The UV Advantage

By Dr. Ralph Moss from CancerDecisions.com Newsletter A. Bernard Ackerman, MD, is an exceptionally distinguished dermatologist and one of the world's foremost authorities on the subject of skin cancer. In 1999, after a long career in academic medicine, he founded and became director of the Ackerman Academy of Dermatopathology in New York. Largely because of his leadership and high standards, Dr. Ackerman's institution quickly became the world's largest training center in the field of dermatopathology. (Dermatopathology is the study of the disease processes that affect the skin. It involves detailed knowledge of the microscopic anatomy of the skin's structure in health and disease.) Dr. Ackerman and his six associates examine more than 100,000 skin specimens and do more than 4,000 consultations per year. Dr. Ackerman has published 625 research papers and his list of honors and awards includes this year's Master Award, given to one person a year by the American Academy of Dermatology. What makes this accomplished scientist particularly interesting is not just his distinguished career in academic medicine but the fact that he challenges some of the dermatology profession's most cherished dogmas. According to an article in the New York Times (July 20, 2004), at age 67, Dr. Ackerman "continues to teach and write, and also to ask for data and question his field's conventional wisdom." "The field is just replete with nonsense," he told the Times. For instance: Dr. Ackerman does not believe that the link between melanoma and sun exposure (a central dogma of dermatology) has been proven. He himself is deeply tanned and unafraid to expose his body to the sun. He does not believe that sunburns, even the painful or blistering kind sustained early in life, necessarily lead to cancer. While some studies do show a small association, he says, others show none. Even those studies that show some such correlation "disagree on when the danger period for sunburns is supposed to be," writes Gina Kolata, author of the New York Times article. Taken as a whole, "the research is inconsistent and fails to make the case." He doesn't buy the argument that sunscreens protect against melanoma. He points to a recent editorial in an orthodox journal, Archives of Dermatology, which also concludes that there is scant evidence to support this crucial dogma (Bigby 2004). Finally, while the incidence of basal cell and squamous cell carcinoma have been shown to be closely linked to lifetime sun exposure, Dr. Ackerman challenges the tenet that the more intense a person's exposure to the sun, the greater their risk of melanoma. He believes that the data for this also is not compelling. Although we are told that the incidence of melanoma increases in populations that live nearer the equator, the correlation is not that simple. Epidemiological data on melanoma, says Dr. Ackerman, are imprecise and inaccurate. The data simply "cannot demonstrate cause and effect." Indeed, a rec

An insider with the guts to oppose mainstream guidelines on exposure to sunlight, the best way for most people to make vitamin D, and on taking more than 400 IU of vitamin D per day in supplements, Dr. Holick has followed in Dr. Linus Pauling's footsteps, doing for vitamin D what Pauling did for vitamin C. Here is a fearless quotation describing some of the advice you may have believed: "So desperate is the anti-sun lobby to convince you of the dangers of the sun so that you will buy its products year-round, the representatives will tell you with a straight face that if it's February in Boston and you're planning to walk to the corner store to buy a quart of milk or sit outside on your lunch break, you should wear [smear on] sunscreen. This is wrong-headed and alarmist. Even on the sunniest February day, the sun isn't strong enough in New England or New York to increase your risk of skin cancer significantly... The scare tactics of the cosme-ceutical industry have been embraced by most of the dermatology profession. These groups have worked in concert and frightened the daylights out of people - or, to put it more accurately, frightened people out of the daylight." (pp12-13) Evidence is given from Dr. Holick's own work and others that vitamin D levels are too low in a large fraction of the world's humans, especially those with dark skin and living more than 30° from the equator. This deficiency causes more osteoporosis, rickets, high blood pressure, stroke, heart attacks, arthritis, multiple sclerosis and cancer than had been believed just 20 years ago. The types of skin cancer caused by excessive sunlight are easily treated and are rarely fatal. With the greatest care, Dr. Holick explains how to obtain the UVB rays from the sun (or tanning parlor lights) without receiving too much UVA or becoming burned. He does advocate the use of sunscreens, the ones that absorb UVA as well as UVB, after you have had all the sun exposure that is safe. For the very pale-skinned or for arctic dwellers, supplements are advocated. This easy-to-read book, backed by 120 citations to papers in peer-reviewed journals (unfortunately not numbered), has an index and a glossary. Dr. Holick is no outsider, having published over 200 peer-reviewed papers, and with a lifetime of research in dermatology and endocrinology. Not all is perfect. The little diet advice is misinformed (p55) , pretty much the low-fat low-cholesterol nonsense that has been discredited for years (http://www.thincs.org/unpublic.Joel4.htm). The Atkins diet is hardly a fad with 60,000,000 people using some form of it in the USA alone [Joel M. Kauffman, Low-Carbohydrate Diets, J. Scientific Exploration , 18(1), 83-134 (2004)]. In fact, vitamin D is made by the action of UVB on cholesterol in the skin! A large number of clinical studies showed that total cholesterol levels Some very fine data from two studies was given on the use of vitamin D supplements to prevent bone fractures (pp85-86). One

no less than 5 stars and attention from all who care about their health and well-being. I cannot imagine any reviewer not giving this book 5 stars (unless it were one from the sun-screen industry, perhaps). As one of the world's greatest experts on the health effects of UV radiation, Dr. Holick and his arguments cannot easily be contested and are perfectly reasonable and balanced. I found the book very well and clearly written and the tables in the back make it very easy for people anywhere in the world with any of the 5 types of skin to determine how much unprotected sun exposure to get. Do not miss out on this crucial information, this is the most lucid discussion of sunlight exposure I have read.

Often, but not too frequently, new health paradigms come along that seem counterintuitive to nature. And given enough time, along with approval of the prevailing economic and political interests, they become entrenched in society, and then very difficult to dislodge. So engrained it becomes, that it becomes a part of our regular vernacular. Take for instance our exposure to sunlight, or our lack of it. For if you haven?t heard, sun exposure causes skin cancer. Or unless you haven?t been around in the past decade, you obviously have not been aware of the epidemic of skin cancer that is affecting our citizens. There are countless numbers of public service announcements and television advertisements from sun tan lotion manufacturers warning you of exposure to these so-called harmful rays of the sun, Ultraviolet A and B to be exact. Well, Dr. Holick is here to tell you that what you have been hearing is not entirely correct. In fact, He is telling you that regular moderate exposure to sunlight is not only a requirement for a healthy life, but also a requisite for living. Being an Arizona native and having a history of non-melanoma skin cancer gives me a unique perspective. I will continue to receive moderate exposure to sunlight and try very hard to limit burning of any kind. For mankind has had a beneficial relationship with the sun for thousands of years. The key, as with many health related issues, is moderation.

If you suffer from any of the chronic diseases such as arthritis, depression, multiple sclerosis, fibromyalgia, etc., check out this book. Lack of vitamin D is rampant in our culture, where we slather on sunscreen to "protect" ourselves from the sun, which the dermatologists have taught us to fear. Sun on skin is natural, and without it we will have nothing but health problems. Get the book, it's easy to read; look at PubMed for more research findings that just came out, which prove what he says is true. I "treated" myself with tanning beds last winter, and my 20-year case of painful arthritis disappeared. With UV light and calcium supplements, my health is better than ever.