May is Skin Cancer Awareness Month - Protect Yourself!

There are many things to celebrate in the month of May - Cinco de Mayo, the Tulip Festival and Mothers' Day, farmers' markets are opening up for the season, and Victoria Day, the first long weekend kicking off summer.  May is also abundant with awareness days and weeks, and May itself marks Mental Health Awareness, Asthma & Allergies Awareness, and - the subject of this post, one that really hits home for me - Skin Cancer Awareness Month.

Just over two years ago, in early March 2012, my fair-skinned, strawberry-blond, copiously befreckled husband stepped out of the shower, and as he was dressing, I noticed a particularly dark spot on his left shin - something I could not recall having seen there before.  I had just completed an advanced pathology course, and knowing how to spot potentially cancerous moles was one of the subjects covered in the lectures.  Kevin's freckles are generally small and a light reddish-brown colour, even the larger mole- or birthmark-like spots, and this one was dark and shiny, with an irregular pinkish border on one side.  I urged him to have it checked out by our GP, who removed it for biopsy.

Kevin's suspicious mole, March 3 2012,
later confirmed stage 0 melanoma.
Note the colour and irregular border.
This mole was approximately 0.5cm in diameter.

He got the call at work, and called me afterward to share.  Sure enough, the results had came back, in a bad news/good news kind of way.  The bad news: it was melanoma.  The good news: it was only stage 0 - we had caught it just in time.  I still can't quite describe the mixture of emotions running through me at that moment - fear and panic ("I was right to be concerned!"), relief and gratitude ("We caught it early, thanks to that course!"), and juuust a touch of hysteria ("I need to take care of you!  What happens now?  Let's go load up on vitamin D, sunscreen, and new hats, right now!").  Not surprisingly, he took the rest of the day off, not for himself, but for me.

Though they were sure they got it all when they did the biopsy, the area around the cancerous mole would be removed as a precaution in August: 1cm deep and 1" around, and a skin graft from a spot a few inches away applied to the excised area.  The excised tissue was tested and he was pronounced cancer-free, but he must go for full-body dermatological check-ups every 6 months until the 5-year mark.  Edit: he recently had one of these check-ups, and since he's been clear for nearly 2 years, he now only needs to go annually.

January 2013 (5 months post-op) -
Kevin now has 2 sizable scars on his left shin,
where the melanoma was excised (bottom)
and where the skin graft was taken (top).

In the time between and following Kevin's diagnosis and surgery, this story prompted many friends and family members to become more vigilant and check their own skin for irregular spots.  Now I'm sharing it with you, and I hope you'll take these steps to protect yourself and someone you love:

Know the signs and check yourself.  If you have any freckles or moles, do a monthly "spot check".  Be aware of the ABCDE visual signs of skin cancers.  Look in the mirror in good light - use a handheld mirror where necessary.  Get a friend or loved one to look at spots on your back or other hard-to-see places.  Take good-quality pictures of new or possibly unusual spots, preferably with a ruler or small object for measurement references to compare with next month's pictures of the same spots.  Be consistent - use the same camera and lighting sources.

Load up on vitamin D.  First, get your blood levels checked.  Ask your GP to add vitamin D to your blood work.  Unfortunately, this is not covered by OHIP (unless you meet certain criteria) and may cost around $50.
Why is vitamin D important?  Recent and growing research is showing that vitamin D helps modulate the immune system, an important factor in preventing and managing cancer cell growth.  Additionally, vitamin D is synthesized in the skin with sun exposure, and may provide some protection from the harmful rays of the sun.
Around 15 minutes per day of unprotected sun exposure in the summer can be enough to boost levels adequately, if not for the full year, then at least for the season.  However, as Canadians, we have less sun exposure in general, and are thus more susceptible to vitamin D deficiency, not just in the winter, but year-round (and especially with this winter having lasted so long, I suspect many people may be more deficient than usual).  For this reason, it is imperative to have your blood levels tested in the late winter-early spring when levels are naturally lowest, and supplement accordingly year-round.
In terms of supplementation, the RDI for vitamin D is 1000IU for adults and 400IU for children per day - if no deficiency currently exists.  Those who are deficient (showing <30ng/ml or <75nmol/L) need more than this to bring levels back to optimum (40-60ng/ml or 100-150nmol/L).  As an example, my first vitamin D blood test showed a very surprisingly low 25nmol/L, and I took between 2000-4000IU of lanolin-sourced emulsified vitamin D3 per day for over a year (with the higher amount in the winter and on very cloudy days), until my next annual physical, where my blood test showed 126nmol/L.  I recommend at least 2000IU per day for adults on a regular basis, and more for those who are immune-compromised (e.g. autoimmune, inflammatory conditions, digestive disorders, etc) or suffer from seasonal affective disorder.

Protect your skin.  "Slip on a shirt, slap on a hat, slop on some sunscreen."  I grew up with this mantra for sun protection, and it still holds true.  Cover up wherever possible.  After you've gotten some unprotected sun exposure for vitamin D synthesis, apply sunscreen.  Look for natural brands with an SPF of at least 30 at your local health food store, eco shop, or larger supermarkets, or try finding one online or through independent cosmetics retailers.  If there is a "tester" tube available, try it first to be sure you like the feel of it on your skin, as some may be thick and greasy, which could clog pores and exacerbate breakouts; and/or leave a white residue on skin and clothing.  I like Aubrey Organics, Nature's Gate, and Arbonne Baby Care sunscreens.  The protection factor (SPF) weakens over time, so it's best to replace your sunscreen annually.
Avoid tanning, including tanning beds.  Over time this damages your skin, leading to premature aging, and increases your risk for skin cancers.  People with fair complexions, many freckles or moles, blue eyes, and blonde or red hair (such as Kevin) are at higher risk.
Remember too that your skin absorbs about 60% of whatever you put on your skin into your bloodstream within just minutes after application!  Avoid products containing known carcinogens, such as parabens and phthalates.
Sunburns (even just one bad one) also increase the risk of skin cancers.  While after-burn care may not reduce your risk, it's still worth doing to get relief.  Try fresh aloe vera gel or chilled chamomile tea on your skin, or a natural after-sun or calendula cream to cool the burn.  Coconut oil is also soothing.  Up your intake of antioxidant vitamins A, C, E, and minerals zinc and selenium, all of which are crucial to good skin health.  Orange, yellow, and red fruits and vegetables, as well as cruciferous vegetables and dark leafy greens, are great sources of vitamin A and C.  Nuts and seeds, particularly Brazil nuts, macadamias, pecans, and almonds are abundant with vitamin E, zinc, and selenium.  These nutrients are also available together in supplement formulas (look for "ACESZ" or similar).

So enjoy the sunny days of summer - and keep your skin safe.

How do you care for your skin in summer?

February is Heart Month - 6 Ways to Show Your Heart You Care

Cinnamon hearts, paper hearts, heart-shaped boxes (of both the Nirvana and chocolate-filled variety)... the symbol of romantic love is ubiquitous in February, with Valentine's Day celebrations still fresh in our minds.  And perhaps not as well-celebrated, but definitely notable, February is also Heart Month, devoted to awareness of heart disease and stroke.  In that spirit, here are 6 ways to show your heart some love this month.

1) Antioxidants - particularly anthocyanins and coenzyme Q10 (CoQ10).  Anthocyanins are found in dark red, purple, blue, and black fruits and vegetables, such as blackberries, blueberries, cherries, raspberries, purple grapes, black plums, beets, eggplants, and purple potatoes.  A study using cherry juice highlighted its high content of antioxidants (particularly anthocyanins), crediting them for increased rate of cardiovascular recovery, as well as muscle strength recovery in a group of marathon runners, compared to the placebo group.  Try adding the foods listed above to reap the benefits.

CoQ10 is used for energy in the body, but also may assist recovery after a heart attack, improve muscle strength, and help lower blood pressure and angina.  It's found in several animal sources, such as game, beef, fish, dairy, and eggs, but there are also several plant-based sources, such as broccoli, spinach, peanuts, rye, wheat, and some berries.

2) Spices - especially cayenne, ginger, garlic, and cinnamon.  These spices can help improve bloodflow through vasodilation.  Their heat also improves bloodflow by causing flushing and mild sweating on the surface of the skin.  Additionally, they may also help thin the blood, and in the case of cinnamon, help regulate blood sugar fluctuations as well.  A recent study looked at the effects of aged garlic extracts and their beneficial effects when combined with certain blood pressure medications, noting better lowering effects than with just medication alone.  If you are taking blood thinning, anticoagulant, or blood pressure regulating medications, use caution when adding spices such as these to your diet, and particularly in the form of more concentrated herbal supplements.

3) Omega-3 fatty acids.  These unsaturated fats help keep the blood liquid and slippery, allowing for better bloodflow.  They are also naturally anti-inflammatory, helping keep blood vessels wide.  The most readily-utilized sources come from cold water fish, krill, and squid, since the form primarily found in their oils is pre-formed DHA.  Plant-sourced omega-3s, such as those from hemp, chia, walnuts, and flax, require more translations once in the body in order to reach the DHA form, but due to many factors, not least of which are stress and nutritional deficiencies, may get diverted from the right pathway.  That said, plant-based DHA supplements made from algae are a great back-up for plant-based eaters consuming omega-3s from other sources.  Again, if you are taking medications such as those listed in point 2, use caution with omega-3 supplements.
And don't forget other forms of unsaturated fats, such as those from olive oil, avocados, nuts and seeds.

4) Blood sugar balancing.  Prevent blood sugar spikes and fluctuations by avoiding high-sugar, refined foods, and eating regularly-spaced, macronutrient-balanced meals and snacks - that is, a combination of complex carbs, lean proteins, and healthy fats.  Too much sugar in the blood can lead to inflammation of the blood vessels.  One of the theories of arterial plaque formation implicates damage from high blood sugar as a possible cause.  Getting enough fibre can also help slow the rise of sugar in the blood, and help sweep excess out of the body.  Try swapping out your breakfast doughnut and coffee for a slice of sprouted grain toast and natural almond butter and cup of green tea.

5) B vitamins - especially niacin, folic acid and B12.  Niacin can help balance blood cholesterol and triglycerides, folic acid helps improve elasticity of blood vessels, and B12 helps the body metabolize homocysteine, which can build up in the blood and is considered a marker for heart disease risk.  Remember that B12 deficiency is commonly considered something that affects vegetarians and vegans more than it does omnivores, but omnivores actually run a greater risk of deficiency.  Additionally, a deficiency in B12 can also affect folic acid levels as well, since the two work better together.  Great sources of niacin include: seafood, beef, mushrooms, potatoes, peanuts, avocados, dates, passionfruit, oats, and brown rice; folic acid: oranges, kale, Swiss chard, asparagus, broccoli, avocados, oats, beans and lentils; B12: eggs, dairy, fortified plant-based milks and cereals, and red star nutritional yeast.  Fermented foods such as sauerkraut, tempeh, miso, and kimchi can help optimize gut flora, which in turn produce more vitamin B12 for you!

6) Exercise - with emphasis on resistance training and cardiovascular workouts.  Resistance training helps build overall muscle strength and endurance, helping to decrease risk of injury and disability over the long term.  You can do resistance training with weights such as kettlebells, plates, or bar/dumbbells, or your own body weight.
Aerobic workouts help increase the heart's strength and improves efficiency of the pumping mechanism, and improves dilation of the blood vessels and oxygenation of the blood, leading to a lower resting heart rate and less strain on the heart.  Be aware that pushing your heart rate too high during exercise can lead to sudden dizziness and feeling faint, and can increase the risk of a cardiac event.  Knowing your max heart rate (roughly 200 minus your age in years) and keeping your heart rate in a target zone of 60-80% of that max can help strengthen your heart without pushing it too hard.  High-intensity interval training (HIIT), which incorporates short bursts of high-intensity exercise with short rest or low-intensity periods, is a great way to get your cardio, and burn some fat at the same time!

What are your favourite ways to love your heart?

Heart-healthy recipe: Sweetheart Blood Orange Creamsicle Smoothie