Presidential Healthcare center

We provide the same Preventive Executive Physical Program as received by the President of the United States.


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The Number of Moles on Your Right Arm Could Be Tied to Your Cancer Risk, Study Finds

A study suggests that physicians may be able to gauge risk by focusing on a patient’s right armMoles

Moles are usually harmless, but they can be used to assess a person’s risk for developing skin cancer. Someone with more than 100 moles across their body, for example, can be at a greater risk for melanoma, according to experts. Now a new study suggests that physicians may not have to look at a patient’s entire body—instead, doctors can focus on the patient’s right arm, where the presence of 11 or more moles moles 2could signal a greater risk of melanoma.

The study, published in the British Journal of Dermatology on Monday, looked at 3,594 twins, and then a larger group of men and women, who all had nurses count how many moles they had on 17 different parts of their body. The researchers found that the number of moles on a person’s right arm was most predictive of their total number of moles on their body. Women with over seven moles on their right arm were nine times more likely to have over 50 moles on their whole body. People with over 11 moles on their right arm were more likely to have over 100 moles on their whole body.

Other areas of the body that stood out as possible predictive regions were above the right elbow, the legs and, for men, the back.

Source: Times


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Airline Crews May Be More Likely To Get Skin Cancer

Airlines and sun exposure

Pilots and flight attendants may be at an increased risk of developing the most deadly form of skin cancer, suggests a new analysis.

While the study cannot pinpoint why flight crews are at higher risk, the researchers suggest it could be the result of greater exposure to ultraviolet (UV) radiation, which causes damage to the DNA in skin cells, at high altitudes.

“This is very worrisome and awareness needs to increase and protective measurements must be undertaken,” said the study’s lead author, Dr. Martina Sanlorenzo from the University of California, San Francisco.

Pilots and other members of the cabin crew should be aware of the increased risk, she told Reuters Health in an email. Additionally, they should get skin checks and protect themselves from UV radiation.

Skin cancer is the most common form of cancer in the U.S., Sanlorenzo and her colleagues write in JAMA Dermatology.

Over 3.5 million Americans will be diagnosed with skin cancers in 2014, according to the American Cancer Society. About 76,000 people will be diagnosed with melanoma, which is the type of skin cancer that is most likely to lead to death.

Past studies have suggested that airline pilots and other flight crew members are prone to getting more skin cancers, but the association was poorly understood, the researchers write.

For the new analysis, they combined data from 19 previous studies published between 1990 and 2013. In total, they had data on over a quarter million people.

The researchers used a measure known as standardized incidence ratio, which helps gauge whether the cancer cases observed among specific groups of people are more or less than what would be expected in the general population.

According to the National Cancer Institute, the average American has about a 2 percent risk of developing melanoma during his or her lifetime.

Among participants in the 19 studies, the researchers found that melanoma was about twice as common among pilots and flight crew members than would be expected in the general population.

The researchers caution that they can’t say why cabin crews may be more likely to develop melanoma. It could be due to greater exposure to solar radiation as altitude increases and the protective barrier of the atmosphere thins.

There may, however, be other unknown factors among cabin crews, apart from UV exposure, that affect their melanoma risk, the study team writes.

The researchers don’t have any data on airplane passengers, but Sanlorenzo notes that “frequent flyers that fly as often as cabin crew should get regular skin checks and protect themselves from UV radiation.”

She suggested that the U.S. Federal Aviation Administration should take more measurements of how much UV radiation pilots and cabin crews are exposed to inside commercial planes, versus, for example, aircraft with special radiation-blocking windows.

“A prospective study could be done studying melanoma incidence in pilots/cabin crew flying airplanes where windows block UVA and UVB (radiation) entirely,” she said.

UVA and UVB radiation from the sun damage skin-cell DNA and are partly responsible for skin aging and for promoting skin cancer.

Source: Reuters


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Status of Spray Sunscreens Still Uncertain

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The FDA has not reached a decision about the safety and efficacy of spray-on sunscreens, but continues to accumulate information to base an eventual verdict, a skin specialist said here. After manufacturers stated their case, the agency concluded that available information about spray-on sunscreens is insufficient to rule on its safety or whether it works as advertised. With respect to safety, the principal issues relate to the inhalation potential of spray-on sunscreens, according to Henry Lim, MD, of Henry Ford Health System in Detroit, who presented an update on the status of sunscreens during the summer meeting of the American Academy of Dermatology.

“Anyone potentially could inhale the product, children or adults,” Lim told MedPage Today. “It is not yet clear what the potential is or how great a risk it might pose.”

The FDA has been monitoring the situation since June 2011, when the agency issued rules for manufacturer testing to establish the safety and effectiveness and rules that tightened labeling requirements for sunscreens. At the same time, the FDA requested more data from manufacturers and comments from consumers and other interested parties. The rules went into effect in 2012. The FDA has continued to accumulate and review information on sunscreen safety, Lim said, but maintains that information is still insufficient to make definitive decisions on safety and effectiveness. A year ago the agency did issue a consumer safety notice, warning against use of spray-on sunscreens near an open flame. According to the FDA, at least five cases of serious burns had been reported at that time.

Earlier this year, Consumer Reports urged parents not to expose children to spray-on sunscreens until the FDA reaches a decision about the products’ safety. With regard to effectiveness, manufacturers of spray-on sunscreens have yet to demonstrate that the products provide coverage equivalent to that of other formulations, such as oils and lotions. Lim pointed out that spray-on sunscreen coats the skin with small droplets that have equally small spaces in between. Whether that affects the products’ protection against ultraviolet (UV) radiation remains unclear.

sunscreenDuring his presentation at the AAD, Lim also addressed alternative formulations of sunscreens in various stages of development. Some of the products have been available without prescription for years, including vitamins C and E. Technically, the oral products are not “sunscreens” but antioxidants, said Lim, who has participated in studies of some of the products. In theory, the products work inside the body to counter the effects of exposure to UV radiation.

One of the most widely studied oral compounds is polypodium leucotomos, an extract of a fern plant indigenous to parts of Central America. Laboratory studies have demonstrated potential antioxidant and anti-inflammatory properties, Lim said.

Small clinical studies dating back almost 20 years have produced evidence suggesting the substance affords protection against phototoxicity, solar urticaria, and polymorphous light eruption. Besides vitamins C and E, other substances evaluated as potential oral photoprotectants include lutein and alpha-melanocyte stimulating hormone (alpha-MSH) analogs. Studies of oral lutein have demonstrated protoprotective potential in humans, and alpha-MSH analogs have been found helpful in management of erythropoietic protoporphyria and solar urticaria, associated with increased tolerance to artificial light and increased melanin content.

As for the long-term potential of oral photoprotection candidates, Lim remained cautious. “The results have been encouraging, but these products are still in early stages of development,” he said. Regardless of the outcome for oral photoprotectants, none of them should be considered a replacement for conventional sunscreens and the longstanding advice regarding limitations on UV exposure and use of protective clothing, broad-brimmed hats, and sunglasses, he added.

Source: MedPage Today

We include skin cancer screening in the Center’s executive physicals.