A study conducted by the Centers for Disease Control and Prevention showed that the average annual number of adults treated for skin cancer was 3.4 million in 2002 and 4.9 million in 2011.
Skin cancer is of particular concern in Colorado because of the elevation, said Dr. Kevin Whaley with Summit Dermatology. “We’re high in elevation; and, for every 1,000 feet you go up, you lose 6 to 7 percent of the protection naturally provided by the atmosphere,” he said.
Melanoma is the most lethal form of skin cancer, said Dr. Michael Leslie with Vanguard Dermatology. “This is one of the rare cancers that is increasing in number these days,” he said. “An estimated 120,000 new cases will be diagnosed in 2015. About 10,000 people die from it per year.”
Both Whaley and Leslie said they use the ABCDEs of melanoma to help determine whether a skin lesion or mole is melanoma. A lesion could be melanoma, if it meets all of the following:
A – asymmetrical
B – border is uneven, notched or fuzzy
C – color is uniform with no variations like blacks, reds or whites
D – diameter is bigger than about one quarter of an inch
E – evolving and changing in any way, including size, color and shape
“If you see something that meets the ABCDE criteria, it doesn’t mean it’s bad but you should probably get it checked out,” Whaley said.
“Early sun exposure, especially sunburns that blister can increase your risk of getting melanoma. You should use sunscreen, hats and sunglasses. Try to avoid sun exposure between 10 a.m. and 2 p.m. Make sure to reapply sunscreen. A lot of people don’t put enough of it on so they don’t get the full SPF value. I would recommend putting it on about 30 minutes before going outside.”
Sunscreens that include helioplex and thelios ingredients lasts longer on the skin, Whaley said.
While overexposure to sunlight can lead to melanoma or other types of skin cancer, genetics equates for more than half the risk of developing melanoma, Whaley said. “The biggest risk factors for getting melanoma are genetic,” he said. “If your immediate family members like your parents, children and siblings have it, that increases your risk.”
Whaley said having irregular moles also increases the risk of developing melanoma so those moles need to be checked on a regular basis. “Some melanomas grow sideways or radially, and others grow deeper,” he said. “Deeper melanomas worsen your odds of beating it.”
The most common areas for women to develop melanoma is on their legs, while the most common places for men is on their back, Leslie said.
Whaley said it is a common misconception that people cannot get a sunburn on the palms of their hands or the soles of their feet, so any skin cancer-related risk is slim. “You can still get melanoma on your palms or your feet,” he said. “I’ve had people who have had melanoma under their toenails.”
For more superficial melanomas, the typical treatment is excision in an area slightly larger than the lesion, Leslie said. “That can be done under local anesthetic in the office,” he said. “For more invasive types, newer treatments have been developed that target certain cell-signaling molecules, which is much more effective than chemotherapy.”
“Your prognosis can be greatly improved if you get early screening. Early detection is the key.”
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Political controversy and U.S. Supreme Court lawsuits over retail recreational marijuana in Colorado have taken the focus off medicinal cannabis, legalized in Colorado in 2000. Recreational marijuana can be purchased without the additional step of a doctor's authorization. Despite the increasing ease and availability, the number of registered medical marijuana patients has grown almost 10 percent since Amendment 64 passed.
Cannabis for the psychoactive effects can be consumed by inhaling and eating. Patients can get other medical benefits from marijuana and the cannabinoid chemicals in the plant by using topical infused products such as eye drops and skin salves.
“Topicals are fantastic for inflammation reduction; and, if they are formulated correctly, they can take the place of many pain medications and even prevent surgeries,” said Rebecca Holley, founder of Therapy in a Bottle in California. She said her company makes salves, massage oils, bath soaks and sugar scrubs with and without cannabis infusion.
Holly said her target market, such as people over 40, state workers and law enforcement personnel, are not going to walk into dispensaries. “We needed a way to accommodate them and bring non-believers through the back door of the cannabis world, using hemp seed oil and other botanicals; and then giving them the option of something cannabis-infused.”
The Medical Marijuana Registry Program Update, published monthly by the Colorado Department of Public Health and Environment, reports that about 1 percent of Colorado medical marijuana cards are issued for glaucoma, 4 percent for cancer and the side effects of cancer treatments, 1 percent for HIV/AIDS and 2 percent for seizures. Ninety-four percent of medical cards were issued for severe pain. Patients can report more than one condition on their application.
Tetrahydrocannabinol, usually referred to as THC, is the primary psychoactive part of marijuana products. Cannabidol, or CBD, has apparent medical benefits without the side effect of creating a pot high in the patient. High-CBD strains of marijuana have been developed to cater to the medicinal market.
“Many recreational outlets in Colorado and Washington are finding adult consumers prefer infused products, edibles and tinctures because it does not necessitate harming their lungs,” said Mitchell Stern, president of Burning Bush Nurseries, a marijuana grow operation in California that caters to medical dispensaries. “The level of ingenuity that we see among CBD-infused-products rivals the creativity of THC-infused products, both in marketing and substance. At a recent trade show, I received a kit of three different tincture sprays, all made with CBD-rich plant material so as not to get the user high.”
The federal Controlled Substances Act continues to classify marijuana as a drug with “no currently accepted medical use.” The medical dispensary industry continues to try to find legal means to scientifically prove any benefit to medical marijuana. In December, the Colorado Board of Health approved $8.4 million for grants over five years to research the medical impacts of cannabis products.
If this upcoming research is able to offer scientific backup for pro-legalization activists' claims of health benefits, high CBD strains and infused products could become more accessible and culturally acceptable to more people and health organizations. Stern said, “As more and more adults become less concerned with the social stigma surrounding cannabis, I think more and more people will realize that there are better treatment options available that don't include the use of prescription drugs that bring with them a myriad of side effects.”