Letters for the week of July 14-20, 2004 

Too little sunlight kills more people than too much. Careful with your conclusions about the Columbine shooters.

"Under the UV Sun," Feature, 6/23

Sunlight: Too much is better than not enough
I was glad that you at least mentioned Michael Holick and some of his findings. Inasmuch as the article focused very heavily on the risks of sun exposure in causing skin cancer, I wish you had mentioned a passage in Holick's The UV Advantage where he talks of the work of researcher Dr. William Grant (SUNARC.org). Grant estimates that in 2002, insufficient sun exposure leading to vitamin D deficiency caused 85,000 more cases of cancer and 30,000 more deaths from cancer. This is far more than the 7,500 estimated annual deaths from skin cancer that you quote. Even adding in an estimated 3,000 more deaths that might result from increased sun exposure (Grant's estimate), the proper (not reckless) sun exposure Holick and Grant emphasize would still save 20,000 lives per year from cancer alone.
Michael Babcock, Oakland

The vitamin D deficiency
The story presented both sides of the tanning issue, but in a manner that emphasized the adverse health impacts using anecdotal evidence. Scientific conclusions of this nature are generally reached on the basis of observations of a large number of people in which all factors that could affect the outcome are included. There have been only two studies in the United States that examined the link between indoor tanning and melanoma; the one in the SF Bay Area found a statistically insignificant risk reduction, while the one in Connecticut found an insignificant risk. In Canada and Europe, a 50 percent increased risk of melanoma is generally found in such studies, but there are likely a number of differences between lifestyle and tanning practices there than in the US.

The primary risk factors for melanoma include frequent sunburning, fair skin, freckles, numerous moles, a high-fat, low-fruit and -vegetable diet, alcohol consumption, etc. Surprisingly, occupational exposure to solar UV reduces the risk of melanoma according to studies in Canada, Denmark, and the Netherlands. Lifetime dose of UV is a risk factor for basal cell and squamous cell carcinoma, so one should not tan excessively.

As for the health benefits of UV radiation, they are primarily related to vitamin D production from the UVB portion (290-315 nm). Both solar radiation and lamps used in tanning beds have 3 to 5 percent of the UV radiation in the UVB region. My research indicates that 47,000 Americans die prematurely from sixteen types of internal cancers annually from insufficient UVB or vitamin D. Also, that half of the estimated 400,000 Americans with multiple sclerosis (MS) would not have MS if they lived in the southern states and spent a modest amount of time in sunlight. Many bone and muscle diseases are linked to insufficient vitamin D, as are a number of other diseases and conditions.

There is, indeed, a vitamin D deficiency epidemic in the US. Most Americans derive the majority of their vitamin D from solar UVB radiation. Dietary sources are generally insufficient for optimal health unless one eats lots of fatty fish, which has its own problems. The current estimate is that people need about 1000 IU per day. Exposure to natural and artificial UVB is a good way to generate vitamin D, and to look good as well.

For more information on the health benefits of UVB and tanning, and counters to the arguments from the dermatologists, please visit our Web site, SUNARC.org.
William B. Grant, Ph.D, founding director, Sunlight, Nutrition and Health Research Center (SUNARC), San Francisco

Get thee to a dermatologist
Thanks for letting your readers know about the very real issue of skin cancer. After spending most of my youth on the beaches of Southern California burning and peeling, I found myself a thirty-year-old recovering melanoma patient. Luckily I found mine in time. Six months later, and I would not have been so lucky. Use sunscreen, get over tanning, and get to a dermatologist for a checkup!
Jamie Alexander, Berkeley

Check that mole
I read with interest your article on melanoma. I too had an oversize mole on my hairline (covered with bangs), which I noticed was bleeding. I took myself to the county hospital and the doctor told me it was only a skin tag (never heard that name before). They offered to take it off, but I thought, why bother? I ignored it, even when it briefly bled again. While reading the article, I put up my hand to feel it for the first time in years. It had all but disappeared.

I wonder if Billy had been told the same thing. I was lucky. The public should be better informed about such things.
Jerri Willmore, Walnut Creek

Scared pale
Near the end of 2002, I was diagnosed with melanoma. I was 39 years old. Not only did I have a melanoma on my leg, but also on my right temple. The small mark on my temple that I had asked my doctor to take a look at during that first visit turned out to be even deeper and more advanced than the cancer on my thigh. I had three different surgeries to remove the melanomas. My doctor suggested that I get a CT scan of my head and abdomen just to make sure the melanoma had not metastasized.

A few days after the scan, I remember sitting on this cold metal table; my doctor sat down in front of me, folded his hands, and said: "Rich, the CT scans are showing four masses on your liver. The cancer may have spread." He suggested I get an ultrasound. That test also showed four masses on my liver. One oncologist I met with told me that if the melanoma had spread to my liver, there's not much they can do because it's such an aggressive cancer. It seemed like everyone I told about this had someone they knew who died of melanoma. Not good for the psyche! I had to wait another three weeks before I could get an appointment for a PET scan -- which is the most advanced exam for finding cancer cells.

Soon after the PET scan, I met with an oncologist to review the findings. He wasn't sure what the doctors had seen on those CT scans and the ultrasounds. He said maybe the masses were just clusters of blood vessels (hemangiomas) and the test might have been what they call "false positives." He said that hemangiomas are not dangerous, but they can look like cancer in a CT and an ultrasound. Then he looked at me and said, "All that matters, Rich, is that I can confidently say that you're 100 percent cancer-free."

I was a competitive bodybuilder for ten years and I owned a health club near Boston with tanning beds that I used to get a "base tan" before competitions. So I know I brought this scare on myself. When I was going through this melanoma experience, I promised myself that I would never go in a tanning bed again and that I would always wear sunscreen. I have a great life. It was hard to believe that I might be leaving early. I hope no one has to go through the fear I went through to learn the lessons I needed to learn.
Rich Fettke, Lafayette

"The Bullying Industrial Complex," Feature, 6/16

The Monkees helped, too
As Park Day School's community outreach coordinator, I would like to clarify something in Katy St. Clair's well-researched and -written article on bullying. Second graders at Park did not write the antibullying pamphlet Stop Bullying in Elementary School. Credit belongs to the Super Dragon Peace Monkees, a second-grade class at Park Day (the Peace Dragons), and a second- and third-grade class at Emerson School (the Super Monkees).

The brochure, the result of a months-long collaboration between the two classes, was supported by the Mosaic Project and Park Day's Community Outreach Program. Bringing two groups of kids together from private and public school to work on an issue that affects all children was one of the most important aspects of the project. In November, none of the students knew each other. By May, when they were performing antibullying skits, kids from the two schools had forged meaningful friendships.

Emerson's kids deserve as much credit as the Park kids.
Laurie Grossman, Oakland

Behavior is a priority
My children (second and fifth grade last year) attend a private elementary school that from day one in kindergarten actively promotes appropriate behavior. They have class rules, meetings, and discussions about how to treat each other.

Last semester, my second grader brought home a new sheet about "problem solving." It was a small piece of paper that outlined for the kids how to express themselves when they are having a disagreement while maintaining responsibility for their own contributions. We do not have a problem with bullies, and the older and younger grades regularly play together. I think if the schools made it a priority to emphasize being responsible for your own behavior at a young age, it can help keep the "bullies" from ever developing.
Julie Pilling, Oakland

CORRECTION
We incorrectly identified the man in the photograph that accompanied our July 7 Calendar item about the Brainwash Drive-In Movie Festival. He was not Mark States, but DJ Neel N. Kizmiaz.

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