10 ms·

I found this quote particularly telling: > “I don’t argue with their data,” says David Fisher, chair of the dermatology department at Massachusetts General Hos

by qqtt 4y ago

I found this quote particularly telling: > “I don’t argue with their data,” says David Fisher, chair of the dermatology department at Massachusetts General Hospital. “But I do disagree with the implications.” The risks of skin cancer, he believes, far outweigh the benefits of sun exposure. “Somebody might take these conclusions to mean that the skin-cancer risk is worth it to lower all-cause mortality or to get a benefit in blood pressure,” he says. “I strongly disagree with that.” It is not worth it, he says, unless all other options for lowering blood pressure are exhausted. Instead he recommends vitamin D pills and hypertension drugs as safer approaches. To paraphrase "the data isn't wrong, but it contradicts dogmatically held beliefs, and so a strict regime of pills and treatments are required first before indulging in this heresy". It takes a lot to break persistent medical dogmas, and these platitudes of "avoid sun exposure at all costs because skin cancer" are starting to become generational sayings that are ingrained in prevalent thinking. Also just want to point out what is touched on in the article - melanoma (skin cancer caused by UV) in the USA kills about 7000-8000, with that trend line decreasing. Heart disease kills around 700,000 people a year in the USA alone. Food for thought.

chasebank 4y ago
Makes me wonder about melanoma rates within outdoor working populations, like construction workers. Do we see more or less the same ratios in their population?
- pilsetnieks 4y ago
  From this very article: > And perplexingly, outdoor workers have half the melanoma rate of indoor workers. Tanned people have lower rates in general. “The risk factor for melanoma appears to be intermittent sunshine and sunburn, especially when you’re young,” says Weller. “But there’s evidence that long-term sun exposure associates with less melanoma.”
- PKop 4y ago
  Read the article.
- deleted 4y ago
  [deleted]
mint2 4y ago
>” To paraphrase "the data isn't wrong, but it contradicts dogmatically held beliefs, and so a strict regime of pills and treatments are required first before indulging in this heresy".” That rephrasing in itself can be describe as a dogmatic belief that supplements are bad/conspiracy. It’s a dogmatism pile. Eat sun exposed mushrooms if vitamin d pills aren’t ones cup of tea, but in northern climes relying on sun for vitamin d is not realistic much of the year.
- astrange 4y ago
  The issue described in the article seems to be that sunlight does a lot more than produce Vitamin D - thinking a natural process is the same as taking exactly one chemical by mouth is the kind of modernist nutrition science that gets overturned later.
- trompetenaccoun 4y ago
  There is no empirical evidence the pills do anything. Did you read the article? It's likely one of those spurious correlation type of situations. Being outdoors or having sun exposure, maybe living healthier lifestyles... whatever it is it corresponds with higher vitamin D levels, that's all. It's a bit much claiming those suspicious of pill pushing are part of the actual cult. If someone thinks taking vitamin D pills is necessary they're the one who has to provide the evidence, not the other way around.
robertlagrant 4y ago
This is why we need the phrase "evidence-based medicine": the prevalence of the alternative. Doctors aren't automatically scientists or critical thinkers.
treis 4y ago
I suspect there is a happy medium of sun exposure that gets you nearly all the benefits without much increase in skin cancer.
- BLKNSLVR 4y ago
  I'd say you're probably right, but then things like the hole in, or the thickness of, the ozone layer would make a difference between pre- and post-industrial sun exposure.
  - JKCalhoun 4y ago
    My Apple Watch needs a UV sensor that accumulates UV exposure levels and can tell me when it's time to come inside.
    - shepherdjerred 4y ago
      That would actually be pretty cool
s3p 4y ago
It upsets me that no one mentions the link between sun exposure and aging. The people who seem to not age are commonly those who use sunscreen or protect their face/neck from the sun. Without sun exposure, the skin naturally heals and replaces scarring. This is why people with post-acne hyperpigmentation will often need to wear sunscreen for a long time while using a topical retinoid-- to both increase the rate of skin cell turnover and to make sure the new skin is adequately healed.
- fshbbdssbbgdd 4y ago
  Is your hypothesis that avoiding sun exposure slows aging generally, or just that it makes the skin look younger? I’m worried about many of the effects of aging, but don’t care a whole lot about how my skin looks.
  - jelliclesfarm 4y ago
    Skin is the largest organ of the body. It is an indicator of the inner health as well even though the main function of the skin is to protect the tissue/fat and other layers. so you should care about how your skin looks. You can protect your skin from excessive sun exposure, but if your diet isnt adequate or healthy, it will show through your skin.
  - shrimpx 4y ago
    It's just aesthetic. Heavy sun exposure throughout life leads to wrinkles and sun spots/splotchy skin later in life. White collar workers likely needn't worry, though. That advice is more for people who spend their working hours in the sun.
    - dougmsmith 4y ago
      > White collar workers likely needn't worry, though. Have to disagree with this one, everyone who can't escape sunlight and likes to go outside at all is affected. People in the American southwest from all walks of life age shockingly faster (in appearance) than their northern state counterparts. I'd meet women who were 25 and looked 35 (by northern expectations), and it only accelerates from there (35 looking like 50, 50 looking like 70).
purple_ferret 4y ago
Well he's a dermatologist. His bias is towards fighting skin cancer. He looks at it through the lens of somebody who regularly deals with people who are dying from melanoma. He's tasked with fighting a battle, not winning a war. As an anecdotal aside, I always read about people who treat cancers as being more militant in their beliefs, but they're also dealt with tough hands.
- nostromo 4y ago
  And the author is writing an article for Outside, which also has a clear bias in presenting a one-sided argument.
  - mgh2 4y ago
    Take this with a grain of salt, doubt its monetary motivation: sell Outside+ subscriptions
- version_five 4y ago
  Right. The road to hell is paved with the good intentions (and myopia) of narrow specialists who want others to prioritize the thing they worry about. Technicians of all kinds need to realize their most helpful role is to provide inputs so people can make their own decisions, not to actually recommend (or recently mandate) what people decide to do.
  - scoopertrooper 4y ago
    If you think of UV light exposure as a therapy of sorts, then it's fair to weigh its benefits and risks against alternative treatments. If the supposed benefits of UV light exposure can be achieved through an alternative treatment that poses a lower risk of skin cancer, then why wouldn't that be the superior treatment?
    - version_five 4y ago
      Because real people like to go to the beach or go running or a million other outdoor activities. And some people even like the look of a tan, or want to show off their bodies. Or people don't want to spend their time thinking about that stuff and have other priorities. That is my point about the narrow advice. People have diverse goals, and there is a lot more to going out in the sun than optimizing your vitamin d levels. Treating people like we're all farm animals that need some standard, dictated care formula works for nobody
croes 4y ago
>melanoma (skin cancer caused by UV) in the USA kills about 7000-8000 How many need treatment? Can skin cancer be cured better than heart diseases? And heart disease is a pretty broad term, if you say heart diseases you should say cancer not just skin cancer. And cancer killes 600,000 a year.
ziftface 4y ago
I think you're reading too much into that quote. I think they just meant that they acknowledge that there are benefits to sun exposure but in his opinion it's not worth the risk of getting skin cancer. Even if turns out to be misguided, that's not dogma.
tremon 4y ago
Instead he recommends vitamin D pills and hypertension drugs as safer approaches. I suspect anybody who recommends medication over natural resources has a bridge to sell.
- pessimizer 4y ago
  Especially more statins. They won't give up until they're adding them to the water.
6510 4y ago
> Also just want to point out what is touched on in the article - melanoma (skin cancer caused by UV) in the USA kills about 7000-8000, with that trend line decreasing. Heart disease kills around 700,000 people a year in the USA alone. This is actually borderline nonsensical in the context: > People with low levels of vitamin D in their blood have significantly higher rates of virtually every disease and disorder you can think of: cancer, diabetes, obesity, osteoporosis, heart attack, stroke, depression, cognitive impairment, autoimmune conditions, and more.
nradov 4y ago
The most common hypertension drugs are statins. While those can be necessary for some patients, they come with a long list of negative side effects. Recommending them as a first line therapy before moderate UV light exposure is medical malpractice. https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/statin-side-effects/art-20046013 https://www.mayoclinic.org/diseases-conditions/high-blood-ch...
NonNefarious 4y ago
I found this quote particularly undermining of his credibility: "It’s entirely intuitive,” he responded. “Homo sapiens have been around for 200,000 years. Until the industrial revolution, we lived outside. How did we get through the Neolithic Era without sunscreen?" By boning each other at the earliest possible age and procreating before we could die of cancer. DUH. The guy's a scientist but can't logically filter out causes of mortality that don't typically transpire until after child-bearing age?
deleted 4y ago
[deleted]
- deleted 4y ago
  [deleted]
NoPicklez 4y ago
If skin cancer deaths caused by UV are low in the US and the doctor is still concerned, I can side with the concern our doctors have in Australia. Where we lead the world on rates of skin cancer.
anjel 4y ago
As if there's any BP meds benign of significant side fx and long term bio-consequences. (They sure are profitable though.)

by qqtt 4y ago

chasebank 4y ago

Makes me wonder about melanoma rates within outdoor working populations, like construction workers. Do we see more or less the same ratios in their population?

pilsetnieks 4y ago
From this very article: > And perplexingly, outdoor workers have half the melanoma rate of indoor workers. Tanned people have lower rates in general. “The risk factor for melanoma appears to be intermittent sunshine and sunburn, especially when you’re young,” says Weller. “But there’s evidence that long-term sun exposure associates with less melanoma.”
PKop 4y ago
Read the article.
deleted 4y ago
[deleted]

mint2 4y ago

>” To paraphrase "the data isn't wrong, but it contradicts dogmatically held beliefs, and so a strict regime of pills and treatments are required first before indulging in this heresy".” That rephrasing in itself can be describe as a dogmatic belief that supplements are bad/conspiracy. It’s a dogmatism pile. Eat sun exposed mushrooms if vitamin d pills aren’t ones cup of tea, but in northern climes relying on sun for vitamin d is not realistic much of the year.

astrange 4y ago
The issue described in the article seems to be that sunlight does a lot more than produce Vitamin D - thinking a natural process is the same as taking exactly one chemical by mouth is the kind of modernist nutrition science that gets overturned later.
trompetenaccoun 4y ago
There is no empirical evidence the pills do anything. Did you read the article? It's likely one of those spurious correlation type of situations. Being outdoors or having sun exposure, maybe living healthier lifestyles... whatever it is it corresponds with higher vitamin D levels, that's all. It's a bit much claiming those suspicious of pill pushing are part of the actual cult. If someone thinks taking vitamin D pills is necessary they're the one who has to provide the evidence, not the other way around.

robertlagrant 4y ago

This is why we need the phrase "evidence-based medicine": the prevalence of the alternative. Doctors aren't automatically scientists or critical thinkers.

treis 4y ago

I suspect there is a happy medium of sun exposure that gets you nearly all the benefits without much increase in skin cancer.

BLKNSLVR 4y ago
I'd say you're probably right, but then things like the hole in, or the thickness of, the ozone layer would make a difference between pre- and post-industrial sun exposure.
- JKCalhoun 4y ago
  My Apple Watch needs a UV sensor that accumulates UV exposure levels and can tell me when it's time to come inside.
  - shepherdjerred 4y ago
    That would actually be pretty cool

s3p 4y ago

It upsets me that no one mentions the link between sun exposure and aging. The people who seem to not age are commonly those who use sunscreen or protect their face/neck from the sun. Without sun exposure, the skin naturally heals and replaces scarring. This is why people with post-acne hyperpigmentation will often need to wear sunscreen for a long time while using a topical retinoid-- to both increase the rate of skin cell turnover and to make sure the new skin is adequately healed.

fshbbdssbbgdd 4y ago
Is your hypothesis that avoiding sun exposure slows aging generally, or just that it makes the skin look younger? I’m worried about many of the effects of aging, but don’t care a whole lot about how my skin looks.
- jelliclesfarm 4y ago
  Skin is the largest organ of the body. It is an indicator of the inner health as well even though the main function of the skin is to protect the tissue/fat and other layers. so you should care about how your skin looks. You can protect your skin from excessive sun exposure, but if your diet isnt adequate or healthy, it will show through your skin.
- shrimpx 4y ago
  It's just aesthetic. Heavy sun exposure throughout life leads to wrinkles and sun spots/splotchy skin later in life. White collar workers likely needn't worry, though. That advice is more for people who spend their working hours in the sun.
  - dougmsmith 4y ago
    > White collar workers likely needn't worry, though. Have to disagree with this one, everyone who can't escape sunlight and likes to go outside at all is affected. People in the American southwest from all walks of life age shockingly faster (in appearance) than their northern state counterparts. I'd meet women who were 25 and looked 35 (by northern expectations), and it only accelerates from there (35 looking like 50, 50 looking like 70).

purple_ferret 4y ago

Well he's a dermatologist. His bias is towards fighting skin cancer. He looks at it through the lens of somebody who regularly deals with people who are dying from melanoma. He's tasked with fighting a battle, not winning a war. As an anecdotal aside, I always read about people who treat cancers as being more militant in their beliefs, but they're also dealt with tough hands.

nostromo 4y ago
And the author is writing an article for Outside, which also has a clear bias in presenting a one-sided argument.
- mgh2 4y ago
  Take this with a grain of salt, doubt its monetary motivation: sell Outside+ subscriptions
version_five 4y ago
Right. The road to hell is paved with the good intentions (and myopia) of narrow specialists who want others to prioritize the thing they worry about. Technicians of all kinds need to realize their most helpful role is to provide inputs so people can make their own decisions, not to actually recommend (or recently mandate) what people decide to do.
- scoopertrooper 4y ago
  If you think of UV light exposure as a therapy of sorts, then it's fair to weigh its benefits and risks against alternative treatments. If the supposed benefits of UV light exposure can be achieved through an alternative treatment that poses a lower risk of skin cancer, then why wouldn't that be the superior treatment?
  - version_five 4y ago
    Because real people like to go to the beach or go running or a million other outdoor activities. And some people even like the look of a tan, or want to show off their bodies. Or people don't want to spend their time thinking about that stuff and have other priorities. That is my point about the narrow advice. People have diverse goals, and there is a lot more to going out in the sun than optimizing your vitamin d levels. Treating people like we're all farm animals that need some standard, dictated care formula works for nobody

croes 4y ago

>melanoma (skin cancer caused by UV) in the USA kills about 7000-8000 How many need treatment? Can skin cancer be cured better than heart diseases? And heart disease is a pretty broad term, if you say heart diseases you should say cancer not just skin cancer. And cancer killes 600,000 a year.

ziftface 4y ago

I think you're reading too much into that quote. I think they just meant that they acknowledge that there are benefits to sun exposure but in his opinion it's not worth the risk of getting skin cancer. Even if turns out to be misguided, that's not dogma.

tremon 4y ago

Instead he recommends vitamin D pills and hypertension drugs as safer approaches. I suspect anybody who recommends medication over natural resources has a bridge to sell.

pessimizer 4y ago
Especially more statins. They won't give up until they're adding them to the water.

6510 4y ago

> Also just want to point out what is touched on in the article - melanoma (skin cancer caused by UV) in the USA kills about 7000-8000, with that trend line decreasing. Heart disease kills around 700,000 people a year in the USA alone. This is actually borderline nonsensical in the context: > People with low levels of vitamin D in their blood have significantly higher rates of virtually every disease and disorder you can think of: cancer, diabetes, obesity, osteoporosis, heart attack, stroke, depression, cognitive impairment, autoimmune conditions, and more.

nradov 4y ago

The most common hypertension drugs are statins. While those can be necessary for some patients, they come with a long list of negative side effects. Recommending them as a first line therapy before moderate UV light exposure is medical malpractice. https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/statin-side-effects/art-20046013 https://www.mayoclinic.org/diseases-conditions/high-blood-ch...

NonNefarious 4y ago

I found this quote particularly undermining of his credibility: "It’s entirely intuitive,” he responded. “Homo sapiens have been around for 200,000 years. Until the industrial revolution, we lived outside. How did we get through the Neolithic Era without sunscreen?" By boning each other at the earliest possible age and procreating before we could die of cancer. DUH. The guy's a scientist but can't logically filter out causes of mortality that don't typically transpire until after child-bearing age?

deleted 4y ago

[deleted]

deleted 4y ago
[deleted]

NoPicklez 4y ago

If skin cancer deaths caused by UV are low in the US and the doctor is still concerned, I can side with the concern our doctors have in Australia. Where we lead the world on rates of skin cancer.

anjel 4y ago

As if there's any BP meds benign of significant side fx and long term bio-consequences. (They sure are profitable though.)