Be careful of the amount of exposure to the sun during peak summer: HCFI

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Sun safety measures can help prevent skin cancer

New Delhi, 20th May 2019: Statistics indicate that the incidence of skin cancer is about 70% more in Indian men than women. It is one of the most common types of cancers around the world and can even occur without regular sun exposure. May is observed as the skin cancer awareness month and the need of the hour is to raise awareness on how to protective oneself from the condition.

Skin cancer occurs when there is unchecked growth of unnatural skin cells or tissues. The causes range from genetic factors to exposure to ultraviolet radiation. Although melanoma is the least common form of skin cancer, it accounts for majority of deaths due to the condition. Most skin cancers can be easily prevented by practicing sun safety measures.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “Melanoma is one of the deadliest forms of skin cancer and develops in melanocytes or the pigment cells present in the skin. It can spread to other parts of the body (metastasize) and cause serious illness and death. One can use the ABCDE rule to spot signs of melanoma: A symmetry – one part of a mole or birthmark doesn’t match the other; B order – edges are irregular, ragged, notched, or blurred; Color – this is not the same all over and may include shades of brown or black, sometimes with patches of pink, red, white, or blue; Diameter – spot is larger than ¼ inch across – about the size of a pencil eraser; Evolving – mole is changing in size, shape, or color.”

Some common symptoms of skin cancer include changes to skin; a skin sore that fails to heal; a spot or sore that becomes painful, itchy, or tender, or which bleeds; a spot or lump that looks shiny, waxy, smooth, or pale; a firm red lump that bleeds or appears ulcerated or crusty; and a flat, red spot that is rough, dry, or scaly.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “Cancer, if detected early, can be treated at a much lower cost compared to that incurred when diagnosed at an advanced stage. The mortality rate is also lowered substantially if people report for screening when the earliest symptoms manifest. Unfortunately, nearly two-thirds of cancer cases are diagnosed at an advanced stage, reducing patients’ chances of cure and survival.”

Cancers of unknown primary or CUP accounts for up to 4 to 5 percent of all cancer diagnoses and can be classified into four categories: Adenocarcinoma, Squamous cell carcinoma, Neuroendocrine carcinoma (differentiated or poorly differentiated) and poorly differentiated cancer. Accurate prediction of the tissue of origin using immunohistochemical staining and/or gene expression profiling is now possible in most CUP patients, and site-specific therapy based on these predictions is replacing empiric chemotherapy as the new treatment standard.

Some tips from HCFI

  • Avoid the sun during the middle of the day. Schedule outdoor activities for other times of the day, even in winter or when the sky is cloudy. Clouds offer little protection from damaging rays. Avoiding the sun at its strongest helps you avoid the sunburns and suntans that cause skin damage and increase your risk of developing skin cancer.
  • Wear sunscreen year-round. Sunscreens don’t filter out all harmful UV radiation, especially the radiation that can lead to melanoma, but they do give overall sun protection. Use a broad-spectrum sunscreen with an SPF of at least 15.
  • Wear protective clothing. Cover your skin with dark, tightly woven clothing that covers your arms and legs and a broad-brimmed hat, which provides more protection than a baseball cap or visor does.
  • Opt for sunglasses that block both types of UV radiation — UVA and UVB rays.
  • Avoid tanning beds. Tanning beds emit UV rays and can increase your risk of skin cancer.
  • Become familiar with your skin so you’ll notice changes. Examine your skin regularly for new skin growths or changes in existing moles, freckles, bumps and birthmarks.

Ignore TSH up to 10

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An international panel of experts has concluded that patients with subclinical hypothyroidism should not be routinely offered thyroid hormone replacement therapy.

In the recommendations published online this week in the BMJ, the expert panel writes “for adults with subclinical hypothyroidism, thyroid hormones consistently demonstrate no clinically relevant benefits for quality of life or thyroid-related symptoms, including depressive symptoms, fatigue, and body mass index (BMI).”

The guidance, based on findings from a systematic review and meta-analysis of 21 trials with 2192 participants published in November (JAMA. 2018;320:1349-1359) represents a “strong recommendation” against prescribing thyroid hormones (primarily levothyroxine LT4) in adults with subclinical hypothyroidism.

Subclinical hypothyroidism is defined as elevated thyroid stimulating hormone (TSH) levels when free T4 (thyroxine) levels are normal.

  • Subclinical hypothyroidism is known to affect around 5% of the adult population and 10-15% of the elderly.
  • About 90% of patients with subclinical hypothyroidism have TSH levels of 4-10 mlU/L, but a slight increase may be normal in older people.
  • Symptoms when present include fatigue, muscle cramps, sensitivity to cold, sluggish thinking and depression; as per the expert panel, 20-25% of people with normal thyroid levels report one or two of these symptoms.
  • In the majority of cases, the issue resolves itself. About 62% of people with TSH levels of 4-10 mlU/L have normalization of thyroid levels within 5 years without any treatment, states the report. The risk of overt hypothyroidism emerging from the subclinical forms of the condition ranges between 2% and 5% per year.
  • Observational data suggest an association between subclinical hypothyroidism and an increased risk of coronary heart disease, the associations have not been seen with TSH levels of 5-10 mIU/L.

(Source: Medscape)

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA