Sunlight's Vitamin D May Help Prevent Skin Cancer
It may be puzzling, but scientists' findings suggest that the main cause of skin cancer - sunlight - might also help protect against the disease, says a study in Nature Immunology.
The key could lie in the amount of ultraviolet B (UVB) light the skin absorbs - enough to stimulate a healthy, vitamin D-linked immune response in the skin but not so much that it boosts skin cancer risk.
"I do think that a little bit of sunlight is good for people, but I think that one of the problems that the American Cancer Society and dermatologists have is, how do you define what a little bit is?" says Marianne Berwick, Ph.D., at the University of New Mexico's Cancer Research and Treatment Center.
"How do you tell people that it's okay to have a little bit of sunlight but not too much?" she asks.
In 2005, Dr. Berwick's team published a controversial study that found that melanoma patients with higher levels of daily sun exposure actually had better survival than patients who spent less time in the sun.
"I've been searching for an explanation for that ever since," she says.
Now, findings from a group led by immunologists at Stanford University may provide an answer.
In their study, the Stanford team worked with cells in the lab and discovered a biochemical chain of events that appears to link sunlight exposure to the skin's own immune defenses.
The researchers started from the notion that an inactive precursor of vitamin D, called vitamin D3, is generated in the skin in response to sun exposure. That has been known for years.
Specifically, a short-wavelength form of UV light, called UVB, is responsible for D3 generation.
D3 is inactive, however. Through contact with various enzymes in the liver and kidneys, the body turns D3 into an active compound called 1,25(OH)2D3.
And that is where the immune-system connection kicks in, the Stanford authors say.
In their experiments, they found that the new compound sent a signal to (immune) T-cells, pushing them to migrate back to specific sites in the skin's epidermis.
Once there, these powerful immune system agents stand on guard against infection and even cancer, the researchers say.
"So, the same wavelengths of sunlight that are most potent in inducing skin cancer - UVB - are also the wavelengths that produce this vitamin D precursor, D3," says Dr. Martin Weinstock, chairman of the skin cancer advisory group at the American Cancer Society.
And it is D3 that starts the whole chain of events rolling.
Dr. Weinstock stresses that the Stanford study is far from conclusive, however, and should not be seen as an excuse to bake in the sun.
"We know that the sun is the major avoidable cause of skin cancer," he says. "This study is interesting and points to a productive area of research, both to confirm this in other settings and to flush out the implications of the finding. But does it really relate to skin cancers in real live people? We don't know.
"So, avoiding intense sun, protecting yourself when you're out in intense sun - that's still our recommendation, and this is not going to change that," says Dr. Weinstock.
Kathleen Egan, Sc.D., at the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Fla., agrees that the study findings are "tantalizing" but need further study.
Especially since the release of Dr. Berwick's melanoma study, "there's been an awful lot of questions about how - or if - vitamin D has a part to play in potentially offering some [cancer] protection under some circumstances," she says.
"But it's very difficult to tease out, because the main human source of vitamin D is, in fact, sunlight exposure, which is also the most important risk factor for melanoma," says Dr. Egan.
Nutritionists have known for decades that sunlight stimulates vitamin D production in the skin. In fact, this natural process is the body's major source of the nutrient.
A proper amount of vitamin D is crucial to bone health, "and there's also a bunch of evidence that vitamin D may have a role in preventing colon cancer, although there's still some controversy about that," Dr. Weinstock says.
So, how much sunlight is enough to get the ideal amount of vitamin D?
Katharine Tallmadge, a dietitian and spokeswoman for the American Dietetic Association, suggests that most people can probably get the US Department of Agriculture's recommended 400 daily international units (IUs) of vitamin D by spending a half-hour to an hour outside per day.
However, the Office of Dietary Supplements at the National Institutes of Health (NIH) states that 10 to 15 minutes of sun exposure to face, hands, arms, or back without sunscreen at least twice a week is generally enough to produce adequate vitamin D.
Dr. Egan agrees. She says it is not difficult for people to soak up the sun's goodness without boosting their cancer risk.
In response to even a moderate amount of sunlight, "the skin actually creates an amazing amount of vitamin D," says Dr. Egan. "It doesn't take much exposure to make enough of the vitamin D that's certainly needed to preserve bone health, for example."
Always consult your physician for more information.
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According to the National Institutes of Health (NIH), Vitamin D is a fat soluble vitamin that is found in food and can also be made in your body after exposure to ultraviolet (UV) rays from the sun.
Sunshine is a significant source of vitamin D because UV rays from sunlight trigger vitamin D synthesis in the skin.
Sun exposure is perhaps the most important source of vitamin D because exposure to sunlight provides most humans with their vitamin D requirement, states the NIH.
UV rays from the sun trigger vitamin D synthesis in skin.
Season, geographic latitude, time of day, cloud cover, smog, and sunscreen affect UV ray exposure and vitamin D synthesis.
For example, says the NIH, sunlight exposure from November through February in Boston is insufficient to produce significant vitamin D synthesis in the skin.
Complete cloud cover halves the energy of UV rays, and shade reduces it by 60 percent.
Industrial pollution, which increases shade, also decreases sun exposure and may contribute to the development of rickets in individuals with insufficient dietary intake of vitamin D.
Sunscreens with a sun protection factor (SPF) of 8 or greater will block UV rays that produce vitamin D, but it is still important to routinely use sunscreen to help prevent skin cancer and other negative consequences of excessive sun exposure.
An initial exposure to sunlight (10 -15 minutes) allows adequate time for Vitamin D synthesis and should be followed by application of a sunscreen with an SPF of at least 15 to protect the skin.
Ten to fifteen minutes of sun exposure at least two times per week to the face, arms, hands, or back without sunscreen is usually sufficient to provide adequate vitamin D.
It is very important for individuals with limited sun exposure to include good sources of vitamin D in their diet.
Always consult your physician for more information.
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