Do Tanning Beds Really Cause Melanoma?
If you believe all the negative hype on tanning beds that's going around lately, you'll run the other way instead of enjoying this easy and pleasurable way to get some vitamin D.
But Dr. William Grant of the Vitamin D Council has taken a closer look at the claims that sunbeds can cause melanoma - and an untimely death - and found that the observational studies showing tanning booths are harmful did't consider many of the confounding factors for melanoma risk, such as:
Solar UV exposure
Type of UV lamp
Additionally, he points out that observational studies are not generally accepted by the health or medical community as proof of cause. In fact, he says, "many of the same authors largely rejected observational studies of beneficial effects of vitamin D in reducing risk of cancer, although allowed that findings for colon cancer were reasonably strong."
A Closer Look at Tanning Beds and Melanoma Risk
A study published in the July issue of the British Medical Journal1 estimates that sunbed use in 18 European countries accounts for nearly 2,000 cases of melanoma per year for men and just over 2,340 cases per year for women in 2008. The authors claim your risk of melanoma doubles if you begin using a sunbed before the age of 35.
But according to Dr. Grant:
"A more important question in melanoma risk is death from melanoma. The mortality rate can be estimated by the ratio of melanoma deaths to cases in the 27 countries of the European Union, available from GLOBOCAN. Assuming that the EU-18 used... account for 71 percent of both cases and deaths, there would be 186 melanoma deaths for men and 304 deaths for women in 2008.
Any evaluation of whether something should be used should also estimate benefit.
This was not done...
Sunbeds are a good source of vitamin D, producing at least 10,000 IU in a single session. There are about 15 types of cancer for which solar ultraviolet-B (UVB) irradiance has been found inversely correlated with incidence or mortality rate in ecological studies. Vitamin D production is the only mechanism suggested to explain the findings."
He goes on to discuss how one can estimate the benefits of reducing the risk of internal cancers with the use of tanning beds. Citing a 2010 Swedish study2 that investigated the relation between prediagnostic vitamin D levels and incidence of breast, colorectal, and other cancers, Dr. Grant claims the benefit-to-risk ratio based on overall cancer deaths to melanoma cancer deaths is 47 to 1 for men and 37 to 1 for women.
"Since there are many other health benefits of vitamin D, the overall benefit-to-risk ratios are much higher," he writes. "There have been several papers reporting health benefits of sunbed use including higher bone mass density, reduced risk of thrombotic events, and reduced risk of endometrial cancer.
It should also be noted that the role of UV in risk of melanoma is complex. Those who have chronic UV exposure do not have higher risk of melanoma than others. Solar UVB light is the primary source of vitamin D for most people. In winter at high latitudes, it is impossible to make vitamin D from solar UVB. One source for vitamin D in winter is artificial UVB as from sunbeds..."
Interestingly, another meta-analysis that didn't get any traction in the mainstream press was published in the April issue of Public Health Nutrition.
It states quite succinctly:
"The literature was searched in the electronic database MEDLINE to indentify published data between 1981 and 2011. Studies were included if they reported relative risk for cutaneous malignant melanoma (CMM) associated with sunbed use, vitamin D and UV effects on human health. UV from sun and sunbeds is the main vitamin D source. Young people with white or pigmented skin in northern Europe have a low vitamin D status. A number of health benefits from sufficient levels of vitamin D have been identified. However, UV exposure has been suspected of causing skin cancer, notably CMM, and authorities warn against it.
Conclusions: The overall health benefit of an improved vitamin D status may be more important than the possibly increased CMM risk resulting from carefully increasing UV exposure. Important scientific facts behind this judgement are given."
Optimizing Your Vitamin D Levels Can Cut Your Internal Cancer Risk - - - IN HALF
As Dr. Grant and the Public Health Nutrition review concluded, the dramatic reduction in overall cancer risk, along with all the multi-varied health benefits associated with improved vitamin D status, more than makes up for any potential increase in melanoma risk when using a tanning bed. Again, the benefit-to-risk ratio of reducing your risk of dying from any particular type of cancer, compared to your risk of dying from melanoma could likely be anywhere from 37 to 47 to 1 according to Dr. Grant.
According to the authors of that Swedish study Dr. Grant cited above:
"These analyses estimated that the 50 percent reduction in incidence occurs for a value of 78 nmol/L [31 ng/ml] compared with the value at 24 nmol/L [10 ng/ml] for breast cancer, and a value of 60 nmol/L [24 ng/ml] compared with the value at 15 nmol/L [6 ng/ml] for colorectal cancer."
A rather voluminous amount of research now attests to the protective effect of vitamin D against at least 16 different types of cancer, and as stated above, normalizing your vitamin D levels can cut your internal cancer risk IN HALF! And that's just by raising your levels up to the 30 ng/ml range, which is still believed to be a deficiency state by most vitamin D experts. Ideally, you want your vitamin D levels in the 50-70 ng/ml range, and even upwards of 100 ng/ml if you have or are seeking to prevent cancer or heart disease.
Sensible Sunlight Actually Protects Against Melanoma
Another important factor to remember is that exposure to UVB light is actually protective against melanoma - or rather, the vitamin D your body produces in response to UVB radiation is protective.
As written in The Lancet:
"Paradoxically, outdoor workers have a decreased risk of melanoma compared with indoor workers, suggesting that chronic sunlight exposure can have a protective effect."
Another study in Medical Hypotheses suggested that indoor workers may have increased rates of melanoma because they're exposed to sunlight through windows, and only UVA light, unlike UVB, can pass through window glass. At the same time, these indoor workers, who get three to nine times less solar UV exposure than outdoor workers, are missing out on exposure to the beneficial UVB rays, and have lower levels of vitamin D. The study even noted that indoor UV actually breaks down vitamin D3 formed after outdoor UVB exposure, which would therefore make vitamin D3 deficiency and melanoma risk even worse. A number of associations between regular sun exposure and decreased melanoma risk can be found in the medical literature.
Occupational exposure, such as farmers and fishermen, and regular weekend sun exposure are associated with decreased risk of melanoma
Sun exposure appears to protect against melanoma on skin sites not exposed to sun light, and melanoma occurring on skin with large UV exposure has the best prognosis
Patients with the highest blood levels of vitamin D have thinner melanoma and better survival prognosis than those with the lowest vitamin D levels
Beneficial Health Effects of UV Radiation Besides Vitamin D Production
While discussions about the health benefits from sun exposure typically center around vitamin D, which your skin produces in response to UVB rays, UVB exposure actually has a number of other health effects unrelated to vitamin D production - whether it's from the sun or a safe tanning bed.
Ultraviolet (UV) radiation affects a number of other pathways. For example, UV exposure can help improve your mood through the release of endorphins, and may even help reduce fibromyalgia pain. Several skin diseases can be treated with sun exposure or phototherapy, i.e. the use of a tanning bed, including:
Symptoms of multiple sclerosis can also be suppressed with UV exposure, independent of vitamin D synthesis (which is also beneficial for MS. In fact, vitamin D deficiency may be a contributing factor in nearly 60 percent of MS cases). Additionally, UVA radiation, which is generally more harmful in terms of its potential to cause skin cancer, is not entirely without merit. For example, UVA's generate nitric oxide (NO), which can help reduce blood pressure and has a beneficial effect on cardiovascular health, in addition to having an antimicrobial effect.
UV Radiation has Long History of Use as Treatment of Disease
According to a recent article in Dermato-Endocrinology:
"Solar ultraviolet (UV) radiation has been used since ancient times to treat various diseases. This has a scientific background in the fact that a large number of molecules (chromophores) in different layers of the skin interacts with and absorbs UV.
...Phototherapy is a valuable option in the treatment of many psoriatic and nonpsoriatic conditions, including atopic dermatitis, sclerosing skin conditions such as morphea, scleroderma, vitiligo, and mycosis fungoides. Phototherapy is the treatment of certain skin disorders with UV radiation which can be produced by the sun, fluorescent lamps, short arc lamps with UV filters and lasers.
Depending on the shape of the spectrum of radiation emitted by the source, phototherapy can be divided into broadband UVB (290-320 nm), narrow band UVB (310-315 nm), monochromatic UVB (308 nm from an excimer laser), broadband UVA (320-400 nm) and UVA-1 (340-400 nm).
...Traditionally, broadband UVB phototherapy has been used to treat psoriasis, which is an inflammatory skin disease, characterized by keratinocyte hyperproliferation with 1-2 percent prevalence in the general population. However, now more often narrowband UVB or monochromatic UVB are used for the clearance of psoriasis. Narrow-band UVB clears psoriasis faster and produces longer remissions than broadband UVB. Action spectra for UV-induced erythema, DNA damage, photoimmunesuppression, squamous cell carcinoma and vitamin D synthesis are very similar, all in the UVB spectral region of 280-310 nm.
Narrowband UVB do not contain the most erythemogenic and carcinogenic wavelengths.
...Sunbathing or tanning beds seem to have a potential to reduce pain in patients with fibromyalgia. Patients with the chronic pain condition fibromyalgia have reported a greater short-term decrease in pain after exposure to UV compared with non-UV radiation exposure..."
Another article written by Richard J. Wurtman, while older, still contains a lot of interesting information about the health benefits of sunlight, and is well worth a read-through. He rightfully points out the role of sunlight on synchronizing the hormonal rhythms of your body. Melatonin, for example, which is synthesized by your pineal gland, is profoundly affected by light and dark, and proper exposure to bright sun during the day is important for maintaining your internal rhythm. Melatonin, as you may recall, is also a potent antioxidant with cancer-fighting properties, so please do not underestimate the importance of daily UV exposure - as well as the avoidance of artificial light after sunset.
What Makes for a Safe Tanning Session?
There are two primary concerns with tanning beds that you need to be aware of:
1. UV dose. The FDA uses a unit called "one erythemal dose" as a means of calibration for the indoor tanning industry - which is just a fancy word for one tanning session. One erythemal dose equates to the amount of time it takes for a tanning device to produce erythema (slight pinkening of the average person's skin), and this erythema indicates you have achieved a safe dose of UV - which translates to an optimal dose of vitamin D.
However, keep in mind that the erythemal dose can differ for each person based on skin type and strength of lamps – just as a safe "dose" of sunshine differs for people based on their skin type, geographic location, and time of day. Start with the lowest recommended dose (time) to avoid getting burned, especially if you are light skinned.
The FDA also makes recommendations about how often you should receive a dose, stating you should wait 24-48 hours between tanning sessions. The reason for this is that it takes at least 24 hours for the erythema to go away.
The FDA's exposure schedule can be described as CONTROLLED SUNSHINE, making it a very safe way to receive the benefits of the sun while indoors. Once you have a base tan, you can then enjoy more time in the sun without burning, and in that respect, you receive some protection that you would not otherwise have.
2. EMF exposure. Most tanning equipment use magnetic ballasts to generate light. These magnetic ballasts are well known sources of EMF fields that can contribute to cancer. If you hear a loud buzzing noise while in a tanning bed, it has a magnetic ballast system. Dr. Wellness strongly recommend you avoid these types of beds and restrict your use of tanning beds to those that use electronic ballasts.
Why Does Sun Exposure Get so Much Negative Press?
The negative press about sun exposure and tanning is more than simple ignorance or lack of education on the part of government agencies and scientists. The truth is out there to be found, for those who want to find it. It again boils down to blatant greed. Multi-million-dollar corporations enjoy enormous profits from the products they sell to allay your fears.
They create the fear so that they can sell you their solution:
Suntan lotions and creams
Moisturizers with SPF
Anti-aging skin care
Think about how the ads for these products abound in winter and early spring when people worldwide flock to sunny climates for long-awaited vacations. This is the peak season for indoor tanning as well, and the market forces take full advantage. Consider the money to be made in a pairing between suntan lotion manufacturers and the travel industry - airlines, cruise lines, and the like.
Big Industry knows you will never give up your sunshine, and they've learned how to capitalize on it by creating a "sun-phobia" - with a lot of help from Big Pharma and the AMA.
It's all about the money.