Comment by leetrout | Hacker News Reader

Comment by leetrout | Hacker News Reader

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Wear sunscreen.

Get your moles checked.

My dad died in July 1996 from a nasty mole on his back. He would ask me to scratch his back and I remember being 8 or 9 years old and having to scratch around it as it was near the seam of his tank top (which likely aggravated it daily). And would make comments about it being "gross". We just didn't know what we know today.

He was drying off after showering one morning and got blood all over the towel from the mole. He went to the dermatologist and was told he had malignant melanoma. This was in September 1995 and he was in the ground before the middle of July 1996. Nine months to get his affairs in order. I remember driving around and seeing his old college pals (one of which I still see once a year or so for lunch to this day). I remember him buying a bag phone, a "car phone" so we could keep in touch as he drove from Eastern KY to Duke University for experimental treatments (I believe it was the one that led to the immunotherapy treatments used today). He told my mom even if it didn't help him he hoped it would help someone.

I avoid the sun with the exception of the back of my neck and the top of my hands. He has no clue (nor do the dermatologists) what caused it but, like other posts mention, likely sunburns in childhood.

I am so hopeful for this treatment and thankful for the progress made on the immunotherapy fronts.

>Wear sunscreen.

Melanoma in adults is typically tied back to acute blistering sunburn events that happened before the age of 18 (as you seem to be aware). The most common sites of melanoma are chest and back in men and legs in women, areas that are more often than not covered by clothing and not in need of sunscreen.

Cumulative sun exposure on the other hand causes the other types of skin cancer - not melanoma, which this vaccine is targeting.

The most common chemical sunscreen ingredients cause cancer themselves and are wildly overdue for FDA review and removal (that has been held up for political reasons). For those who wish to wear sunscreen I recommend non-nano zinc mineral sunscreen such as Thinksport. Look for "non-nano" and zinc oxide (not titanium oxide, which is often nano in part and also a carcinogen) on the label.

> The most common sites of melanoma are chest and back in men and legs in women

> The most common chemical sunscreen ingredients cause cancer themselves

Both of these statements are out-of-date.

Recent studies show two different histological subtypes of melanoma for young adults vs older adults, each following a different common mode of presentation [1]. Melanoma in younger adults tends to present on the long limbs and is thought to have different contributing factors.

Also "common chemical sunscreen ingredients cause cancer" is a common FUD trope. Sunscreen reduces cancer mortality, full stop. Each person's circumstances vary based on their daily habits, geography, and personal/familial history.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8482997/

Re: 'Also "common chemical sunscreen ingredients cause cancer" is a common FUD trope. Sunscreen reduces cancer mortality, full stop. Each person's circumstances vary based on their daily habits, geography, and personal/familial history.'

You didn't actually prove anything with your counter point here, as confident as you are - which is as confident to whom you're responding to.

At this level of ideological-indoctrination, it seems each person would have to actually participate [run and observe them] in the trials to see if certain ingredients cause an increase in rates of cancer.

How else do people indoctrinated into a belief, believing they simply know better - and must be right, than have people repeat clinical trials on animal models [or better]? Genuine question.

> Melanoma in adults is typically tied back to acute blistering sunburn events that happened before the age of 18 (as you seem to be aware)

I'm curious how this was studied. I feel like that's when everyone gets really bad sunburns because this has to be extremely hard to actually confirm. Doesn't everyone get sunburns when they were in this age category? It's when we are young and irresponsible, putting on sunscreen requires persistence on something that doesn't seem important in the short term (and arguably is a newer trend).

I totally believe that sun damage on your skin causes skin cancer but studying your choices in your younger years to later years seems quite difficult to confirm through research. Wouldn't they need to confirm adults that were diligent about putting on sunscreen their entire life, including when they were kids?

Re: "Melanoma in adults is typically tied back to acute blistering sunburn events that happened before the age of 18 ..."

With the practical advice to counter this being gradual increase of sun exposure to allow your body to build a deep layer of protection (tan) - of which sun screen will prevent, and then if you miss any spots and get full blast of sun for hours all of a sudden then those will be points of vulnerability.

Pharmaceutical industrial complex: create-advertise the problem, sell the solution(s) = profit!!

Note that your quote from GP only relates to melanoma. They also said "Cumulative sun exposure on the other hand causes the other types of skin cancer."

Its there evidence that the incremental tanning you describe actually protects you from skin cancer and will not cause other cancers? If not, this seems like a very reckless comment.

Melanoma is far more deadly than the other types of cancers. If building a base tan can protect you from the acute blistering burns that are known to cause melanoma, it may be worth it

At the same time make sure you are getting enough sun exposure to avoid bottoming out your Vitamin D levels. Low Vitamin D is linked to a number of bone and muscle issues.

10 minutes direct sunshine per day is said to be enough to generate a full compliment of vitamin D, and typically will not result in tanning. However, reduced exposure can be easily offset through diet or vitamin supplement.

Low vitamin D is linked to weakened immune system and higher rates of cancers.

> He told my mom even if it didn't help him he hoped it would help someone.

He did help. Absolutely. A friend was diagnosed with stage 4 melanoma 5 years ago, and she's in full remission today with an optimistic prognosis. Her life is possible because of researchers and people like your dad.

I'm sorry for your loss.

> Get your moles checked.

Tell that to my GP. Both my parents had melanoma, and they each had one additional type of skin cancer each. Their dermatologist is insistent that I get checked, but my GP doesn't think it's necessary, so my HMO won't pay for it.

It might be a worthwhile investment in self-preservation.

In the US, even with a referral, dermatology is not considered preventative, so high deductible POS plans are left to HSAs too.

My HMO pays almost 100% of in-network care with a referral (there is a nominal per-visit co-pay), so that at least wouldn't be an issue there, as long as I don't run into silly things like "The facility you visited was in-network, but Person X who did some of your care was an out-of-network contractor" which has bit me for emergency care before.

Sounds like your GP isn't doing their job? Time to get a different one.

Fire your GP.

I'll try, but my 3 previous GPs, who were all better than my current one, are no longer in-network. Presumably the insurance doesn't pay well enough to keep the better doctors. It's a substantial amount of paperwork (both with the insurance and the new GP) with no guarantee things will be better.

They probably can't depending on insurance.

Insurance isn't a suicide pact that ties you to one particular, shitty GP.

For many people it is. They cannot see another doctor if they want to continue doing things like eating food. If they're lucky enough to be insured at all.

Could you explain the mechanism of this? I am unsure how this situation could arise. There are seemingly infinite GPs in-network on any insurances.

Is their GP the only practitioner in-network for them? Their network has one member?

No, but changing your GP normally requires a new patient consult.

Many GPs aren't taking new patients (or at least from whatever insurance you have) or the initial new patient visit may take 4+ months to schedule.

GP is not a particularly popular choice for doctors as it pays significant less than any specialty does.

Depends if there are other in-network GPs in a range where OP can reasonably travel to.

And who are also accepting new patients.

You are likely hurting yourself a lot more by avoiding the sun.

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