posted on the Internet by charlatans, who then offer their “reliable” cure. Many patients died because of such tricks or lost the opportunity to be cured by delaying proven treatment methods.
Psychologists say that there is no need to hide your illness. Are people becoming more active in sharing their diagnosis?
When you have been diagnosed with this, it is very important to get quality psychological support to join the environment in a new quality, with new views on life and society. But until now, many patients in Russia do not want to tell what diagnosis they have been given. They don’t want to share this not just with friends and work colleagues, but also with their family - they are afraid of pity, they are afraid that they will look needy. Cancer is a social stigma. IN Lately attitudes towards cancer patients began to change for the better. This is also partly due to the fact that celebrities with cancer began to talk about it. They share this with their fans and thereby help people understand that everyone gets cancer - rich and poor alike - and we need to help each other.
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