We don’t all need regular skin cancer screening – but you can know your risk and check yourself
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Australia has one of the highest skin cancer rates globally, with nearly 19,000 Australians diagnosed with invasive melanoma – the most lethal type of skin cancer – each year.
While advanced melanoma can be fatal, it is highly treatable when detected early.
But Australian clinical practice guidelines and health authorities do not recommend screening for melanoma in the general population.
Given our reputation as the skin cancer capital of the world, why isn’t there a national screening program? Australia currently screens for breast, cervical and bowel cancer and will begin lung cancer screening in 2025.
It turns out the question of whether to screen everyone for melanoma and other skin cancers is complex. Here’s why.
The current approach
On top of the 19,000 invasive melanoma diagnoses each year, around 28,000 people are diagnosed with in-situ melanoma.
In-situ melanoma refers to a very early stage melanoma where the cancerous cells are confined to the outer layer of the skin (the epidermis).
Instead of a blanket screening program, Australia promotes skin protection, skin awareness and regular skin checks (at least annually) for those at high risk.
About one in three Australian adults have had a clinical skin check within the past year.
Why not just do skin checks for everyone?
The goal of screening is to find disease early, before symptoms appear, which helps save lives and reduce morbidity.
But there are a couple of reasons a national screening program is not yet in place.
We need to ask:
1. Does it save lives?
Many researchers would argue this is the goal of universal screening. But while universal skin cancer screening would likely lead to more melanoma diagnoses, this might not necessarily save lives. It could result in indolent (slow-growing) cancers being diagnosed that might have never caused harm. This is known as “overdiagnosis”.
Screening will pick up some cancers people could have safely lived with, if they didn’t know about them. The difficulty is in recognising which cancers are slow-growing and can be safely left alone.
Receiving a diagnosis causes stress and is more likely to lead to additional medical procedures (such as surgeries), which carry their own risks.
2. Is it value for money?
Implementing a nationwide screening program involves significant investment and resources. Its value to the health system would need to be calculated, to ensure this is the best use of resources.
Narrower targets for better results
Instead of screening everyone, targeting high-risk groups has shown better results. This focuses efforts where they’re needed most. Risk factors for skin cancer include fair skin, red hair, a history of sunburns, many moles and/or a family history.
Research has shown the public would be mostly accepting of a risk-tailored approach to screening for melanoma.
There are moves underway to establish a national targeted skin cancer screening program in Australia, with the government recently pledging $10.3 million to help tackle “the most common cancer in our sunburnt country, skin cancer” by focusing on those at greater risk.
Currently, Australian clinical practice guidelines recommend doctors properly evaluate all patients for their future risk of melanoma.
Looking with new technological eyes
Technological advances are improving the accuracy of skin cancer diagnosis and risk assessment.
For example, researchers are investigating 3D total body skin imaging to monitor changes to spots and moles over time.
Artificial intelligence (AI) algorithms can analyse images of skin lesions, and support doctors’ decision making.
Genetic testing can now identify risk markers for more personalised screening.
And telehealth has made remote consultations possible, increasing access to specialists, particularly in rural areas.
Check yourself – 4 things to look for
Skin cancer can affect all skin types, so it’s a good idea to become familiar with your own skin. The Skin Cancer College Australasia has introduced a guide called SCAN your skin, which tells people to look for skin spots or areas that are:
1. sore (scaly, itchy, bleeding, tender) and don’t heal within six weeks
2. changing in size, shape, colour or texture
3. abnormal for you and look different or feel different, or stand out when compared to your other spots and moles
4. new and have appeared on your skin recently. Any new moles or spots should be checked, especially if you are over 40.
If something seems different, make an appointment with your doctor.
You can self-assess your melanoma risk online via the Melanoma Institute Australia or QIMR Berghofer Medical Research Institute.
H. Peter Soyer, Professor of Dermatology, The University of Queensland; Anne Cust, Professor of Cancer Epidemiology, The Daffodil Centre and Melanoma Institute Australia, University of Sydney; Caitlin Horsham, Research Manager, The University of Queensland, and Monika Janda, Professor in Behavioural Science, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How stigma perpetuates substance use
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In 2022, 54.6 million people 12 and older in the United States needed substance use disorder (SUD) treatment. Of those, only 24 percent received treatment, according to the most recent National Survey on Drug Use and Health.
SUD is a treatable, chronic medical condition that causes people to have difficulty controlling their use of legal or illegal substances, such as alcohol, tobacco, prescription opioids, heroin, methamphetamine, or cocaine. Using these substances may impact people’s health and ability to function in their daily life.
While help is available for people with SUD, the stigma they face—negative attitudes, stereotypes, and discrimination—often leads to shame, worsens their condition, and keeps them from seeking help.
Read on to find out more about how stigma perpetuates substance use.
Stigma can keep people from seeking treatment
Suzan M. Walters, assistant professor at New York University’s Grossman School of Medicine, has seen this firsthand in her research on stigma and health disparities.
She explains that people with SUD may be treated differently at a hospital or another health care setting because of their drug use, appearance (including track marks on their arms), or housing situation, which may discourage them from seeking care.
“And this is not just one case; this is a trend that I’m seeing with people who use drugs,” Walters tells PGN. “Someone said, ‘If I overdose, I’m not even going to the [emergency room] to get help because of this, because of the way I’m treated. Because I know I’m going to be treated differently.’”
People experience stigma not only because of their addiction, but also because of other aspects of their identities, Walters says, including “immigration or race and ethnicity. Hispanic folks, brown folks, Black folks [are] being treated differently and experiencing different outcomes.”
And despite the effective harm reduction tools and treatment options available for SUD, research has shown that stigma creates barriers to access.
Syringe services programs, for example, provide infectious disease testing, Narcan, and fentanyl test strips. These programs have been proven to save lives and reduce the spread of HIV and hepatitis C. SSPs don’t increase crime, but they’re often mistakenly “viewed by communities as potential settings of drug-related crime;” this myth persists despite decades of research proving that SSPs make communities safer.
To improve this bias, Walters says it’s helpful for people to take a step back and recognize how we use substances, like alcohol, in our own lives, while also humanizing those with addiction. She says, “There’s a lack of understanding that these are human beings and people … [who] are living lives, and many times very functional lives.”
Misconceptions lead to stigma
SUD results from changes in the brain that make it difficult for a person to stop using a substance. But research has shown that a big misconception that leads to stigma is that addiction is a choice and reflects a person’s willpower.
Michelle Maloney, executive clinical director of mental health and addiction recovery services for Rogers Behavioral Health, tells PGN that statements such as “you should be able to stop” can keep a patient from seeking treatment. This belief goes back to the 1980s and the War on Drugs, she adds.
“We think about public service announcements that occurred during that time: ‘Just say no to drugs,’” Maloney says. “People who have struggled, whether that be with nicotine, alcohol, or opioids, [know] it’s not as easy as just saying no.”
Stigma can worsen addiction
Stigma can also lead people with SUD to feel guilt and shame and blame themselves for their medical condition. These feelings, according to the National Institute on Drug Abuse, may “reinforce drug-seeking behavior.”
In a 2020 article, Dr. Nora D. Volkow, the director of NIDA, said that “when internalized, stigma and the painful isolation it produces encourage further drug taking, directly exacerbating the disease.”
Overall, research agrees that stigma harms people experiencing addiction and can make the condition worse. Experts also agree that debunking myths about the condition and using non-stigmatizing language (like saying someone is a person with a substance use disorder, not an addict) can go a long way toward reducing stigma.
Resources to mitigate stigma:
- CDC: Stigma Reduction
- National Harm Reduction Coalition: Respect To Connect: Undoing Stigma
- NIDA:
- Shatterproof: Addiction language guide (Disclosure: The Public Good Projects, PGN’s parent company, is a Shatterproof partner)
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Vitamin C (Drinkable) vs Vitamin C (Chewable) – Which is Healthier?
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Our Verdict
When comparing vitamin C (drinkable) to vitamin C (chewable), we picked the drinkable.
Why?
First let’s look at what’s more or less the same in each:
- The usable vitamin C content is comparable
- The bioavailability is comparable
- The additives to hold it together are comparable
So what’s the difference?
With the drinkable, you also drink a glass of water
If you’d like to read more about how to get the most out of the vitamins you take, you can do so here:
Are You Wasting Your Vitamins? Maybe, But You Don’t Have To
If you’d like to get some of the drinkable vitamin C, here’s an example product on Amazon
Enjoy!
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Gut-Healthy Spaghetti Chermoula
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Chermoula is a Maghreb relish/marinade (it’s used for both purposes); it’s a little like chimichurri but with distinctly N. African flavors. The gut-healthiness starts there (it’s easy to forget that olives—unless fresh—are a fermented food full of probiotic Lactobacillus sp. and thus great for the gut even beyond their fiber content), and continues in the feta, the vegetables, and the wholewheat nature of the pasta. The dish can be enjoyed at any time, but it’s perfect for warm summer evenings—perhaps dining outside, if you’ve place for that.
You will need
- 9oz wholewheat spaghetti (plus low-sodium salt for its water)
- 10oz broccoli, cut into small florets
- 3oz cilantro (unless you have the soap gene)
- 3oz parsley (whether or not you included the cilantro)
- 3oz green olives, pitted, rinsed
- 1 lemon, pickled, rinsed
- 1 bulb garlic
- 3 tbsp pistachios, shelled
- 2 tbsp mixed seeds
- 1 tsp cumin
- 1 tsp chili flakes
- ½ cup extra virgin olive oil
- For the garnish: 3oz feta (or plant-based equivalent), crumbled, 3oz sun-dried tomatoes, diced, 1 tsp cracked black pepper
Note: why are we rinsing the things? It’s because while picked foods are great for the gut, the sodium can add up, so there’s no need to bring extra brine with them too. By doing it this way, there’ll be just the right amount for flavor, without overdoing it.
Method
(we suggest you read everything at least once before doing anything)
1) Cook the spaghetti as you normally would, but when it’s a minute or two from being done, add the broccoli in with it. When it’s done, drain and rinse thoroughly to get rid of excess starch and salt, and also because cooling it even temporarily (as in this case) lowers its glycemic index.
2) Put the rest of the ingredients into a food processor (except the olive oil and the garnish), and blitz thoroughly until no large coarse bits remain. When that’s done, add the olive oil, and pulse it a few times to combine. We didn’t add the olive oil previously, because blending it so thoroughly in that state would have aerated it in a way we don’t want.
3) Put ⅔ of the chermoula you just made into the pan you used for cooking the spaghetti, and set it over a medium heat. When it starts bubbling, return the spaghetti and broccoli to the pan, mixing gently but thoroughly. If the pasta threatens to stick, you can add a little more chermoula, but go easy on it. Any leftover chermoula that you didn’t use today, can be kept in the fridge and used later as a pesto.
4) Serve! Add the garnish as you do.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Less Obvious Probiotics Benefits
- Making Friends With Your Gut (You Can Thank Us Later)
- What Matters Most For Your Heart? ← spoiler: this is why, while we do watch the sodium, we care more about the fiber
- All about Olive Oil: Is “Extra Virgin” Worth It?
- Our Top 5 Spices: How Much Is Enough For Benefits?
Take care!
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You, Happier – by Dr. Daniel Amen
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The implicit question “what’s your brain type?” makes this book sound a little like a horoscope for science-enjoyers, but really, the “brain type” in question is simply a way of expressing which neurochemicals one’s brain makes most and/or least easily.
That’s something that a) really does differ from one person to another b) isn’t necessarily fixed forever, but will tend to remain mostly the same most of the time for most people.
And yes, the book does cover figuring out which neurotransmitter(s) it might be for you. On a secondary level, it also talks about more/less active parts of the brain for each of us, but the primary focus is on neurotransmitters.
It’s easy to assume “everyone wants more [your favorite neurotransmitter here]” but in fact, most people most of the time have most of what they need.
For those of us who don’t, those of us who perhaps have to work more to keep our level(s) of one or more neurotransmitters where they should be, this book is a great guide to optimizing aspects of our diet and lifestyle to compensate for what our brains might lack—potentially reducing the need to go for pharmaceutical approaches.
The style of the book is very much pop-science, but it is all well-informed and well-referenced.
Bottom line: if you sometimes (or often!) think “if only my brain would just make/acknowledge more [neurotransmitter], this book is for you.
Click here to check out You, Happier, and discover a happier you!
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21% Stronger Bones in a Year at 62? Yes, It’s Possible (No Calcium Supplements Needed!)
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Bone density is a concern for a lot of people past a certain age, and it can lead to an endless juggling of vitamin and mineral supplements to try to get the right balance. Sachiaki Takamiya advocates for a natural diet- and exercise-based approach instead, showing good results with his Okinawan-influenced Blue Zones diet and lifestyle.
As a caveat, he has not gone through menopause, so this video does completely overlook the implications of that. Nevertheless, even if some of us must get our hormones from a bottle these days, this diet and exercise approach is a very good foundation and the advice here is important for all—we can take all the estrogen we need and still have weak bones if our diet and exercise aren’t there as needed.
From strength to strength
Sachiaki Takamiya’s bone density wasn’t bad the previous year, but this year it is better, hitting 123.4%. This is important information, because it’s easier to achieve an n% increase (for any given value of n) if your starting point is lower. For example, a 50% increase from 1g is 1.5g (so, 0.5g difference), whereas a 50% increase from 20g is 30g (so, a 10g difference). Since his starting value was high, this makes his 21% rise particularly noteworthy—and mean that a reader with a lower starting value will most likely see even better gains, if implementing this protocol.
You may be wondering: isn’t a bone mass density of 123.4% about 23.4% more than we want it? And the answer is that the 100% value is taken from an average peak bone mass in young adults, so having it at 100% is fine, and having it a bit higher is still better—it just means he’s outclassing healthy young adults, less likely to break a bone if he falls, etc.
As for what he ate: he focused on getting calcium and magnesium, as well as vitamins D and K2, all from food sources. Key foods included small fish (sardines, niosi, jaco), nattō, mushrooms, and seaweed (nori, wakame, hijiki). In particular, he emphasizes nattō’s benefits for bones, as well as for the gut, heart, and brain.
As for his exercise: he did weight-bearing exercise and resistance training—including calisthenics and yoga, as well as sport, and simply walking and running. His weekly routine looked like this:
- Monday: heart rate zone 2 jogging (45 min)
- Tuesday: bodyweight HIIT and flexibility (20 min)
- Wednesday: heart rate zone 2 jogging (60 min)
- Thursday: bodyweight HIIT and flexibility (40 min)
- Friday: heart rate zone 2 jogging (45 min)
- Saturday: bodyweight HIIT and flexibility (20 min)
…as well as social sports (e.g. tennis, amongst others), and additional activities such as gardening, and cycling for groceries.
For more on all of the above (this is a very information-dense video), enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Vit D + Calcium: Too Much Of A Good Thing?
- The Bare-Bones Truth About Osteoporosis
- Which Osteoporosis Medication, If Any, Is Right For You?
- How To Do HIIT (Without Wrecking Your Body)
- The Five Pillars Of Blue Zone Longevity
Take care!
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Why Do We Have Crooked Teeth When Our Ancestors Didn’t?
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Evidence shows that people in ancient times typically had straight teeth set well into strong jaws, with even wisdom teeth fitting properly.
So, what went wrong? Did evolution do us a disservice?
Some information to chew on
Transition from hard-to-chew diets to processed, refined foods over millennia has reduced jaw size while tooth size stayed constant. Smaller jaws lead to tooth crowding, crookedness, and impacted wisdom teeth, requiring braces or extractions in modern times.
However, all is not lost!
Studies on non-human animals show softer diets reduce jaw and facial growth, causing dental crowding. In other words: dental crowding is primarily attributed to dietary and lifestyle changes, though genetics may play a role.
And notably, when it comes to humans, populations with less processed diets experience fewer dental problems, suggesting lifestyle modifications could help prevent tooth crowding.
And no, it is not too late. Remember, you are rebuilding your body all the time, including your bones!
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Exercises That Can Fix Sinus Problems (And More) ← this also improves the jaw structure
Take care!
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