Week 17 - Mad Dogs and Englishmen

Peanut butter is good for you!

In tropical climes there are certain times of day
When all the citizens retire,
to tear their clothes off and perspire.
It's one of those rules that the biggest fools obey,
Because the sun is much too sultry
and one must avoid its ultry-violet ray --
Papalaka-papalaka-papalaka-boo.
Digariga-digariga-digariga-doo.
The natives grieve when the white men leave their huts,
Because they're obviously, absolutely nuts

-Mad Dogs and Englishmen, Noel Coward (1932)

Here in the southern hemisphere we are passing through Winter. The weather is starting to warm up and signs of Spring are all around. This is the time of the year I start itching to get away in my 4x4. This is the best time of the year to visit those places which become unbearably hot later in the season. One problem with being in the great outdoors is increased exposure to the sun. Previously I did not worry much about it, but things have now changed… So, I have been looking at all the ways in which I can reduce my exposure to the sun.

Some facts on ultraviolet light

There is a wealth of information on ultraviolet radiation on the internet. Wikipedia is a good place to start if you would like more detail.

Ultraviolet radiation is radiation with a shorter wavelength than ordinary light. The ultraviolet spectrum covers a range of wavelengths, and is subdivided into UVA (longest wavelength), UVB (medium wavelength) and UVC (shorter wavelengths). Although the sun emits radiation over a very wide range, we are protected by the atmosphere, which absorbs the shorter wavelengths, so 99% of the UV radiation which reaches the earth’s surface is in the UVA range. This is fortunate as the shorter wavelengths have higher energy, and can have substantial effect on living organisms (Us!)

UVA is the least harmful, but can contribute to the aging of skin, DNA damage and possibly skin cancer. It penetrates deeply and does not cause sunburn. UVB light causes erythema – reddening of the skin (sunburn), and can cause skin cancer. This cancer connection is one reason for concern about ozone depletion and the ozone hole.

The body tans when exposed to moderate levels of radiation by releasing the brown pigment melanin. This helps to block UV penetration and prevent damage to the vulnerable skin tissues deeper down. Suntan lotion that partly blocks UV is widely available. The SPF rating describes the amount of protection given. This protection, however, applies only to UVB rays responsible for sunburn and not to UVA rays that penetrate more deeply into the skin.

Some sunscreen lotions include compounds such as titanium dioxide which helps protect against UVA rays. Other UVA blocking compounds found in sunscreen include zinc oxide and avobenzone.

Measuring ultraviolet radiation

The sun emits radiation, and particles, over a very wide range. Various satellites are in place to monitor the behaviour of the sun. The most dangerous of this radiation consists of X-rays, but these do not reach the surface of the earth, being absorbed by the ozone layer. The amount of UV radiation reaching the ground varies widely, and depends on the angle of the sun, the thickness of the ozone layer, and the amount of water vapour and other particles (dust) in the atmosphere.

The UV Index is a measure of how strong the UV radiation from the sun is at a particular place. The scale ranges from 0 (night-time) to 15 or 16. There is no qualitative difference between low and high UV levels: The only difference will be the rate at which your skin burns! It is recommended that people protect themselves when the UV index is 3 or higher.

Various services provide a prediction of the UV Index. In the US, the US Environmental Protection Agency provides useful information through the SunWise program. Closer to home, the South African Weather Service monitors the UV Index at various points around the country. The graph shows the measured UV Index for Pretoria, fairly close to where I live.

Wearing a hat

I had a nice hat with a broad brim, but somehow it got lost. So last week I bought a new one, and now keep it near my car keys, and take it with me whenever I might find myself out in the Sun.

Solar film for the SUV

I spend quite a lot of time in my car, and obviously when we are out touring we spend the whole day in the car. I was told that a good quality solar film will remove 97% or so of the ultraviolet light. The cost is very reasonable, so I had film installed on all the windows in my SUV, except the front windscreen, which I will think about for a while: The film introduces a certain amount of distortion, and this may not be clever on the windscreen.

There are a few manufacturers of solar film, and they all say that their products will remove 97% or better of the ultraviolet light. However, there are some cheaper or “budget” films which may not be up to this standard.


The following information was found on the web:

Bekaert : http://www.solargard.com/index.cfm Tables show these films block 98% of UV light. “Window films block nearly 100% of ultraviolet light from passing through glass. The Panorama window films are approved products of the Skin Cancer Foundation.”

Toray Plastics: http://www.torayfilms.com/ Excell XT371 film: UV Protective degree (310-380 nm) – 99.2%.

So, what does this mean? Well, if the film blocks, for example, 98%, of the UV, this is equivalent to a reduction factor of 50. If the UV Index is 10, it would be effectively reduced to 10/50, ie: below 1. This is a substantial reduction!

Suntan lotions, sunscreen and sunblock

The objective is to protect your skin from the sun’s UV radiation. But just to confuse us, remember that there are suntan lotions which do the opposite, in order to tan more quickly!

There are many different formulations for sunscreens. The SPF (Sun Protection Factor) is a measure of the effectiveness of sunscreen, and works as a multiplier. For example, if you would normally develop sunburn after 30 minutes, then a sunscreen with an SPF of 10 would extend this time to 300 minutes, or 5 hours. You would still tan, but could stay much longer in the sun.

However, there are some other factors which may affect the effectiveness. For example, you need to make sure that sufficient sunscreen is used, and also that the sunscreen is properly applied to all exposed parts of the body. Also, it is important to ensure that the sunscreen is not removed, for example, by rubbing, or swimming, etc.

Now that I have done all this investigation, I collected together the various sunscreens we have around the house. These are:

Nivea Sun: SPF 20 – UVA+UVB protection plus vitamin E; main ingredient Ethylhexyl Methoxycinnamate
Elizabeth Anne’s Sun smart baby: SPF 40 – UVA+UVB protection with vitamin E and Aloe Vera; main ingredient Ethylhexyl Methoxycinnamate. Also contains Titanium Dioxide (UVA)
Dis-Chem SPF 30+ sunscreen: UVA + UVB protection; main ingredients Octyl Methoxycinnamate, Benzophenone 3 and Titanium Dioxide (UVA).

Here are some useful links if you are interested in further information:

US Environmental Protection Agency – SunWise program: http://www.epa.gov/sunwise/

Wikipedia: http://en.wikipedia.org/wiki/Ultraviolet and http://en.wikipedia.org/wiki/UV_index

US National Weather Service – Climate Prediction Center: Current UV Index forecast: http://www.cpc.ncep.noaa.gov/products/stratosphere/uv_index/uv_current.shtml

Today’s Space Weather, Space Environment Centre: http://sec.noaa.gov/today.html

SA Weather Service UVB Graphs: http://www.weathersa.co.za/UV/UV.jsp

Paranoia and accidents

Looking back at all my posts, it looks like I'm doing well, and very positive. But you cannot believe how worried I have been over the last two weeks. It started when I found I was scratching a small mark on my forehead, and it didn't want to heal. And then I suddenly found a large mark on my stomach. It looked like a large clear mole, but with a dark colour on one side.

Oops! During the daytime I was not so worried, but at night, after interferon, I have been really bugged. And it didn't help that I had to wait a couple of weeks to see my dermatologist.

Anyway, to cut a long story short, I saw him today. He had good look and declared the one spot no problem at all, and the spot on my stomach a sebacious wart (seborrhoeic wart). From the British Association of Dermatologists web site:

Seborrhoeic warts are also known as seborrhoeic keratoses and as basal cell papillomas. The term ‘senile wart’ has now been dropped as it offended many patients. Seborrhoeic warts are harmless growths on the skin, which are very common in the elderly. They are often pigmented.

Despite their name, seborrhoeic warts are nothing to do with sebaceous glands or viral warts. They are benign growths due to a build up of ordinary skin cells. They are strongly age-related. They usually start to appear after the age of 40 years, and most old people will have at least a few seborrhoeic warts: some will have large numbers. They are not infectious and do not become malignant.

So there it is. He treated both with liquid nitrogen, so that should be that. I love the infiltration of political correctness!

But I feel like an absolute idiot today. This morning I was walking in the garden, looking over the vegetable garden. It's the end of winter now, and we are starting to think about what seeds to put in as soon as the ground warms up. I was not careful enough, and stood on a pile of leaves.... And my foot slipped sideways, and I twisted my ankle quite badly. It was so painful I shouted, and had to sit down on the ground for a couple of minutes until the pain reduced.

After about an hour I had a large swelling, and decided I may as well see my GP. She took one look and sent me off for an x-ray. We couldn't see any broken bones so that's good for a start. But what a nuisance: I have been so proud of my regular exercise every day, walking my dogs, and now I will have to keep my foot elevated, and walking to a minimum. I will have to see what I can do at the gym so that I at least get some exercise every day.

Accidents will happen!

Week 16 – Too late to say farewell

(Note: Names and places have been changed to protect the innocent!)

Jim was one of those people who was larger than life. Originally from Rhodesia, he was tall, tanned and well-spoken, and he was also a heavy smoker. Nothing unusual about that in the early days – Just about everybody smoked, and cigarettes were extremely cheap.

Jim became ill and stopped working. I’m not sure what the cause was, but I gradually became aware that it was serious. I thought of going to visit him, but somehow didn’t get around to it. And then suddenly he died.

The news shocked me, and made me think about how I had behaved. I was very young, and Jim’s death did not make me think about my own mortality, but it suddenly seemed so final – I had not even sent him a card; I had not phoned to keep in touch; and now he was dead and gone, and I would never be able to tell him how much I valued his friendship.

It taught me a valuable lesson. I resolved not to let this happen again. If someone I knew was ill, in hospital, or at risk, I would make every effort to visit, before it was too late.

And then, a couple of years later, Monty, another one of my work colleagues became ill. He was older than me, and we had shared an overseas study trip of six weeks, so we had got to know each other fairly well. And very suddenly he also passed away. And I had not made contact with him – I can’t remember the reasons why.

After a memorial service was held at our workplace, I had a telephone call from his wife. We had never met, but she was calling to thank me for being his friend over the years. I was embarrassed, and didn’t know what to say. She must have thought me an imbecile or worse, or hopefully she realized that I was confused. Here was a woman who had just lost her husband of many years, and she was calling me. I should have been able to say something to console her; Mention something, anything, to make her loss more bearable, but I was tongue-tied.

So, had I really learned the lesson? I resolved once again that I would make every effort to make contact with anyone who is old, or in ill-health, or in hospital.

More recently, I put this lesson to use more successfully. My uncle Rob (real name) lived fairly close by, and he contacted me a few times, just to keep in touch, or for help with his computer. He was getting old, and had trouble with his vision and his hearing. Eventually he landed up in hospital with various problems. I made an effort to visit him often in the hospital, and we had many nice chats. I learned a lot about our family history, and got a new view of his life. Rob got past these problems and returned home.

At Christmas he was taken ill during dinner, and landed back in hospital. After some major surgery he was in the intensive care section, and I visited him as often as I could. A couple of times when I visited, I found him asleep. Instead of waking him, I just sat with him for a while, and then left him to continue sleeping. He was certainly not alone, with visits by all members of his family, but I think he appreciated seeing me, and chatting about this and that. We didn’t solve any of the world’s problems, but that was not the objective!

After a couple of weeks he returned home. And suddenly one day I got a call to say that he had passed on. What can one say: I was extremely sad, but at the same time glad that his suffering was over. And I had no regrets about not visiting him. We had spent many hours together, and I got to know a side of him which I would otherwise never have found. And I’m sure that I brought some interest and joy into his life.

Lastly I must relate a story about my friends Mike & Mary. Mike and I worked together in our very first jobs, and we were good friends. Mike & Mary bought a house not far from us, and settled down to build their lives and their family. In the earlier years we had some contact, but this became more and more sporadic, even though we lived fairly nearby. One gets so involved in work and family.

A few years back I heard that Mike had not been well. He had been in hospital for removal of a spot in his lungs, and was recovering. At this time I did not realize how serious this was. The message I got was that the cancer had been cut out, and he would be back to normal soon.

That year was not a good year for me, with some serious work challenges. The result was that I did not make contact with Mike, although he was on my mind. At one stage I tried to contact him, and was told that he was still recovering, and it would be better to wait until he was a little stronger. I should have made the time.

A few months later I heard that Mike was now really ill, and I went to visit him. By this time he was at home, being looked after very competently by a hospice nurse. He was not in good shape: The first time I visited, I’m not sure if he even knew who I was. He passed away shortly afterwards.

There are a couple of themes to this blog:

1. Do it now! Keep in contact with all your valued friends and family. You never know how long any of them will still be around. I regret not maintaining contact over the years, and particularly when Mike was ill. And now it is too late.

2. Enjoy your life – Now! There is little purpose in putting off that trip to a South Sea island, or taking up bungee-jumping, or really starting on that water colour project. You may not be around to enjoy it.

3. Look after yourself. Make sure that you don’t expose yourself to known hazards, such as smoking.

Week 15 – BOINC! and the search for Little Green Men

Today there are literally millions of computers sitting quietly on desks or in dark corners, doing pretty well nothing most of the time. Probably the first project to attempt to harness all this computer power was the SETI project – The Search For Extra-terrestrial Intelligence. The idea is to allow each home computer to connect to a central server, and download a small portion of the task, and then plod away until that portion is complete, and then return it to the server.

BOINC stands for the Berkeley Open Infrastructure for Network Computing, which provides all the facilities to download tasks, and collect the results. “The intent of BOINC is to make it possible for researchers in areas as diverse as molecular biology, climatology, and astrophysics to tap into the enormous but under-utilized calculating power of personal computers world-wide.” At July 2006, BOINC has approximately 735 000 users, with over 900 000 computers, spread over 249 countries. There are currently 28 separate projects.

Why am I discussing this on a blog focused on the melanoma experience? Well, one of the projects you can support via BOINC is Rosetta@home, which is attempting to solve one of the longest standing problems in molecular biology: the "protein folding" problem. Proteins are the miniature machines that carry out almost all the important functions in your body. As with any machine, understanding how proteins work requires understanding what their structures are. However, until very recently, it has seemed nearly impossible to compute the structures of proteins from their amino acid sequences, and solving this problem has been something of a scientific "Holy Grail". The major stumbling block is the very large amount of computing time required to solve the problem.

The Rosetta@home project is contributing to research into Malaria, Anthrax, HIV, other viruses, Alzheimer’s disease, and Cancer, and it was this last one that made me finally get my act together, and download the software. I would rather contribute to basic research in this area than, eg; the SETI project, as it has a more direct bearing on our current problems.

I found it quite simple to download the software and get it working on my two pcs. One pc is a rather old desktop, but it is available 24 hours a day. My notebook is more recent and much faster. Once started, BOINC automatically downloads work tasks, and grinds away whenever the machine is not busy. As soon as I press any key on the keyboard, it suspends the task and the machine is available for work as usual.

However, there is a catch, and this relates to our backward communications systems here in South Africa. At home I have a broadband connection, which I need for my consulting work. The speed of the connection is not an issue, but unfortunately bandwidth is limited in South Africa. For cost reasons I opted for the lowest bandwidth cap, which is 1 GB per month. This is quite sufficient for my normal purposes, but once I started using BOINC I quickly reached my limit, and had to switch it off about half way through the month.

So, what is the bottom line on this? Well, I can still contribute to some extent, but there is no way I can just leave BOINC running all the time … Well, not until the cost of bandwidth drops in South Africa!

So, another good idea bites the dust. Pity!

Some useful references if you want to explore further:

Rosetta@home: http://boinc.bakerlab.org/rosetta/
BOINC: http://boinc.berkeley.edu/
SETI@home: http://setiathome.berkeley.edu/
There are also good articles on BOINC, SETI@home and Rosetta@home on wikipedia.

Week 14 - Pictures

Week 14 - Vitamin D, cancer and sunshine

One of our local newspapers has picked up on a debate concerning the supposed “magic bullet” of Vitamin D. Oliver Gillie, who runs the non-profit organization Health Research Forum, has been expounding his theory that we have got it all wrong: Sunlight is good for you, and in fact exposure to sunlight is correlated with a reduction in various cancers, and also protects us from upwards of 25 different diseases!

Oliver Gillie is a freelance medical researcher and writer. Formerly he was medical correspondent of The Sunday Times, then medical editor and later special correspondent of The Independent newspaper. He has a BSc and PhD degrees from Edinburgh University where he studied genetics and developmental biology. Gillie says:

Human beings need regular exposure to sunlight on their skin so that they can make vitamin D which is vital for health. Yet the British government advises the public to “cover up, keep in the shade”. This advice is mistakenly modelled on a programme developed in Australia where a tropical to Mediterranean type of climate provides much more vitamin D. Faulty calculations made by the National Radiological Protection Laboratory have misled UK government advisers into thinking that casual exposure of hands and face to the sun in the UK will provide sufficient vitamin D for health.

In fact casual exposure does not provide enough vitamin D in the British Isles and the majority of people in the UK have an insufficient level of vitamin in the blood, particularly in winter.The risk of skin cancer from sun exposure is much smaller than the public has been led to believe while the risks of vitamin D deficiency or insufficiency, which are seldom mentioned, are now known to be very substantial. Insufficient vitamin D at crucial times of life or for prolonged periods appears to increase the risk of several cancers, including breast and bowel cancer, diabetes, high blood pressure, schizophrenia, multiple sclerosis and many other chronic diseases including even tooth decay.

The UK government campaign for prevention of skin cancer, led by Cancer Research UK, has in effect been a campaign against sunbathing. Perhaps its most misleading aspect has been the slogan: “There is no such thing as a healthy tan”. This ignores evidence that people who have a deep tan are less likely to get melanoma, the most serious form of skin cancer. While people who get sunburnt, an indication of extensive exposure to the sun, are less likely to get multiple sclerosis or prostate cancer. Oliver Gillie’s report, Sunlight Robbery, explains how government policy has gone badly wrong and urges people to sunbathe whenever they can, wearing as few clothes as possible, while taking care not to bake or burn.

I have read the documents on his website, and frankly I am not convinced. It is a fact that people living in Europe do not see the sun very much, and it may be that this leads to low vitamin D levels. However, there are quite a few problems with Gillie’s suggestions.

I am always worried by someone who has the answer to everything, more so when he insists that he and a small group are the only people who see the truth, and that the rest of mainstream scientists are consciously ignoring what, to Gillie, are self-evident facts. The document Sunlight Robbery: Health benefits of sunlight are denied by current public health policy in the UK is filled with comments such as “Evidence that these diseases are caused, at least in part, by a deficiency of sunlight and vitamin D has accumulated at an accelerating pace over the last 10 years but is not well known, even to professional scientists,” “Present government policy on sunlight is the product of limited specialist knowledge, particularly of dermatologists.”, and “Sunlight may have other benefits, not at present fully understood.”

Gillie and others make the point that a certain level of exposure to the sun, producing a tan, seems to protect against melanoma and other skin cancers. However, Kaskel et al have this to say (2001) “Sunburn in childhood and increased sun exposure during annual holidays in sunny areas should be avoided. In contrast, outdoor activities in childhood, including soccer and gardening, should be encouraged because they are associated with a lower risk of melanoma formation.”

When I was young (a long time ago…), we did not have television, computers, video games, etc. I grew up in Johannesburg, South Africa, at approximate latitude 26° S. I lived quite far from school, and had to ride a bike to and from school every day .. And most of my friends lived near the school, so I was always out and about on my bike. In summer we spent many happy hours in the sun at swimming pools, and I recall getting seriously burnt on many occasions.

Fast forward a few years, and I graduated to a motor car. One spends quite a lot of time in the car, although this is usually in the early morning and late afternoon traffic, when the sun is less intense, but also at a lower angle. We drive on the left, so I had more exposure on the right hand side of my face … And this is precisely where I have had many skin problems, with two melanomas over the last few years.

The problem I see with Gillie’s recommendations, even if his conclusions are correct, is: How is anyone going to translate this into action, without increasing the incidence of melanoma? Skin types vary widely, so what is acceptable for you may be dangerous for me. The amount of exposure to the sun depends on the latitude, altitude above sea level, angle of the sun, pollutants in the atmosphere, and so on, making it almost impossible to provide people with a rule of thumb.

I see a very real danger that each person will interpret his/her situation subjectively, and run the risk of getting it wrong! As a simple example, when I was young, we would spend hours at the public swimming pool, trying to attract the attention of girls… (We hardly ever succeeded…) But the result was that we got awfully burnt! Although we knew better, this did not stop us – We just ignored the consequences, as kids usually do. And in those days there was no sunscreen, and no awareness of melanoma.

No Mr Gillie, I think you have not thought this through properly. It is dangerous to make recommendations without taking into account human nature. For example, what about the large numbers of Brits who use cut price airlines to spend a week in the Mediterranean sun in mid-summer? None of these boys and girls have built up a tan, and then suddenly expose their skin excessively for 6 days before flying home. Seems to me to be a perfect formula for developing melanoma in 20 years time.

Postscript: Don't get me wrong: I am all in favour of large numbers of young ladies suntanning in the parks at lunchtime, wearing as few clothes as possible...

For anyone interested in reading more:

Health Research Forum: http://www.healthresearchforum.org.uk

CANCERActive article: http://www.canceractive.com/page.php?n=509

Quackwatch: http://www.quackwatch.org
and particularly the page A Special Message for Cancer Patients Seeking "Alternative" Treatments, at http://www.quackwatch.org/00AboutQuackwatch/altseek.html