By Karen Rowan
MyHealthNewsDaily

While the risk of developing skin cancer is known to be linked with exposure to ultraviolet light, it's been less clear whether the UV lamps used in nail salons might raise the risk of skin cancer. Now, a new study suggests these lamps don't increase skin cancer risk.

In the study, researchers looked at three commonly used UV nail lamps. They measured the light, in terms of its likely carcinogenic effects, and calculated the "UV dose" that a user would receive during a 10-minute nail-drying session.

Not all ultraviolet lamps are the same — for example, people with the skin condition psoriasis may be treated with lamps, and studies have shown these "narrowband UVB" treatments raise the risk of skin cancer only minimally, compared with the more damaging rays of tanning salon lamps.

The new study showed that between 13,000 and 40,000 nail-drying sessions would be needed before a person would receive the same UV dose as a person with psoriasis who received light treatments for their condition, according to researchers Dr. Alina Markova, of the Massachusetts General Hospital in Boston, and Dr. Martin Weinstock, of Brown University. 

That's about 250 years of weekly manicures.

The findings mean that using these UV lamps "does not produce a clinically significant increased risk of developing skin cancer," the researchers wrote.

Two previous studies have looked at this question, the researchers said. In a 2009 report, researchers concluded that UV nail lamps were a risk factor in the cases of two women who developed skin cancer known as squamous cell carcinomas on the backs of their hands. In the other study, a laboratory hired by the nail salon industry tested many UV nail lamps and concluded UV light levels emitted were low and safe.

However, researchers of the new study noted that report about the two women was anecdotal, and did not include measurements of the UV light from the lamps. They also said the methods used in the industry-funded study were inappropriate.

"Dermatologists and primary-care physicians may reassure patients regarding the safety of these devices," the researchers wrote in their article, published Thursday (Dec. 6) in the Journal of Investigative Dermatology.

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Most people who buy cosmetic lotions and potions know that while the people working behind the department store makeup counters may wear white lab coats, the stuff they sell is more about packaging than science.

But a Northwestern University team is bucking that image, reporting today that they’ve created a way to regulate genes affecting the skin -- merely by applying moisturizer.

Not only could their technology pave the way for cosmetics that actually work, but it also might also prove to be a valuable weapon in fighting melanoma, the deadliest form of skin cancer, or diseases like psoriasis, and wounds like the intractable sores that often plague diabetics.

“This is a blockbuster in the ways we will treat diseases of the skin,” said Chad Mirkin, director of the International Institute for Nanotechnology and the George B. Rathmann Professor of Chemistry at Northwestern said. “We’re talking about ailments, scarring, wound healing, ways of regulating them or retarding them.”

In a research paper published today in the Proceedings of the National Academy of Sciences, Mirkin and his colleagues describe not a drug, exactly, but a way of delivering small sections of nucleic acids (DNA and RNA are nucleic acids) called short interfering RNA, or siRNA, to cells. The cells take up the siRNA, which then alters the way a gene inside each cell can be read by the protein-making system.

The team used gold particles with a diameter of 13 nanometers. (One nanometer is 1-billionth of a meter. A typical strand of human hair is roughly 60,000 nanometers wide.) They coated the particles with siRNA to create what they call “spherical nucleic acid nanoparticle conjugates,” or SNAs. Millions of SNAs were then added to a commercially available petroleum-based skin moisturizer and the mixture was applied to mice and to lab-grown human skin.  

In their key experiment in mice, they used their new system to tamp down the activity of a gene called epidermal growth factor receptor, or EGFR, that’s involved in the growth of melanoma. As its name implies, EGFR receives messages from the epidermal growth factor protein. So toning down EGFR will interrupt the message; growth will be reduced or stop.

After mice were treated with the mixture three times per week for three weeks, the expression of the EGFR gene was reduced by 65 percent.

'Impressive' results
Steve Dowdy, professor of cellular and molecular medicine at the University of California San Diego, and a Howard Hughes Medical Institute investigator specializing in RNA inhibition and ways to deliver siRNAs, called that result “impressive.” 

But EGFR was just a proof-of-principle target. The delivery system could, in theory, carry targeted siRNA to regulate any number of genes, including ones related to skin aging.

Mirkin’s enthusiasm for the possibilities of the new therapy is rare. It’s unusual for a scientist to rave about his work in such terms, especially one in the field of siRNA, which has a checkered history filled with scientific frustrations and failed companies.

Ten years ago, scientists predicted a new era of siRNA therapies, but the hype machine ran into a roadblock: how to deliver siRNAs into cells and make them regulate the target gene and not cause any collateral damage.

The issue mainly has been size, Dowdy explained. Two million years of evolution have created cells that do a good job of keeping foreign stuff out. In order to enter a cell passively, a substance has to be about 1 nanometer or less, one reason why small molecule drugs -- pills -- are so tough to create. Another problem is that cell membranes carry a negative charge. They repel negatively charged molecules, like siRNAs. 

“It’s like trying to squeeze an elephant through the top of your desk,” Dowdy said.

Mirkin explained that his team’s delivery system relies on so-called “scavenger receptors” on the cell surface to grab the nano SNAs and gobble them up. Once the SNAs were inside the cell, they were able to begin silencing the EGFR gene.

Dowdy said he’s “cautious” about Mirkin’s claims for SNAs, given the history of other delivery systems that have been tried. So far no solution has been perfect, though siRNA technology is being tested in human clinical trials. 

Another issue is the nanospheres themselves. For example, the Food and Drug Administration has yet to rule on the use of nanoparticles in sunscreens until more data can be gathered on what effects, if any, the particles might have if they pass through skin and enter the bloodstream. Last week, the agency announced that the tiny technology needs more safety testing before it can be used in consumer goods.

But Dowdy did agree that for use on skin -- especially in cases like psoriasis or diabetic wounds where the skin surface has already been compromised, Mirkin’s group may be onto something.

Mirkin certainly hopes so. He’s founded a company called Aurasense Therapeutics. Just as Botox was originally meant to be used for muscle disorders, but now makes heaps of money thanks to its wrinkle-fighting properties, Aurasense stands to reap a windfall if anybody can walk up to a counter and buy a lotion or cream that really will reduce the signs of aging.

“I’ve never been more excited about anything,” Mirkin said.

Still, whether nano-delivered gene regulation is going to be the next Botox remains to be seen.

Brian Alexander (www.BrianRAlexander.com) is co-author, with Larry Young PhD., of "The Chemistry Between Us: Love Sex and the Science of Attraction," (www.TheChemistryBetweenUs.com)  to be published Sept. 13.

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By Rachael Rettner
MyHealthNewsDaily

Young adults are doing things that dangerously increase their risk of skin cancer, according to new reports for the Centers for Disease Control and Prevention.

In 2010, half of all adults ages 18 to 29, and 65 percent of white people in this age group, reported that they were sunburned at least once in the past year, the report said.

In addition, about a third of white women reported using indoor tanning in the past year.

Both sunburn and indoor tanning increase the risk of melanoma, the deadliest type of skin cancer. Indoor tanning before age 35 increases melanoma risk by 75 percent, the CDC says.

While efforts to reduce indoor tanning have traditionally focused on adolescents, "This study suggests that as adolescents mature into young adults, they may continue to need environmental support to develop and maintain healthy behaviors and to change their perspectives about tanning," study researcher Anne Hartman, of the National Cancer Institute, said in a statement.

In one study, CDC researchers surveyed a nationally representative sample of about 5,000 adults ages 18 to 29 about their sun-protection behaviors and sunburn in the past year.

They found that while use of certain sun-protective behaviors, such as wearing clothing to the ankles and staying in the shade, increased between 2000 and 2010, the prevalence of sunburn remained about the same (about 50 percent). The researchers do not know whether sun-protective methods were used properly (for instance, whether a sufficient amount of sunscreen was applied.)

The majority of young adults did not adequately protect themselves from the sun. For instance, in 2010, 37 percent of women and 15 percent of men reported using sunscreen always or most of the time. Just 3.8 percent of women and 6.7 percent of men reported wearing a wide-brimmed hat. (Wide-brimmed hats provide full sun protection to the face, ears and neck, while baseball caps and sun visors do not provide sufficient protection, the CDC says.)

A second study surveyed about 25,200 adults ages 18 and over about their indoor tanning. Overall, 5.6 percent of adults said they had used indoor tanning in the past year. The highest prevalence was among white women ages 18 to 21, at 31.8 percent. In the Midwest, 44 percent of white women in this age group reported using indoor tanning.

Of those who used indoor tanning, about 58 percent of women and 40 percent of men reported tanning at least 10 times in the past year.

The U.S. Preventative Services Task Force recently recommended children and young adults ages 10 to 24 receive counseling from their primary care doctor on ways to reduce their skin cancer risk.

"More public health efforts, including providing shade and sunscreen in recreational settings, are needed to raise awareness of the importance of sun protection and sunburn prevention to reduce the burden of skin cancer," Dr. Marcus Plescia, director of CDC's Division of Cancer Prevention and Control, said in a statement. "We must accelerate our efforts to educate young adults about the dangers of indoor tanning to prevent melanoma as this generation ages," Plescia said.

The new CDC reports will be published tomorrow (May 11) the agency's Morbidity and Mortality Weekly Report. 

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By Joyce Ho, Stacey Naggiar, and Dr. Nancy Snyderman
NBC News

Growing up in Lakewood, Colo., Jodi Duke was like most high school girls her age -- eager for the beautiful bronze skin so often popularized in the media. 

“I think there's a lot of peer pressure,” said Duke. “You look in magazines, you look on TV, people are not pale ... and that, coupled with the peer pressure at school, I think leads to behavior that you seek out how to make yourself look different.”

She found indoor tanning beds the best quick fix to get the glow she wanted and developed a habit of visiting the salon once a week. Before she knew it, was going twice a week and eventually, every day.

At age 19, after a year of daily tanning, Duke was diagnosed with melanoma, the most dangerous type of skin cancer.

“I think I was kind of in a state of shock,” said Duke, who is now 36.  “I don’t remember a lot about that day except going in the bathroom and just crying.”

Duke is not alone. A new study published Monday in the journal Mayo Clinic Proceedings found the incidence of melanoma in young adults is soaring, with a six-fold increase in the past 40 years. The rise is particularly noteworthy in young females aged 18 to 39, where the incidence of melanoma increased eight-fold from 1970 to 2009, and four-fold in young adult males.

Tanning beds to blame?

Although the study didn’t examine why the numbers have increased, the researchers say gender-specific behaviors such as tanning -- a popular activity among young women -- may be behind this alarming trend.

“The number one thing – stop going to go tanning beds,” said dermatologist Dr. Jerry Brewer, one of the study’s authors. “All correlations point towards that as the reason for the increase.”

For Duke, who said she always knew in the back of her mind that tanning was unhealthy, receiving a melanoma diagnosis was a wake-up call.

“When I got this diagnosis I just knew,” she said. “And I never went back to another tanning bed.”

In response to Brewer’s study, the Indoor Tanning Association released a statement saying, “The authors attempt to make indoor tanning the story while ignoring other more likely risk factors such as heredity, sunburning outdoors and more frequent travel to sunny vacation locations over the last decade where severe sunburns are more likely to occur.”

The organization also pointed out that the population studied is not a representative sample of America. Minnesota, where the research was conducted, has a disproportionately high number of fair-skinned individuals who have higher risk for melanoma. More than 250 young adults, all of whom lived in Olmstead County, participated in the study where they were tracked for four decades as part of the Rochester Epidemiology Project.

The study authors acknowledged the demographic and socioeconomic makeup of the study population as a potential limitation to their findings.

Mortality rates decreasing

The findings were not all negative, however. Researchers found that although the incidence of melanoma is rising among young people, the mortality rates are actually decreasing. Brewer said that these better survival rates are most likely attributable to advances in early detection and awareness of changing moles.

According to Brewer, the important message to take away from the study is that young people can get cancer, and they’re not as invincible as they think.  In fact, another study published in the journal “Cancer Epidemiology, Biomarkers and Prevention,” found that people who have used tanning beds are 74 percent more likely to develop melanoma than those who have not.

Warning signs

According to dermatologist Dr. Robert Dellavalle from the University of Colorado School of Medicine, individuals with blue or green eyes, freckles, moles, or red hair are at higher risk for development of melanomas. Asians and those with darker skin have a lower risk, but may find themselves with more aggressive diagnoses when melanoma is found.

Experts caution that everyone should use SPF to protect themselves from sun damage.  Those with several risk factors for melanoma should exercise careful sun protection and supplement their diets with Vitamin D, the major nutrient we normally receive from sunlight.

After surgery at age 19 to remove a large portion of her arm and 48 weeks of immunotherapy treatment, Duke has now been cancer free for many years. In Aurora, Colorado, she now teaches her young daughters about the importance of sunscreen, and the scar on her arm is a constant reminder to them of what could happen without proper skin protection. 

“If i had to go back I think that one of the obvious answers is that I wouldn't ever tan,” said Duke. “And I would tell myself, ‘You look great the way you are.’”

NBC’s Wonbo Woo contributed to this report.

By Robert Bazell
Chief science and medical correspondent
NBC News

A single case reported Wednesday in the New England Journal of Medicine could indicate a significant change of the course of cancer treatment -- perhaps saving or prolonging thousands of lives.

For more than a century, scientists have been attempting to harness the immune system to fight cancer -- trying to get the antibodies and cells that protect us from bacteria and viruses to kill diseased cells.  Every once in a while, a tantalizing success occurred. But time and again the treatment could not be repeated.

The case begins with a drug called ipilimumab, approved in 2011 for advanced melanoma treatment. The drug turns the immune system into a cancer-killer, bringing some patients back from the brinkof death. Melanoma is one of the deadliest forms of skin cancer, striking 76,000 Americans and killing more than 9,000 every year. Because there are few treatments for advanced melanoma, the new drug was greeted with excitement by doctors and patients. But ipilimumab, sold under the brand named Yervoy by Bristol Myers Squibb, works in only 10 percent to 20 percent of patients.

Until now, no one knew why.

Valerie Esposito, a 42-year-old mother of three, was taking ipilimumab for advanced melanoma and it wasn’t working very well. The cancer was spreading through her body.  One huge tumor, in fact, was pressing on her spine. To relieve the pressure, her doctors at Memorial Sloan Kettering Cancer Center in New York radiated the lump. Within weeks, other tumors throughout her body started shrinking dramatically. 

This has occurred before in cancer immunology. But this time oncologist Dr. Jedd Wolchok and his team of melanoma specialists at Sloan Kettering think they have figured out, at the molecular level, exactly how that shot of radiation altered her immune system to allow the drug to kill far more cancer cells. It created pieces of tumors -- proteins called antigens -- that sparked specific changes in how antibodies and disease-fighting white cells recognized the cancer cells as foreign and thus destroyed them.  Already the researchers are planning a nationwide clinical trial to determine if the findings can allow the drug to help many more patients with advanced melanoma.

They also believe the same approach could work for kidney, lung and other cancers.

Other recent cancer research, also in the NEJM, demonstrated less promising results.

For decades, scientists have known that cancer occurs because of mutations that occur in adult cells in the genes that regulate cell growth. The ideas behind the current buzz words of 'targeted therapy” and “personalized medicine” postulate that researchers will understand the mutations in tumors and develop drugs to target them and stop the cancers. Indeed, a handful of such drugs have proved successful often in a relatively small percentage of cancers of one type or another. 

Determining the sequence of genes in cancers and finding mutations, so-called tumor markers, has gotten increasingly cheaper and easier.  As a result, the British scientists were able to show that within an individual's tumors, different mutations occur in different places and at different times.  The implication is that even if one mutation is stopped others will win out through natural selection and continue driving the tumor to grow.  As Dr. Dan Longo of Harvard points out in an editorial in the Journal “the simple view of directing therapy on the basis of genetic tumor markers is probably too simple.”

The search for cancer treatments has been a long, difficult struggle involving the efforts to understand some of the most fundamental aspects of life itself. We can expect , as we have seen today, steps both forward and back.

Follow Robert Bazell on Facebook and on Twitter @RobertBazellNBC

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By Linda Thrasybule
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Vitamin A supplements could reduce the risk of developing the deadly skin cancer melanoma, according to a new study.

The results show that people takingvitamin A were 60 percent less likely to develop melanoma over the six-year study. People who had taken the vitamin, but weren't currently taking it, did not gain any protective effect. 

The reduced risk was more pronounced in women than men.

"This is promising evidence that in addition to sun protection, there's another option that can help prevent melanoma," said Dr. Mary Gail Mercurio, a dermatologist at the University of Rochester Medical Center, who was not involved with the study.  

Vitamin A is found in foods such as sweet potato, carrots, spinach, milk, eggs and liver. The vitamin plays an important role in vision, bone health, immune function and reproduction, but high doses of it can be toxic. 

The study appears today (March 1) in the Journal of Investigative Dermatology.

Genetics could increase melanoma risk

Melanoma is the sixth leading cause of cancer in the U.S., according to the American Cancer Society. About 76,000 cases of melanomas will be diagnosed this year, based on recent estimates.

In the study, researchers examined about 69,000 men and women, and after about six years, 566 had developed melanoma.

Among the 59,000 people in the study who had never taken vitamin A supplements, there were 506 cases of melanoma, while among the 5,800 people who were currently taking it and had used it regularly over the past 10 years, there were 28 cases.

Study researcher Dr. Maryam Asgari, a dermatologist and research scientist at Kaiser Permanente in Oakland, said the protective effect might be stronger in women than men because men may be more susceptible to skin damage from ultraviolet radiation.

She pointed to a recent animal study that suggests females may have more natural antioxidant protection in the skin than males.

The new study also found the melanoma risk was reduced the most in those who took high doses of the supplement. But Asgari cautioned that takingtoo much vitamin A could lead to such harmful conditions   as birth defects, liver problems and bone loss.

"There are limits to how much vitamin A a person can consume," she said.

The recommended daily amount of vitamin A is 700 micrograms for adult women and 900 micrograms for adult men, according to the National Institutes of Health. Taking more than 2,800 micrograms of vitamin A could lead to toxic symptoms in adults.

Genetic risk

Reducing sunlight exposure has long been recommended to reduce the risk of melanoma. This includes limiting time in direct sunlight, wearing sun block and avoiding tanning beds. 

Unfortunately, not all melanoma is a result of sun exposure. There is also a strong genetic component, Mercurio said. "Even the most vigilant sun-avoider is at risk, especially if they are fair-skinned, freckle easily and have red or blonde hair."

Although she said the study's findings were compelling, she cautioned it's not clear how much vitamin A might bring a benefit.

"We don't know yet the optimal dosage," Mercurio said. "Further studies will clarify how much vitamin A in the form of a supplement would be of benefit for melanoma prevention." 

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By Allison Becker
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The Food and Drug Administration has for the first time approved a drug to treat advanced cases of the most common skin cancer, basal cell carcinoma, the agency announced Monday.

The drug, a capsule called Erivedge (generically known as vismodegib), treats basal cell carcinoma that has metastasized (spread through the body), or that cannot be treated with surgery.

In a clinical study in 96 people, 30 percent of those with locally advanced basal cell carcinoma (which had spread to surrounding tissue), and 43 percent of those with metastatic cancer (which had spread to distant sites in the body) saw their tumors shrink or heal while taking the drug, according to a statement from the FDA. Patients took one pill by mouth each day.  

Doctors treat non-metastatic cases with surgery, radiation or topical treatments, and have an extremely high success rate. But no other treatments exist for inoperable cases, such as people with tumors that have extended into the brain, or people who would become disfigured from surgery.

"This is exciting," said Dr. Désirée Ratner, director of dermatologic surgery at Columbia University Medical Center in New York. "I treat high-risk cases that are doable with surgery, but now there is a nonsurgical medical option for large, very advanced cases."

Ratner said she once had a patient whose tumor covered her entire upper back, and spread into her neck. That patient was not eligible for surgery, she said, but would perhaps have been a candidate for this drug, she said.   

Stopping the spread

Basal cell carcinoma originates in the top layer of the skin, spreads slowly and accounts for 80 percent of all skin cancer cases in the U.S. Each year about 2 million people in the U.S. receive a diagnosis of basal cell carcinoma, making it the country's most common skin cancer. However, less than 1 percent of diagnoses are metastatic. 

Factors that raise a person's risk include having fair, freckly skin, and being chronically exposed to the sun.

The FDA statement noted that Erivedge caused a range of side effects, including muscle spasms, hair loss, weight loss, nausea, fatigue, decreased appetite, vomiting and loss of taste. 

Pregnant women should not take Erivedge, as it could kill or harm a fetus, the agency said. 

How it works

Basal cell carcinoma is linked to mutations in genes that are part of a signaling pathway called the hedgehog pathway. Erivedge works by inhibiting the hedgehog pathway. 

In addition to helping patients with skin cancer, Erivedge might also treat people with other cancers, such as medulloblastoma, a malignant brain tumor that occurs in children; pancreatic cancer; and a type of lung cancer. The drug is currently in trials for other cancers.

Erivedge is produced by the company Genentech. 

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