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IT'S SUMMERTIME already,
Yes, it's rough to be a fair-skinned 44-year-old who grew up in Phoenix with no sunblock. Now I bug him about sunblock all the time. But like many of the tanners at my gym, the damage is already done, and more skin cancers are an inevitable fact of life.
At 44, or even 30, you can be a zealot about sunblock for the rest of your life and still get skin cancer, because the majority of the damage was done before you were 18. Sun causes the vast majority of skin cancers, so it's very preventable. That's where we, as parents, have to come in.
Whatever you believe about global warming and the loss of the ozone, it is an undeniable fact that skin cancer is on the upswing, especially in younger people. Rates in the U.S. have climbed about 3 percent per year in the last 25 years. So be an overprotective parent when it comes to sunblock, hats and sunglasses for your child. Use an SPF of 15 or higher, with UVA and UVB protection.
Don't let your kids go out without it, just as you wouldn't let them ride without a car seat (let's hope).
Keep babies in the shade with their skin covered as much as possible, though you can apply sunblock to babies under the age of 6 months, when necessary.
Darker-skinned people don't burn easily but should still wear sunblock. They are at lower risk for skin cancer, but still can have significant damage to skin cells from the sun.
Anyone whose skin darkens in the sun is sustaining damage. Ultraviolet rays damage the skin cells, and the cells respond by making more melanin, which darkens the skin. So tan skin is damaged skin--there is no such thing as a "healthy tan."
Studies have shown that some people actually get addicted to tanning. The damage to the skin causes the release of endorphins (the body's narcotics), which becomes addictive. But you can get the same high from tough exercise, and that's much better for you. So climb out of that tanning booth and go for a walk (with sunblock on!). If you must be brown, get the fake stuff in a bottle.Advocates for better health
Speaking of addiction, we all need to get our kids addicted to exercise. It's warm now--get your kids off the couch or off the computer and outside running around (with sunblock on, of course). Take advantage of the long hours of sunlight and balmy temperatures.
The American Academy of Pediatrics recently released a statement regarding the pediatrician's role in the prevention and treatment of obesity in children. The AAP recommended that we advocate strongly for:
School and community recreation programs that encourage physical activity.
School curriculums that foster better nutrition.
The creation of school wellness councils that include physician representation.
The reinstatement of compulsory, quality, daily physical education programs.
The protection of school recess time.
The creation of safe recreational facilities, parks, playgrounds, bicycle paths, sidewalks and crosswalks.
More funding for quality research into the prevention of childhood obesity.
Social marketing that promotes physical activity.
But really, pediatricians advocating for these things isn't enough. Parents have more power in schools and, as consumers, more power in influencing companies to provide healthy choices for our children.
If we didn't buy so many french fries and started overwhelming McDonald's with requests for more salads, fruits and veggies,
Parents/consumers can boycott companies that advertise unhealthy foods during children's television shows. We can campaign in our children's schools for daily PE, recess time, healthy food in the cafeteria and no vending machines for soda or junk food. After all, we as taxpayers pay for schools, and we do have a say in what goes on there.
Every time I see a second grader who weighs as much as me (which happens pretty regularly now), I am re-inspired to work hard in this field.A promising vaccine
Speaking of prevention, two vaccines for HPV (human papilloma virus) are being developed currently, and the FDA approved one of them late last week.
Cervical cancer is almost completely preventable by avoiding certain strains of HPV. These are the viruses that cause warts, and certain strains cause genital warts. Infection occurs during sexual contact. Many young women contract it in the first few years of sexual activity, and it is often unnoticed and asymptomatic until later, when abnormal Pap smears start to occur.
Cervical cancer is one of the most detectable of all cancers, because it can be picked up on routine Pap smears. HPV testing can now be done on the same sample taken for the Pap smear. But even when it's picked up early, sometimes the treatment can lead to infertility or an "incompetent" cervix (which leaves a woman unable to carry a baby to term).
The new vaccines could prevent all that. They likely will be marketed to pre-teen girls, to immunize them before any sexual contact has occurred. Ask your health-care provider for more details as they become available.
Abstinence with no genital contact at all is currently the only way to prevent HPV transmission, but using condoms can reduce it significantly. Teen girls who are sexually active should start having annual Pap smears to watch for signs of this potentially deadly virus.Envisioning the future
With more and more scientific developments, it seems that parents and pediatricians have more and more responsibility for the future, adult health of children.
A conference I attended in April at Johns Hopkins included a lecture about the future of pediatrics given by the head of the pediatric department there. He envisioned that in the years to come, all babies will have extensive genetic testing done at birth, so we will know what diseases they are susceptible to and what to watch for, as well as how to treat each child individually.
This raises concerns about being uninsurable if you are born with a high risk for diabetes, for example. One might also wonder about the "self-fulfilling prophecy" of being at high risk for depression, school failure or violence, for example. But the benefits would be enormous in helping to diagnose and properly treat each child before conditions were severe, and sometimes preventing them completely.
In the meantime, we are still in the primitive years of the medical field, and we have to do everything preventively that we know how. Even people with a low risk for skin cancer should wear sunblock. Even people with low heart-attack risk should eat a diet low in saturated and trans fats, and high in fiber and fruits and vegetables. Even those with low risk for adult-onset diabetes should maintain a healthy weight, etc., etc.
It's better to be a zealot about prevention than to see your child suffer with a preventable illness later on.
For more on summer safety, see the American Academy of Pediatrics' Web site, aap.org, for tips on boating safety, sun safety, heat safety, mosquitoes, ticks, etc.
DR. ROXANNE ALLEGRETTI welcomes reader comments and questions. Write her at Free Lance-Star, 616 Amelia St., Fredericksburg, Va., 22401 or e-mail at