Highlights from Nordic Scientific Papers
Old Habits Die Hard!
Patients Continue Excessive Sun Exposure in Spite of Having Melanoma
The fact that ultraviolet radiation from the sun is carcinogenic and is a main cause of malignant melanoma has
been well known among health professionals and in general population for almost 3 decades. Governmental
agencies and patient organizations in many countries invested considerable resources in public campaigns
aiming at the reduction of recreational sun exposure, in a vain hope to halt the steeply increasing curve of
non-melanoma skin cancer and malignant melanoma. The individuals who have been treated for malignant
melanoma should be particularly aware of the importance of excessive sunbathing and more cautious with
relation to sun exposure. The current study of Idorn et al. shows that this is unfortunately not the case.
Below is a summary of a paper by Idorn et al. The full reference for the article is: Idorn LW, Datta P, Heydenreich J, Philipsen PA,
Wulf HC. A 3-Year Follow-up of Sun Behaviour in Patients With Cutaneous Malignant Melanoma. JAMA Dermatol 2013 Oct 2. doi:
10.1001/jamadermatol.2013.5098. [Epub ahead of print].
Luise Idorn (see below) and coworkers analyzed in a prospective, controlled observational study the sun behaviour of
patients with cutaneous malignant melanoma the ?rst, second, and third summers after the diagnosis. Participants wore
personal wristwatch dosimeters that continuously measured
UV exposure. Sun behaviour and ultraviolet exposure pattern
of the 20 patients with previous malignant melanoma was
compared with the same number of age-, sex- and Fitzpatrick
skin type-matched controls. Unexpectedly, patients daily UV
dose increased 25% from the ?rst to the second summer and
33% from the ?rst to the third summer after diagnosis. The
estimated increase was 0.3 SED (standard erythema dose)
each year. The controls maintained a stable UV exposure.
Another provoking observation was that despite the awareness of the deleterious effect of sunburns 50% of controls
and 60% of patients were sunburned at least once during
the study period.
ROBERT GNIADECKI,
This study uncovered a worrisome sun behaviour in patients
treated for malignant melanoma. The sun protective behaviour is very short lived and within 3 years after the treatment,
their sun exposure pattern is no different from the control
population.
Apparently, sun behaviour mimics in many ways an addictive
behaviour such as that of smokers. Despite the warning campaigns linking cancer to smoking and a convincing data showing
that people diagnosed with early stage lung cancer can double
their chances of survival if they stop smoking, more than 80%
of lung cancer patients continue smoking after the diagnosis
(Duffy et al. Commun Oncol 2012, 9: 344-52). Patients with a
history of malignant melanoma are likely to develop another
melanoma within the 5 years after the ?rst tumor and it is likely
that the disregard to sun protection is an important contributor. Unfortunately, the study of Idorn et al. underscores the sad
truth that rational arguments cannot change human behaviour.
Country Editor, Denmark
University of Copenhagen, Bispebjerg Hospital, Bispebjerg bakke 23,
DK-2400 Copenhagen NV, Denmark. E-mail: r.gniadecki@gmail.com
After acquiring the medical degree in 2006 from the University of
Copenhagen in Denmark, Luise Idorn completed 2 years of internal medicine, surgery and dermatology. Due to a great interest in
the association of UVR exposure with cutaneous malignant melanoma, she started doing research with a focus on sun behaviour
in patients with cutaneous malignant melanoma. She received her
PhD in 2013 from the University of Copenhagen and continues
her work within this research ?eld.
152
Forum for Nord Derm Ven 2013, Vol. 18, No. 4