Prevention of skin malignancies with daily berry intake


The skin is the largest organ of the human body. It is responsible for acting as both a barrier and a regulating influence between the outside world and the environment within our bodies. This organ plays a key role in protection against infection, prevention of excessive water loss or absorption, as well as temperature regulation.

Our skin is made up of three distinct layers; the epidermis, dermis, and hypodermis. The outermost layer, the epidermis, is comprised primarily of keratinocytes, which proliferate in the basal layer and gradually migrate outwards towards the surface. As these cells migrate they gradually lose their internal organelles becoming essentially sacs of keratin.

The structural component of the skin, the dermis, is made up of collagen and elastin fibers that provide the strength and elasticity that our skin needs to function. This layer also contains hair follicles, nerves, sweat glands as well as blood vessels that provide oxygen and nutrients to both the dermis and the epidermis. The lowest layer, the hypodermis, is a layer of fat and connective tissue that contains larger blood vessels and nerves. The size of this layer varies throughout the body and from person to person.

Exposure to sunlight has been linked with the development of basal cell carcinoma and squamous cell carcinoma, collectively known as non-melanoma skin cancers (NMSC). These skin tumors are by far the most common form of cancer in humans, with over 1 million new cases identified in the United States each year. In fact, more Americans will be diagnosed with some form of skin cancer than all other cancers combined. NMSC occurs on sun-exposed sites and can be reduced by sun protection.

Approximately 80% of skin cancers are basal cell carcinomas while 16% are the more dangerous type of NMSC, or squamous cell carcinoma of the skin. Although both cancers occur on sun-exposed sites, it is believed that cumulative lifetime sun exposure has a strong dose-response association with squamous-cell carcinoma, whereas for basalcell carcinoma, intermittent sun exposure and exposure during childhood might be more important.

While NMSC is mistakenly believed to be harmless, in reality even immunocompetent patients experience both morbidity and mortality from NMSC. A Danish case-control investigation found mortality rates of 0.12% for BCC and 4.3% for SCC. In the United States, The American Cancer Society estimated there would be about 2,940 deaths from NMSC in 2009. Despite a relatively low mortality rate, the treatment of NMSC is the fifth most costly cancer in the Medicare population.

The estimated cost in the United States in 2002 for the treatment and management of all NMSCs was 1.4 billion dollars, corresponding to 1.6 million office visits. Although exposure to UV radiation can be minimized, it is unlikely that it will ever be completely eliminated. Clearly a better understanding of the development, growth, and treatment of this cancer is critical.

Numerous studies have demonstrated an association of gender, age, race and immunosuppressive status with increased incidence of NMSC development. Epidemiological studies have reported the development of significantly more NMSC in men than in women, with the American Cancer Society reporting approximately twice the incidence in men compared to women. Similarly murine studies have demonstrated that when exposed to equal amounts of sunlight, male mice develop tumors earlier, develop more tumors, and have a higher percentage of tumors of higher malignant grade.

While UV radiation is known to be the major risk factor for the general population, the incidence and the mortality rate greatly increases in the immunosuppressed population such as transplant patients, HIV infected individuals, and patients suffering from chronic lymphocytic leukemia (CLL).

In all of these patients, SCC is vastly over-represented compared with its frequency in non-immunosuppressed patients. The presence of signature p53 mutations in skin tumors arising in immunocompromised patients indicates that as seen in the general population, UV light is also an important etiologic factor for the development of these tumors.

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This article was sent to us by: Michael K. Broids at 01132011

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