Tanning is just one of those things, like chain smoking or base-jumping, that I’ve never cared to try; I am nowhere near athletic enough to attempt jumping off of a mountain face. I am also too, well, white to bask in the natural sun without SPF 50 sunscreen; like most people with skin of Fitzpatrick Scale type of I or II, I burn to a crisp and spend the next half-week smoothing aloe on my skin and crying in regret.

Could this woman be an addict?

Then there are those tanning beds with controllable light and a lack of sand in your hair. Maybe they just seem too cumbersome a process for me, but they do work; lightbulbs bathe you in ultraviolet rays, the “good stuff” that causes tanning. First, I must say that sunlight, natural or artificial, can be important to produce Vitamin D. However, too much or too frequent exposure to sunlight is known to cause skin cancer. Incredibly, the World Health Organization has ranked tanning beds alongside smoking and asbestos as the greatest cancer threats to humans. This is relatively common knowledge, and yet thousands of young people rush to tanning salons every week. A 2010 NHIS study showed that 11.3% of 18-29 year old interviewees had gone to a tanning salon in the past 12 months.

It is possible that many of those people interviewed had only gone once or twice to tanning booths, for a big outing or out of sheer curiosity (which sounds auspiciously like something I would do). But, you could speculate that at least some of the 11.3% of those college-aged tanners go often. Very often. A common rule of thumb in economics, the 80/20 rule, indicates that 80% of many activities are performed by only 20% of participants. Effectively, the Pareto Principle would argue that 80% of all artificial tanning is done by 20% of clients, a stark minority.

One really good mom

Recent research has shown a reinforcing quality in tanning. Using a modified version of the substance use disorders criteria (e.g. drug addictions/dependencies) found in the DSM-IV-TR (the so-called bible of psychiatry), surveyors discovered that an incredible 53% of beachgoers met criteria for sun tanning dependence. That is, 53% of those interviewed would meet substance use-related disorder requirements had their “substance” been a drug.

Exposure to UV light may have an addictive quality for frequent tanners

Interestingly enough, UV light and tanning may have the reinforcing properties of many drugs. In a sample of frequent tanners, researchers used naltrexone, the same anti-drug that EMT services use to bring heroin overdosers “back from the dead,” to test whether salon frequenters receive a drug-like high from tanning. Naltrexone works by blocking opioid receptors; a common analogue is the “runner’s high,” a release of the body’s own painkillers, better known as endorphins. The body’s own high would be blocked by naltrexone and would cause withdrawal symptoms in opioid (heroin, morphine, Oxycontin) addicts. In the study, frequent tanning was defined as tanning 8-15 times a month, more than is necessary to keep a tan, while infrequent tanners had not used UV tanning beds more than 12 times in any given year. Also notable, the randomized study tested for placebo effects and for preference to an heightened amount of UV light. With an increasing dosage of the endorphin-blocking naltrexone, half frequent tanners reported adverse, withdrawal-like symptoms (i.e. nausea, shaking, jitteriness), even causing 2 participants to remove themselves from the study. Also shown was the fact that placebo-treated infrequent tanners displayed less interest in ultraviolet light than the more frequent tanners. The discovery that 4 of 8 frequent tanners showed withdrawal-like symptoms when treated with naltrexone supports the researchers’ hypothesis that UV exposure, especially in high quantities like in use of a tanning booth, has reinforcing properties like drugs; moreover, exposure to UV light may have an addictive quality for frequent tanners.

With research showing that frequent tanning can foster an addictive quality in UV-overexposure, tanning often is playing with fire

Given the relatively common knowledge that overexposure to the sun is known to be a cause of skin cancer, one would think that deliberate overexposure to ultraviolet light would be uncommon. However, as studies have shown, this is not the case, and you would only need to walk on a college campus to notice dozens of adverts for tanning salons. I actually pass by a tanning spot every day on the way to class, and I’m sure there are many more in and around Boston. With research showing that frequent tanning can foster an addictive quality in UV-overexposure, tanning often is playing with fire. My advice is this: If you do visit tanning salons, don’t go more often than you really need to. Like any other addiction, signs of possible dependence are common, including:

• Lying or feeling guilty about how much you tan
• Rationalizing about the health benefits of sun exposure
• Ignoring the proven facts of skin cancer
• Putting tanning before people, appointments, or other important things
• Feeling insecure or sickly if you do not have a “decent” tan
• Feeling depressed if you cannot tan

The health risks of tanning are dire, especially in the long-term development of skin cancer. Along with the fact that tanning has a reinforcing quality alike that of drugs like heroin and Oxycontin, tanning could very well be the great health risk of our generation.

References:

Induction of withdrawal-like symptoms in a small randomized, control trial of opioid blockade in frequent tanners. Journal of the American Academy of Dermatology – Journal of the American Academy of Dermatology

UV Light Tanning as a Type of Substance-Related Disorder – Archives of Dermatology

August 25, 2009 marked the day that America, and most importantly Massachusetts, lost one of its greatest senators, Ted Kennedy. Kennedy was diagnosed with a type of brain cancer called glioblastoma multiforme (GBM) in May 2008 after suffering from a seizure. GBM is a tumor formed in the glial, or supportive, brain cells; there is no current evidence for a genetic predisposition to this type of cancer. The American Cancer Society believes that 21,000 Americans are diagnosed with brain tumors, and about 10,000 are GBMs. They are the most aggressive and common type of brain tumor, which are resistant to many types of treatments. Only 3% of patients diagnosed with these tumors generally survive five years after diagnosis.

Almost two years after Kennedy’s death, doctors are using the drug Avastin to treat GMBs. Avastin blocks the growth of new blood vessels, a necessary component for the survival of tumors. In one study conducted on Dennis Sugrue, physicians thread a fine tube through his blood vessels and into his head to spray the drug on the location where the tumor had been cut out. They did this experiment because the tumor began growing back even after treatment with surgery, radiation, and chemotherapy. The FDA has approved the use of this drug on GMB, based on the results of 2 phase II clinical trials that showed reduced tumor size in the patients, but it can only be administered after a prior treatment is performed on the tumor.

One of the biggest challenges facing the treatment of GBM is the blood-brain barrier, a separation of the circulating blood and the brain’s extracellular fluid. It occurs along the capillaries and prevents the diffusion of many cells into the brain. Dr. John Boockvar, a brain surgeon at New York-Presbyterian/Weill Cornell, is administering the Avastin to Mr. Sugrue by first injecting mannitol, a drug that opens the blood-brain barrier, and then flooding the tumor with the drug. In the future, other drugs may be combined with Avastin to combat GBM. Although it is unknown whether it improves disease-related symptoms or survival in people under this treatment, it is promising.  Mr. Sugrue’s tumor has decreased in size and his treatment is still an ongoing process.

Although the survival rate for GBM is very low, it is unfortunately the reason why there is a push to try more treatments and expand experimental trials. One can only hope that this treatment leads to more breakthroughs, and more patients like Mr. Sugrue will be able to live longer, healthier lives.